电子社区服务管理在恢复期精神分裂症患者中的应用效果

Effects of electronic community management in schizophrenic patients during recovery

目的 探讨电子社区服务管理对精神分裂症患者恢复期服药依从性及心理健康恢复的影响。方法 选择哈尔滨医科大学附属第一医院2014 年6 月—2016 年6 月恢复期精神分裂症出院患者102 例，按照随机数字表法随机分为对照组（n=51）和观察组（n=51），对照组给予常规出院指导与抗精神药物维持治疗，观察组在对照组治疗基础上进行电子社区服务管理，两组均随访1 年时间。比较两组患者症状自评量表（SCL-90）评分、康复状态量表评分、服药依从性及复发率的情况。结果 随访1 年后，观察组患者SCL-90、康复状态量表总分分别为（132.86±19.57）、（46.83±22.54）分，对照组分别为（144.96±36.74）、（61.98±19.47）分，两组比较，差异均有统计学意义（P ＜ 0.05）；观察组患者服药完全依从占70.37%，高于对照组，差异有统计学意义（P ＜ 0.05）。随访1 年，观察组复发率7.84%，对照组复发率43.14%，两组比较差异有统计学意义（χ2=15.236，P ＜ 0.01）。结论 在常规抗精神药物维持治疗的基础上，采取电子社区服务管理可有效提高精神分裂症恢复期服药依从性，改善患者的心理状态，进而促进心理健康的恢复，并可降低其复发率，值得临床推广。

Objective To analyze the effects of electronic community management on medication compliance and mental health recovery in schizophrenic patients at recovery stage. Methods A total of 102 cases of schizophrenic patients who were at recovery stage in the First Affiliated Hospital of Harbin Medical University from June 2014 to June 2016 were selected as the research objects. The patients were divided into control group （n=51） and combination group （n=51） by random number table method. The control group received routine discharge guidance and antipsychotic drug maintenance treatment, and the combination group received electronic community management on the basis of the control group. The two groups were followed up for 1 year. The scores of Symptom Checklist-90 （SCL-90）, Rehabilitation State Scale, medication compliance and recurrence rate were compared between the two groups. Results After 1 year of follow-up, the scores of SCL-90 and Rehabilitation State Scale of the observation group were （132.86 ± 19.57） and （46.83 ± 22.54） respectively, and those of the control group were （144.96 ± 36.74） and （61.98 ± 19.47）. The differences between the two groups were statistically significant （P 〈 0.05）. The complete medication compliance of the observation group was 70.37%, which was higher than that of the control group, and the difference was statistically significant （P 〈 0.05）. After 1 year of follow-up, the recurrence rate of the combination group and the control group was 7.84% and 43.14%, and the difference was statistically significant （X 2=15.236, P 〈 0.01）. Conclusions On the basis of the maintenance therapy for conventional antipsychotic drugs, taking the electronic community management can not only effectively improve the medication compliance in patients with schizophrenia at recovery stage, improve the mental state, and promote the recovery of mental health, but also significantly reduce the recurrence rate, so it is worthy of clinical promotion.