摘要
目的探讨社区多部门系统干预模式对慢性精神分裂症患者症状、社会功能及生存质量的干预效果。方法于2016年3—5月,采用方便抽样法选取上海市浦东新区花木社区卫生服务中心在册管理的、被明确诊断的精神分裂症患者128例为研究对象。随机分为对照组和干预组,每组各64例。对照组由社区卫生服务中心精神卫生防治工作者(精防工作者)按照目前浦东新区精神疾病管理方法对患者进行常规管理;干预组在对照组的基础上增加街道办事处、派出所、残疾人联合会、民办非企业单位(组织)等部门进行多部门管理。两组干预时间均持续1年。干预前和干预后1年时,分别采用阳性与阴性症状量表(PANSS)、个人和社会功能量表(PSP)、世界卫生组织生存质量测定量表简表(WHOQOL-BPRS)、家庭功能评定量表(FAD)评估患者症状、社会功能及生存质量。结果干预前,两组患者PANSS、PSP、WHOQOL-BPRS、FAD评分比较,差异均无统计学意义(P>0.05)。干预后,干预组PANSS一般精神病理症状评分及总分低于对照组,PSP各项评分及总分高于对照组,WHOQOL-BPRS生理、社会关系评分及总分高于对照组,FAD问题解决、沟通、情感反应及总的功能评分低于对照组,差异有统计学意义(P<0.05);两组PANSS阳性症状、阴性症状评分,WHOQOL-BPRS心理、环境评分,FAD角色、情感介入、行为控制评分比较,差异无统计学意义(P>0.05)。结论社区多部门系统干预模式能够有效改善慢性精神分裂症患者症状,提高其生存质量和社会功能,对精神分裂症患者的康复起到了积极作用。
Objective To explore the effect of community-based multidisciplinary systematic interventions on the improvement of symptoms,social performance and quality of life of chronic schizophrenia patients.MethodsFrom March to May 2016,using convenient sampling,we enrolled 128 patients with a confirmed diagnosis of schizophrenia who registered in Pudong New Area Huamu Community Health Service Center located in Shanghai and randomized them into the control group and the intervention group with 64 in each.Both groups received 1-year conventional interventions based on the ways for the management of patients with mental disorders in Pudong New Area delivered by health professionals involved in the prevention and control of mental disorders,the intervention group concurrently received 1-year interventions offered by neighborhood offices,police stations,disabled persons federations,private non-enterprise units （organizations） and so on.Before and at the end of interventions,Positive and Negative Syndrome Scale （PANSS） was used to assess the severity of schizophrenia symptoms,Personal and Social Performance Scale（PSP） was adopted to evaluate the social performance,World Health Organization Quality of Life-Brief（WHOQOL-BPRS） was employed to examine the quality of life,and Family Assessment Device （FAD） was applied to measure the family functioning of the patients.ResultsPrior to the intervention,the mean scores of PANSS,PSP,WHOQOL-BPRS,and FAD were not significantly different between the two groups （P〉0.05）.After intervention,compared with the control group,the intervention group demonstrated much lower mean scores of General Psychopathology Scale and PANSS,but significantly higher mean scores of PSP and its items,mean scores of WHOQOL-BPRS and its 2 domains of physiology and social relationship,mean scores of FAD and its 3 domains of problem solving,communication and affective responsiveness （P〈0.05） except the scores of other parts of the 4 tools （Negative Scale and Positive Scale,mental and environmental domains of WHOQOL-BPRS,roles,affective involvement and behavioral control domains of FAD） were still similar （P〉0.05）.ConclusionCommunity-based multidisciplinary systematic interventions play a positive role in improving the rehabilitation of schizophrenia patients via enhancing the symptoms,quality of life as well as social performance.
作者
尹华卿
YIN Hua-qing(Pudong New Area Huamu Community Health Service Center,Shanghai 201204,Chin)
出处
《中国全科医学》
CAS
北大核心
2018年第16期1998-2002,共5页
Chinese General Practice
基金
上海市浦东新区卫生系统优秀青年医学人才培养项目(PWRq2015-33)
