倍慈模式生计活动对社区精神障碍患者的康复作用

Effects of the livelihood activity of BasicNeeds model on rehabilitation for patients with mental disorders in community

目的探讨参与倍慈模式生计活动对社区精神障碍患者的康复作用。方法以2015年6月1日至12月1日期间加入倍慈精神卫生发展研究项目的精神障碍患者70人作为研究对象，分为研究组35人，对照组35人，研究组在原有药物治疗基础进行倍慈模式生计活动干预12个月；对照组仅接受常规药物治疗。采用世界卫生组织残疾评定量表Ⅱ（WHO—DASⅡ），大体功能量表（GAF）进行评估。结果研究组患者干预后WHO—DASⅡ量表总分[（57．40±23．59）分]、与他人相处[（7．43±4．15）分]、社会参与（9．97±4．99）分]明显低于对照组[（74．17±22．14）分、（11．03±5．12）分、（14．09±4．43）分]；研究组干预后GAF功能得分差值[（11．37±6．19）分]明显高于对照组[（3．20±5．38）分]；多因素Logistic回归分析显示，家庭年收入高（β=3．412，OR=30．325，95％CI=1．634～562．883）、WHO—DasⅡ分数（β=-0．068，OR=0．934，95％CI=0．884～0．987）对社会功能恢复有影响。结论在药物治疗的前提下，倍慈模式生计活动能显著提高社区精神障碍患者的社会功能，降低残疾程度。

Objective To explore the rehabilitation effect of participating in the subsistence activity in the basicneeds model on the community patients with mental disorders. Methods A total of 70 patients with mental disorders were enrolled in the Basicneeds Mental Health Development Research Program from June lst,2015 to December 1st, 2015 were enrolled. They were divided into research group （n= 35） and control group （n= 35）. The research group received subsistence activity intervention in the basicneeds model for 12 months on the basis of the original drug therapy, whereas the control group only received conventional drug therapy. The World Health Organization Disability Assessment Scale Ⅱ （WHO-DAS Ⅱ ） and Gross Assessment of Functioning （GAF） were adopted for assessment. Results The total WHO-DAS Ⅱ score, getting along with others, and communal participation in research group （ （57.40＋23.59）, （7.43＋4.15） and （9.97＋4.99） were significantly lower than those in control group （74.17＋22.14）, （11.03＋5.12） and （14.09＋4.43）. The D-value of GAF score before and after intervention in research group（11.37＋6.19） was higher than that in control group （3.20＋5.38）. Multivariate Logistic regression analysis indicated that high family annual income （β= 3.412, OR= 30.325,95%CI= 1.634-562.883） and WHO-DAS Ⅱ score （β= -0.068, OR= 0.934,95%CI= 0.884-0.987） were the influence factors of the social functional recovery. Conclusion Under the premise of drug therapy,the subsistence activity in the basicneeds model can outstandingly improve the social functions of patients with mental disorders and reduce the disability degree.