消除隔阂计划对精神分裂症患者病耻感的影响

The Effect of Elimination of Barriers Initiative on Internalized Stigma of Patients with Schizophrenia

目的探索消除隔阂计划(Elimination of Barriers Initiative,EBI)对降低社区精神分裂症患者内在病耻感的效果。方法按系统抽样方法抽取符合入组要求的浦东新区精神障碍康复患者90例,按1∶1配对,对照组和干预组各45例。干预组患者进行EBI干预,对照组患者给予常规社区精神病康复管理。使用心理疾病内化污名量表(ISMI)评估干预组和对照组患者干预前、干预6个月后和18个月后的自我污名总得分以及各维度的变化情况。结果干预第6个月后,干预组患者的歧视体验和生活无意义得分降低情况显著优于对照组(P均<0.05),其余维度无显著性差异(P均>0.05);干预18个月后,干预组患者的ISMI总得分、价值否定、刻板印象、歧视体验、社交退缩及生活无意义的维度得分降低情况均显著优于对照组(P均<0.05)。结论建立一支"医院-社区"相结合的精神分裂症康复服务团队实施EBI干预,能有效地改善患者的病耻感。

Objective To discuss the effect of the Elimination of Barriers Initiative（EBI） on internalized stigma of community patients with schizophrenia. Methods A total of 90 patients with mental disorders in Pudong New Area were selected according to the systematic sampling method. One-to-one matched pairs were selected, and the control group and intervention group were 45 cases. The patients in the intervention group were treated with EBI intervention, and the other 45 cases were routine community psychiatric rehabilitation management. Psychological disorder internalization stigma scale was used to evaluate the total score of self stigma and the changes of all dimensions in intervention group and control group before intervention, 6 months and 18 months after intervention. Results After 6 months’ intervention, the scores of discrimination experience aspect and life meaningless aspect in intervention group were both significantly lower than those in control group（P〈0.05）, and other aspects had no significant differences. After 18 months’ intervention, the total scores and scores of all aspects in intervention group were significantly lower than those in control group（all P〈0.05）. Conclusion To establish a Hospital-Community combined schizophrenia rehabilitation service team to carry out EBI can effectively improve the patient’s stigma.