医患共同决策对精神分裂症患者PANSS评分、AHRS评分及疾病认知度的影响

The effect of doctor-patient shared decision-making on PANSS score,AHRS score and disease awareness of patients with schizophrenia

目的研究医患共同决策(SDM)对精神分裂症(SCH)患者阳性阴性症状量表(PANSS)评分、听幻觉量表(AHRS)评分及疾病认知度的影响。方法将2017年9月至2019年3月广州市民政局精神病院收治的120例伴听幻觉SCH患者作为研究对象,随机分为研究组和对照组,每组各60例。研究组采用SDM联合认知护理干预,对照组接受常规认知护理干预。比较干预前及干预9个月后,两组患者PANSS、AHRS评分,两组患者对疾病的认知状况,观察干预期间护理不良事件发生情况比较。结果干预9个月后,两组患者PANSS、AHRS评分均明显降低,且研究组明显低于同一时间对照组,差异有统计学意义(P<0.05),研究组患者对疾病认知度明显高于同一时间对照组,差异有统计学意义(P<0.05),干预过程中两组患者护理不良事件发生率比较,差异无统计学意义(P>0.05)。结论SDM的实施可明显减轻SCH患者症状表现,提高对疾病了解情况,从而增加其对治疗的认可程度,在SCH护理中具有重要临床价值。

Objective To study the effect of doctor-patient shared decision-making(SDM)on the Positive and Negative Syndrome Scale(PANSS)score,Auditory Hallucination Rating Scale(AHRS)score and disease awareness of patients with schizophrenia(SCH).Methods A total of 120 SCH patients with auditory hallucinations admitted to Psychiatric Hospital of Civil Affairs Bureau of Guangzhou City from September 2017 to March 2019 were selected as the study objects and randomly divided into the study group and the control group,with 60 cases in each group.The study group received SDM combined with cognitive nursing interventions,while the control group received conventional cognitive nursing interventions.The PANSS score,AHRS score and disease awareness of patients before the intervention and after 9 months of intervention were compared between the two groups and the occurrence of nursing-related adverse events during the intervention was observed.Results After 9 months of intervention,the PANSS and AHRS scores of the two groups of patients were significantly reduced,and the scores in the study group were significantly lower than those in the control group at the same period,with statistically significant differences(P<0.05).The disease awareness of the study group was significantly higher than that of the control group at the same period,with statistically significant differences(P<0.05).There was no statistically significant difference in the incidence of nursing-related adverse events during the intervention process between the two groups of patients(P>0.05).Conclusion The implementation of SDM can significantly relieve the symptoms of SCH patients,improve their disease awareness,thus increasing their acceptance of treatment.It has important clinical value in SCH nursing.