团队协同管理方案在精神分裂症伴代谢综合征患者中的应用效果

Effect of team collaboration management program on the metabolic syndrome in schizophrenic patients

目的探讨团队协同管理方案对精神分裂症伴代谢综合征患者的影响。方法选取2017年3月—2018年3月上海交通大学医学院附属精神卫生中心收治的精神分裂症伴代谢综合征患者为研究对象。按入院时间分为观察组和对照组,其中对照组(2017年3—9月)47例,观察组(2017年10月—2018年3月)45例。两组患者均予以精神科常规治疗及护理,观察组在此基础上实施团队协同管理方案,在干预前、干预16周后分别采用代谢参数、世界卫生组织生存质量测定简表(WHOQOL-BREF)、阳性和阴性症状量表(PANSS)进行评定。结果干预前两组患者的代谢参数、WHOQOL-BREF、PANSS评分差异均无统计学意义(P>0.05);干预16周后,观察组患者空腹血糖、体重、腰围、甘油三酯、高密度脂蛋白胆固醇、收缩压均低于对照组,差异有统计学意义(P<0.05);观察组WHOQOL-BRER的躯体健康、心理功能领域得分均高于对照组,同时观察组PANSS量表的阳性和一般精神病理症状量表得分低于对照组,差异均有统计学意义(P<0.05)。结论团队协同管理方案能有效控制精神分裂症伴代谢综合征患者的相关代谢参数,提高患者的生存质量,促进其精神症状的恢复。

Objective To investigate the effect of Team collaboration management program on the metabolic syndrome in schizophrenic patients.Methods From March 2017 to March 2018,the schizophrenic patients with metabolic syndrome who were admitted in Shanghai Mental Health Center Affiliated to Shanghai Jiao Tong University School of Medicine were selected as the participants of this study and divided into observation group(n=45)and control group(n=47)according to the time of admission.The two groups were both given routine treatment and nursing care in psychiatric department.Besides of that,the team collaboration management program was implemented in the observation group.Assessments were done before intervention and 16 weeks after intervention using related metabolic parameters,the Brief Scale of World Health Organization Quality of Life(WHOQOL-BREF)and the Positive and Negative Symptoms Scale(PANSS).Results There was no significant difference in metabolic parameters,WHOQOL-BREF and PANSS scores between the two groups before intervention(P>0.05).After 16 weeks of intervention,patients'fasting blood sugar level,body weight,waist circumference,triglyceride,high density lipoprotein and systolic pressure in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The scores of"physical health"and"psychological function"in WHOQOL-BREF in the observation group were higher than those in the control group,meanwhile,the scores of"positive and general pathological symptoms"in PANSS in the observation group were lower than those in the control group,both with statistical significance(P<0.05).Conclusions Team collaboration management program can help controlling the related metabolic parameters of the schizophrenic patients with metabolic syndrome effectively,improve their quality of life and promote recovery from their mental symptoms.