同伴支持服务模式对慢性精神分裂症患者社会功能及同伴自我效能的影响

Effect of peer support service model on social function in patients with chronic schizophrenia and peers' self-efficacy

目的探讨同伴支持服务模式对慢性精神分裂症患者社会功能及同伴自我效能的影响。方法将2017年1月至2018年12月收治的120例慢性精神分裂症患者随机分为2组,对照组(60例)给予常规的康复模式,包括疾病相关知识教育、日常生活技能及社会技能训练等,干预组(60例)在此基础上给予同伴支持服务模式干预,共持续6个月。采用阳性和阴性症状量表(PANSS)、住院精神病人社会功能评定量表(SSPI)评估患者精神症状、社会功能变化,采用一般自我效能感量表(GSES)评估同伴的自我效能。结果干预后3个月,干预组PANSS量表的精神病理评分及总分较干预前明显下降(P<0.05);干预后6个月,干预组SSPI量表的各维度评分及总分均显著低于对照组(P<0.05)。干预后6个月,干预组各维度评分、对照组日常生活能力评分较干预前明显升高(P<0.05);干预后3、6个月,干预组各维度评分均显著高于对照组(P<0.05)。与干预前比较,干预后3个月、6个月,同伴指导员GSES评分显著升高(P<0.05)。结论慢性精神分裂症患者在精神科常规康复治疗基础上引入同伴支持服务,不仅可有效改善患者的社会功能,促进康复,还有助于提升同伴的自我效能感。

Objective To explore the influence of peer support service model on social function in patients with chronic schizophrenia and peers'self-efficacy.Methods A total of 120 elderly patients with chronic schizophrenia admitted from January 2017 to December 2018 were randomly divided into 2 groups.The control group(n=60)was given conventional rehabilitation mode,including disease-related knowledge education,daily life skills and social skills training.All the patients were intervened for 6 months.Positive and negative symptom scale(PANSS)and inpatient psychiatric social function rating scale(SSPI)were used to evaluate patients′mental symptoms and social function changes,and general self-efficacy scale(GSES)was used to evaluate peers′self-efficacy.Results Three months after the intervention,the psychopathological score and total score of PANSS scale in the intervention group were significantly lower than those before the intervention(P<0.05).Six months after intervention,SSPI scale scores and total scores in the intervention group were significantly lower than those in the control group(P<0.05).Six months after intervention,scores of all dimensions in the intervention group and daily living ability in the control group were significantly higher than those before intervention(P<0.05).Three and 6 months after intervention,the scores of all dimensions in the intervention group were significantly higher than those in the control group(P<0.05).Compared with before the intervention,GSES scores of peer instructors were significantly increased 3 and 6 months after the intervention(P<0.05).Conclusions Peer support service based on the routine rehabilitation treatment can not only effectively improve the social function of patients with chronic schizophrenia,but also contribute to the improvement of peers'self-efficacy.