社会生活技能训练对慢性精神分裂症患者社会功能恢复的作用

Effect of social living skill training on the rehabilitation of social function in patients with chronic schizophrenia

目的:探讨社会生活技能训练在慢性精神分裂症患者康复中的作用。 方法:应用行为干预、心理疏导、物质奖励等强化措施,对50例慢性精神分裂症患者进行社会、生活功能的强化训练,疗程2个月;采用阳性症状量表、阴性症状评定量表、康复状态量表、社会功能缺陷量表、日常生活能力量表和护士用住院患者观察量表,进行训练前后的自身对照比较。结果:训练后患者在情感反应(t=5.30,P<0.01)、言语表达(t=4.32,P<0.01)和社交兴趣(t=4.36,P<0.01)等阴性症状方面较训练前有明显改善;其社会能力(t=2.62,P<0.05)、社会兴趣(t=4.12,P<0.05)及退缩行为(t=4.30,P<0.05)有较大提高,日常生活能力(t=6.21,P<0.01)得到明显改善,与训练前相比均有显著性差异(P<0.01);总体康复效果明显(t=3.20,P<0.01)。 结论:多方位的社会、生活功能训练配合正性强化措施,对提高患者的社会、生活能力及精神病残留症状具有一定的作用。

AIM: To explore the effect of social living skill training on the rehabilitation in patients with chronic schizophrenia. METHODS: Fifty patients with chronic schizophrenia were treated with social, living skill training for 2 months by taking some enhanced measures such as behavior intervention, psychological treatment, and material reward. All the patients were evaluated by scale for the Assessment of Positive Symptoms, Scale For The Assessment Of Negative Symptoms, Rehabilitation State Scale, Social Disability Screening Scale, Abilities of Daily Life Scale and Nurses' s Observation Scale for Inpatient Evaluation, and self-control comparison was conducted before and after the treatment. RESULTS: Compared with before training, negative symptoms, such as e-motional response(t=5. 30, P<0.01), verbalization (t =4. 32, P < 0. 01) and social intercourse interest (t = 4. 36, P < 0. 01) after the treatment improved obviously. There was significant improvement in social ability (t = 2. 62, P <0. 05), social interest(t = 4. 12, P < 0. 05), withdrawal behavior( t = 4. 30, P < 0.05) . Daily life ability after the treatment( t = 6. 21, P < 0. 01) ameliorated significantly compared with before training (t = 3.20, P <0.01). CONCLUSION: Multidimensional social life skill training combined with positive reinforcement measures is helpful to improve social life ability and residual psychotic symptoms in patients with chronic schizophrenia.