抗精神病药物导致体重增加的社区干预实践研究

Community intervention practices for weight gain due to antipsychotics

目的:调查社区精神病患者服用药物导致体重增加对运动锻炼的康复需求,联结患者走出家门进行运动锻炼控制体重。方法:项目实施分为3个阶段,分别为动机增强阶段、干预实施阶段以及维护阶段。采取入户访谈、问卷调查、电话回访方式,对精神残疾患者进行调研,并邀请他们参与“放飞”精神健康体育发展康复计划。生活方式干预包括营养干预和运动锻炼。分析康复患者干预前后身体质量指数(BMI)变化情况。结果:首阶段小组调研16例患者愿意参加项目并完成需求问卷调查,占社区精神残疾、智力障碍患者比例为6.53%;由于社区联结影响后期康复者增加至36例。BMI超过24者14例,纳入减肥组;其余视为体重控制组。通过干预措施,体重控制组BMI均控制在正常范围,减肥组BMI有明显降低,差异有统计学意义(P<0.05)。结论:将康复者以及其家属联结起来,共同实施有效的生活方式干预,可控制或减轻患者体重,在社区康复中值得推广应用。

Objective:To investigate the rehabilitation needs of community psychiatric patients with weight gain as a result of using antipsychotics and to connect them out of the home for exercise and weight control.Methods:The project implementation was divided into three stages:motivation enhancement stage,intervention implementation stage and maintenance stage.Household interview,questionnaire survey and telephone return visit were adopted to invite them to participate in the"Flying"program.Lifestyle intervention included nutrition intervention and exercise.SPSS22 version was used to statistically analyze whether the changes of BMI before and after the intervention were significant.Results:16 people who were willing to participate in the project and complete the demand questionnaire,which accounted for 6.53%of them.Due to the influence of community connection,the number of recovered people increased to 36,14 people's BMI over 24 were included in the weight loss group and the rest were considered as control group.Through intervention,BMI in the weight control group was within the normal range,while BMI in the weight loss group was significantly reduced,the difference was statistically significant(P<0.05).Conclusion:The project has implemented effective lifestyle intervention by connecting the rehabilitated people and their families,it is worth popularizing and applying in community rehabilitation.