“互联网+”延续性护理服务模式在严重精神障碍稳定期患者中的应用

Application of“internet plus”continuous nursing service model in patients with severe mental disorders in the stable period

目的探讨“互联网+”延续性护理服务模式对严重精神障碍稳定期患者的干预效果。方法采用非同期对照研究,选取符合严重精神障碍稳定期诊断标准的患者为研究对象,便利抽取2019年1月—12月出院患者为对照组(55例),利用河南省心理援助云平台开展电话随访、健康教育推送和服药提醒。2020年12月至2021年10月出院患者为试验组(59例),对平台进行升级,在对照组的基础上开展“互联网+”延续性护理服务,包括远程教育培训(集体健康教育、药物处置程式训练、社交技能训练、放松训练)、远程医学诊疗(药物治疗、集体认知行为治疗、个体心理咨询)、远程家庭访视(护理风险评估、营养评估、药物副作用评估、精神康复疗效评估)。在干预前、干预6个月后和12个月后,评价患者的精神症状严重程度、康复状态、自知力,以及监护人照顾体验。结果重复测量方差分析结果显示,两组在干预前、干预6个月后和12个月后的精神病评定量表、康复状态量表、自知力与治疗态度问卷、照顾者体验量表得分时间与组间均存在交互效应(P<0.05)。简单效应分析显示,干预6个月后、12个月后,试验组各测量指标结果均优于对照组,差异具有统计学意义(P<0.05)。结论“互联网+”延续性护理服务可有效降减轻患者的精神症状,改善患者康复状态,提高患者自知力,改善监护人照顾体验。

Objective To explore the intervention effect of"internet plus"continuous nursing service model on patients with severe mental disorder in stable period.Methods A non-contemporaneous control study was conducted,patients who met the diagnostic criteria for severe mental disorders during the stable period were conveniently selected as research subjects.Fifty-five patients who were discharged from January 2019 to December 2019 were identified as the control group,and the Henan Provincial Psychological Assistance Cloud Platform was used to conduct telephone follow-up,health education promotion,and medication reminders.Fifty-nine patients who were discharged from December 2020 to October 2021 were identified as the experimental group.Researchers upgraded the platform and carried out“internet plus”continuous nursing services on the basis of the control group,which included distance education training module(collective health education,drug disposal program training,social skills training,relaxation training);telemedicine diagnosis and treatment module(medication,collective cognitive behaviour therapy,individual psychological consultation);remote home visit module(nursing risk assessment,nutritio-nal assessment,drug side effects assessment,and mental rehabilitation efficacy assessment).Finally,the patient’s mental symptoms,recovery status,self-awareness,and caregiver experience were evaluated before intervention,6 months and 12 months after the intervention.Results Repeated measurement analysis of variance showed that there were interaction effects between the two groups in the scores of the Nurses’Brief Psychiatric Rating Scale,Momingside Rehabilitation Status Scale,Insight and Treatment Attitudes Questionnaire,and Experience of Caregiving Inventory before intervention,after 6 months and 12 months of intervention(P<0.05).Simple effect analysis showed that after 6 months and 12 months of intervention,the results of all measurement indicators in the experimental group were better than those in the control group,with statistically significant differences(P<0.05).Conclusion“internet plus”continuous intervention model can effectively reduce patients’mental symptoms,improve patients’rehabilitation status and caregiver experience,improve patients’insight,and improve the quality of life of patients and their guardian.