守护APP应用于社区严重精神障碍管理治疗工作中的效果观察

Observation of clinical effect of guarding APP in mental patients monitoring

目的对江门市新会区会城街道的严重精神障碍患者监护人进行守护APP干预并评价干预效果影响。方法以会城街道辖区内登记在国家精神障碍信息系统1 488在册精神障碍患者作为研究对象,随机抽取分为安装守护APP组1 084例和无安装守护APP组404例。安装组通过监护人使用守护APP实现责任医生对患者进行动态监护和实时监护,提供免费咨询、心理干预、服药指导及随访管理服务;无安装组采用常规随访康复管理措施干预。干预满一年后对比分析两组患者康复措施落实情况、服药依从性(治疗率)、病情及社交改善情况、复发住院率、肇事肇祸率及家属疾病知识知晓情况等指标。结果安装守护App组患者服药依从性(治疗率)及康复措施落实率高于无安装组,家属对精神疾病知识知晓良好率较高;干预后安装组患者的SCL-90评分及心理社交功能评估表评分改善情况优于无安装组,复发住院率和肇事肇祸率明显较低,以上差异均有统计学意义。结论守护APP平台帮助医生与监护人把严重精神障碍患者的监护工作真正落到实处,康复效果优于传统的康复方法,值得进一步推广应用。

Objective Guardianship APP intervention was conducted for the guardians of severe mental disorders in Huicheng,Xinhui district,Jiangmen city and the effect of intervention was evaluated.Methods1488psychiatric patients in the unit area were taken as the research objects,which were randomly divided into the guardian APP installation group of1084cases and the non-installation group of404cases.The installation group uses guardian APP to realize the dynamic guardianship and real-time monitoring of the patients,and we provided free charge consultation,psychological intervention,medication guide,case tracking and follow-up management services.The non installation group adopted the routine rehabilitation management measures after discharge.After a year the implementation of rehabilitation measures,compliance,condition and social improvement,relapse rate of hospitalization,accident rate and knowledge of family disease between the two groups of patients were compared and analyzed.Results The compliance and rehabilitation measures of the patients in the App group were higher than those in the non installation group.The rate of knowledge about mental illness was higher in family members,and the improvement of SCL-90score and psychosocial function assessment score after intervention was better than that of non installation group.The rate of relapse hospitalization and cause trouble were lower.The differences above were statistically significant.Conclusion The guardian APP platform helps doctors and guardians to make the monitoring work of patients with severe mental disorder really practical,and the rehabilitation effect is better than the traditional rehabilitation method,which is worthy of further promotion and application.