整合式心理护理对首发未用药精神分裂症患者激越症状、社会功能的影响

Effects of integrated psychological nursing on agitation symptoms and social function in patients with first episode drug naive schizophrenia

目的 探讨整合式心理护理对首发精神分裂症患者激越症状。社会功能的影响。方法 选取2020年1月~2022年12月至山东省精神卫生中心住院治疗的首发未用药精神分裂症患者。采用随机抽签法分为整合式心理治疗组(心理组)和常规治疗组(对照组),采用阳性和阴性症状量表的兴奋因子(PANSS-EC)评估激越症状、个体和社会功能量表(PSP)评估社会功能,经过4周的干预评估患者的PANSS-EC及PSP的变化。结果 双因素重复测量方差分析显示,两组间治疗前后PSP和PANSS-EC的评分差异有统计学意义(P<0.05),且随治疗时间的延长PSP评分升高(P<0.05),PANSS-EC评分减低(P<0.05)。各时点,心理组的PSP总分高于对照组,PANSS-EC评分低于对照组,组间比较差异有统计学意义(P<0.05)。基线期PSP和经过4周治疗PANSS-EC的减分率进行相关分析,发现PSP和PANSS-EC的减分率呈正相关(r=0.342,P<0.001)。结论 整合式心理护理有利于首发未用药精神分裂症患者的激越症状的缓解、社会功能的恢复,且基线期社会功能越好的患者越有利于激越症状的缓解。

Objective To explore the effects of integrated psychological nursing on agitation symptoms in patients with first episode schizophrenia.The influence of social function.Methods Patients with first-episode schizophrenia who were hospitalized in Shandong Mental Health Center from January 2020 to November 2022 were selected.The patients were randomly divided into integrated psychotherapy group(psychological group)and conventional therapy group(control group).The positive and negative symptom scales(PPANSS-EC)were used to evaluate agitation symptoms,and the Individual and Social Functioning scales(PSP)were used to evaluate the social functioning of the patients.PANSS-EC and PSP changes were evaluated after 4 weeks of intervention.Results After 2 and 4 weeks of treatment,PANSS-EC in the psychological group decreased and PSP increased compared with the control group,and the differences were statistically significant.Two-factor repeated measurement ANOVA showed that the scores of PSP and PANSS-EC before and after treatment were statistically significant between the two groups(P<0.05).PSP score increased(P<0.05)and PANSS-EC score decreased(P<0.05)with the extension of treatment time.At all time points,the total score of PSP in psychological group was higher than that in control group,and the score of PANSS-EC was lower than that in control group,and the difference between groups was statistically significant(P<0.05).A correlation analysis was performed between PSP at baseline and PANSS-EC after 4 weeks of treatment,and a positive correlation was found between PSP and PANSS-EC(r=0.342,P<0.001).Conclusion Integrated psychological nursing is beneficial to the relief of agitation symptoms and the recovery of social function in the first episode drug naive schizophrenia.Patients with better social function at baseline were more likely to relieve agitation symptoms.