社区精神康复会所模式对首发精神分裂症患者认知功能及生活质量的影响

Effect of community mental rehabilitation club model on cognitive function and quality of life of first-episode schizophrenics

目的研究社区精神康复会所模式对首发精神分裂症患者认知功能及生活质量的影响。方法应用便利抽样法,选取2017年2—12月于重庆市精神卫生中心出院的首发精神分裂症恢复期患者160例为研究对象,按照随机字母法分为研究组和对照组,每组80例。对照组患者采用常规护理模式进行干预,研究组患者在对照组的基础上采用会所模式进行康复训练。分别采用阳性与阴性症状量表(PANSS)、MATRICS共识认知成套测验(MCCB)中文版、精神分裂患者生活质量量表(SQLS)对患者疾病严重程度、认知功能及生活质量进行评分。结果两组患者治疗前PANSS总分、阳性因子分、阴性因子分及一般精神病理症状得分之间差异无统计学意义(P>0.05),治疗1年后各项得分显著低于治疗前(P<0.05),且研究组显著低于对照组(P<0.05)。两组患者治疗前MCCB各项得分之间差异无统计学意义(P>0.05),治疗1年后患者处理速度、注意警觉、工作记忆、言语学习和记忆、视觉学习和记忆、推理与问题解决能力、社会认知评分均显著高于治疗前(P<0.05),且研究组显著高于对照组(P<0.05)。两组患者治疗前心理社会、动机精力及症状不良反应评分之间差异无统计学意义(P>0.05),治疗1年后显著低于治疗前(P<0.05),且研究组显著低于对照组(P<0.05)。结论社区精神康复会所模式对首发精神分裂患者有较好的康复效果,可显著改善患者认知功能障碍症状,提髙生活质量。

Objectives To study the effect of community mental rehabilitation club model on cognitive function and quality of life of first-episode schizophrenia patients. Methods By convenience sampling method, 160 patients with first-episode schizophrenia in the convalescent stage discharged from Chongqing Mental Health Center from February 2017 to December 2017 were selected as the study subjects. According to the random alphabetical method, they were divided into the study group and the control group, with 80 patients in each group. The patients in the control group received the routine nursing intervention, while the patients in the study group received club-mode rehabilitation training in addition to what the control group received. The severity of illness, cognitive function, and quality of life of schizophrenic patients were assessed with the Positive And Negative Symptoms Scale (PANSS), the Chinese version of the MATRICS Consensus Cognitive Test (MCCB) and the Schizophrenia Quality of Life Scale (SQLS). Results There was no significant difference in PANSS total score, positive factor score, negative factor score, and general psychopathological symptom score between the two groups before treatment (P > 0.05). After one year of treatment, these scores significantly decreased for both groups (P < 0.05), and the scores of the study group were significantly lower than those of the control group (P <0.05 ). There was no significant difference in MCCB scores between the two groups before treatment ( P>0.05). After one year of treatment, the patientsf processing speed, attention alertness, working memory, speech learning and memory, visual learning and memory, reasoning and problem-solving ability and social cognitive score significantly improved (P <0.05 ), and the scores of the study group were significantly higher than those of the control group (P <0.05). There was no significant difference in the scores of psychosocial, motivational energy, and symptoms and side effects between the two groups before treatment (P>0.05). After one year of treatment, these scores significantly decreased (P <0.05 ), and the scores of the study group were significantly lower than those of the control group (P <0.05). Conclusions Community mental rehabilitation club model has good rehabilitation effect for first-episode schizophrenia patients, can significantly improve the symptoms of cognitive impairment and improve the quality of life of patients.