社区综合干预对重性精神障碍患者家属睡眠质量影响

Effect of comprehensive community intervention on sleep quality of family members of patients with severe mental disorders

目的重性精神疾病为高致残性疾病,对患者、家庭及社会均有较明显的不良影响,为国家重点关注的精神障碍。本研究探讨社区综合干预对重性精神障碍患者家属睡眠质量的影响,以便社区医生对重性精神障碍患者家属提供帮助,进而促进对患者的有效管理。方法将登记在天津市滨海新区塘沽安定医院管理的197名重性精神障碍患者家属随机分为干预组及对照组,对照组给予针对患者的常规干预和管理,干预组在对照组基础上,给予患者家属1次/月,持续1年的综合性干预,包括健康教育、行为干预、团体心理辅导和个别心理治疗方式。采用自制调查表收集一般人口学资料。分别在干预前及干预后第6及12个月末对受试者进行匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)评估。分析两组受试者在干预后第6及12个月末与干预前的差异。结果干预组和对照组重性精神障碍患者家属有睡眠紊乱情况的分别占各组总数的58.59%及57.14%。干预组和对照组治疗前PSQI问卷总分为(10.19±2.45)和(10.02±2.34)分,治疗6个月后分别为(6.28±1.67)和(9.46±1.83)分,治疗12个月后分别为(5.84±1.35)和(8.38±1.97)分,差异有统计学意义,F组间=24.456,F时间=3.785,F组间×时间=46.342,均P<0.05。PSQI各因子评分比较,差异有统计学意义,均P<0.05。结论重性精神障碍患者家属存在睡眠紊乱,社区综合干预可以有效改善重性精神障碍患者家属的睡眠质量。

OBJECTIVE Severe mental illness is a highly disabled disease,which has obvious adverse effects on patients,families and society.It is a mental disorder of national focus.The purpose of this study is to explore the effect of comprehensive community intervention on sleep quality of family members of patients with severe mental disorders,so that community doctors can provide help to family members of patients with severe mental disorders and promote effective management of patients.METHODS 197 family members of patients with severe mental disorders registered in a hospital in Binhai New District were randomly divided into intervention group and control group.The control group was given routine intervention and management for patients.On the basis of the control group,the intervention group was given comprehensive intervention once a month for 1 year,including health education,behavioral intervention,group psychological counseling and individual psychological treatment.General demographic data were collected by self-made questionnaires.Pittsburgh sleep quality index(PSQI)was assessed before intervention and at the end of 6 and 12 months after intervention.The differences between the two groups at the end of 6 and 12 months after intervention and before intervention were analyzed.RESULTS The family members of patients with severe mental disorders in intervention group and control group had sleep disorders,accounting for 58.59% and 57.14% of the total number of groups,respectively.The total score of PSQI questionnaire before intervention in intervention and control group was(10.19±2.45)and(10.02±2.34),respectively.And after treatment for 6 months,it was(6.28±1.67)and(9.46±1.83),respectively.After 12 months,it was(5.84±1.35)points and(8.38±1.97)points respectively.The differences were statistically significant(Fbetween group=24.456,Ftime=3.785,and Fbetween group× time=46.342,all P<0.05).There were significant differences in the scores of PSQI factors,all P<0.05.CONCLUSIONS The family members of patients with severe mental disorders have sleep disorders.Comprehensive intervention can effectively improve the sleep quality of family members of patients with severe mental disorders in community.