复元模式对精神分裂症患者自尊及幸福感的影响

Effects of person-centered care on maintaining self-esteem and general well-being in patients with schizophrenia

目的探讨复元模式对精神分裂症患者精神症状、自尊及总体幸福感的影响。方法将符合入组标准的上海市某区社区精神分裂症患者68例，随机分成干预组及对照组各34例。对照组采用社区一般康复，干预组采取以复元理念为指导的综合康复服务模式，采用阳性与阴性症状量表（PANSS）评定精神症状严重程度，自尊调查表（SEI）评定自尊水平，总体幸福感量表（GWBS）评定总体幸福感。结果两组间比较，干预12个月后，干预组PANSS、SEI及GWBS较对照组改善更明显，差异均有统计学意义（t分别为-11．246、3．194、4．618；P〈0．01）。干预组组内比较，PANSS和GWBS得分与干预前比较差异有统计学意义（F分别为45．011、6．006；P〈0．01），SEI得分干预前后比较差异无统计学意义（F=1．535，P〉0．05）。结论对社区精神分裂症患者进行基于复元理念的康复服务有助于减轻精神分裂症患者的精神症状，改善其低自尊状态，提升总体幸福感。

Objective To investigate the effects of person-centered care on mental symptoms, self- esteem and general well-being in schizophrenia patients. Methods A total of 68 patients with schizophrenia in a community of Shanghai who met the inclusion criteria were selected and randomly divided into intervention group and control group, with 34 cases in each. The community-based general rehabilitation was used in the control group. The intervention group adopted the comprehensive rehabilitation service mode which is guided by the concept of person-centered care. The severity of mental symptoms was assessed by Positive and Negative Syndrome Scale （PANSS）, self-esteem by Self-esteem Inventory （SEI）, overall well-being by General Well- Being Schedule （GWBS）. Results After 12 months of intervention, the differences in PANSS score, SES score and GWBS score between the two groups were statistically significant （t=-11.246, 3.194, 4.618; P 〈 0.01）. In the intervention group, there were statistical signifieanees in the differences in PANSS score and GWBS score between before and after intervention （F=45.011, 6.006; P 〈 0.01）. However, there was no significant difference in SEI scores before and after intervention （F=1.535, P 〉 0.05）. Conclusions Rehabilitation services based on the concept of complex in community schizophrenics can help alleviate the mental symptoms of schizophrenia patients, improve their low self-esteem, and enhance overall well-being.