社区个体服务计划对惠州市精神分裂症患者康复的影响

Effect of community individual service plan on rehabilitation of patients with schizophrenia in Huizhou City

目的探讨社区个体服务计划管理模式对惠州市精神分裂症患者疾病情况及生活质量的影响,为推广个体服务计划社区管理模式提供依据。方法选择惠州市第二人民医院、惠州市复员退伍军人医院精神科于2012年1月~2015年12月实施社区个体服务计划的精神分裂症患者396例作为观察组,另选择2009年1月~2011年12月按照常规的社区管理模式进行管理的精神分裂症患者350例作为对照组,两组患者干预时间均为12个月。采用阳性和阴性症状量表(PANSS)、生活质量综合评定问卷(GQOL-74)对患者入组时、干预后12个月的病情状况及生活质量进行评估。结果两组患者干预前PANSS评分差异无统计学意义(P>0.05);干预后PANSS各项评分均明显低于干预前,差异有统计学意义(P<0.05);观察组患者干预后PANSS阴性症状、阳性症状及总分均明显低于对照组,差异有统计学意义(P<0.05)。两组患者干预前GQOL-74各维度评分差异无统计学意义(P>0.05);干预后GQOL-74各维度评分均明显高于干预前,差异有统计学意义(P<0.05);观察组患者干预后GQOL-74中躯体功能、心理功能、社会功能评分均明显高于对照组,且差异有统计学意义(P<0.05)。结论实施个体服务计划社区管理模式可改善精神分裂症患者的病情,提高生活质量以及社会表现力。

Objective To explore the impact of community-based individual service plan （ISP） on the disease situation and life quality of patients with schizophrenia in Huizhou, in order to provide evidence for the promotion of ISP management. Methods 396 cases of patients with schizophrenia in Department of Psychiatry, the Second People＇s Hospital of Huizhou City and Demobilized Veterans＇ Hospital of Huizhou City from January 2012 to December 2015 were selected as the observational group, and given community-based ISP. Another 350 patients with schizophrenia from January 2009 to December 2011 were selected as the control group, and given conventional community management. The positive and negative symptoms scale （PANSS） and general quality of life inventory （GQOL-74） were used to assess the disease situation and quality of life of the patients in the two groups before intervention and 12 months after intervention. Results Before intervention, there were no significant differences in items scores of PANSS （P 〉 0.05）. After intervention, the items scores of PANSS were significantly lower than before intervention, with statistically significant differences （P 〈 0.05）. After intervention, scores of negative symptom, positive symptom and total item of patients in the observational group were significantly lower than those in the control group, with statistically significant differences （P 〈 0.05）. Before intervention, there were no significant differences in items scores of GQOL-74 （P 〉 0.05）. After intervention, the items scores of GQOL-74 were significantly higher than before intervention, with statistically significant differences （P 〈 0.05）. After intervention, scores of physical function, psychological function, social function of patients in the observation group were significantly higher than those in the control group, with statistically significant differences （P 〈 0.05）. Conclusion The implementation of ISP management model can improve the condition of patients with schizophrenia, improve their quality of life and social performance.