社区健康教育对双相情感性精神障碍康复作用的研究

A study on rehabilitative effect of health education in patients with bipolar affective disorder in communities

目的 探讨社区健康教育对双相情感性精神障碍患者的康复作用。方法 将102例双相情感性精神障碍患者,随机分为研究组和对照组,在药物维持治疗基础上,在社区对研究组患者和家属实施为期2年的健康教育干预。用Beck-Rafaelsen躁狂量表(BRMS)、汉密顿抑郁量表(HAMD)、功能大体评定量表(GAF)进行测评,对治疗依从性、复发率、恶性事件发生率和家属对疾病知识了解程度等进行效果评估。结果 与入组时相比,研究组BRMS、HAMD和GAF各量表评分变化情况均优于对照组(P<0.05或P<0.001),复发率(8.0％)、再住院率(2.0％)和恶性事件发生率(2.0％)均显著低于对照组(分别为33.3％、20.8％和14.6％,均P<0.01),而治疗依从性和家属对疾病知识的了解程度均明显好于对照组(P<0.01或P<0.001)。结论 健康教育对控制双相情感性精神障碍患者的病情,提高患者的治疗依从性与家属的应对能力,降低复发率、恶性事件发生率和再住院率,促进其社会功能的康复等均具有重要作用。

objective To explore rehabilitative effect of health education in patients with bipolar affective disorder in communities.Methods One hundred and two patients with bipolar affective disorder in communities were divided randomly into study and control groups.Both of the two groups of patients received maintenance dose of drug therapy,as well as intervention with health education for the patients themselves and their relatives for two years in the study group.Rehabilitation effect were assessed with Beck-Rafaelsen Manic Rating Scale (BRMS),Hamilton Depression Rating Scale (HAMD) and Global Assessment function (GAF).Therapeutic compliance,rate of recurrence,rate of malignant event occurrence,and understanding of the illness by patients' relatives were also evaluated.Results Scores of BRMS,HAMD and GAF in the study group declined obviously after intervention for two years,as compared with those in the control group (P<0.05 or P < 0.001 ).Rates of recurrence,re-hospitalization and malignant event occurrence were significantly lower in the study group than those in the control group (33.3%,20.8% and 14.6%,respectively,P <0.01) Therapeutic compliance and awareness of illness by patients' relatives were better in the study group than those in the control group (P < 0.01 or P < 0.001).Conclusions Health education played an important role in control of the state in patients with bipolar affective disorder,relief of their symptoms,improvement of their therapeutic compliance and coping ability of their relatives,lowering rates of recurrence and re-hospitalization,and promoting improvement of social function.