文章摘要
黄靖童,杨波,邓煜,罗英茂,郑琼,彭静,廖慧黠,曹缤月,李金山.患者-家属-专家服务模式对社区精神分裂症患者干预效果研究[J].中国康复,2022,37(10):636-640
患者-家属-专家服务模式对社区精神分裂症患者干预效果研究
Effects of User-Family-Expert service model on patients with schizophrenia in the community
  
DOI:
中文关键词: 精神分裂症  患者-家属-专家服务模式  社区精神卫生服务
英文关键词: Schizophrenia  User Family Expert service model  Community mental health services
基金项目:重庆市科卫联合医学科研项目(2021MSXM076)
作者单位
黄靖童 重庆市精神卫生中心歌乐山院区康复科重庆400036 
杨波 重庆市精神卫生中心重庆401147 
邓煜 重庆市精神卫生中心重庆401147 
罗英茂 重庆市精神卫生中心重庆401147 
郑琼 温州医科大学第二附属医院康复医学中心浙江温州 325000 
彭静 温州医科大学第二附属医院康复医学中心浙江温州 325000 
廖慧黠 重庆市精神卫生中心重庆401147 
曹缤月 温州医科大学第二附属医院康复医学中心浙江温州 325000 
李金山 温州医科大学第二附属医院康复医学中心浙江温州 325000 
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中文摘要:
  目的:研究患者-家属-专家服务模式对社区精神分裂症患者症状、社会功能及自知力的干预效果。探讨该模式中的服务绩效评价与干预效果改善量的关系。方法:选取重庆市纳入国家严重精神障碍信息系统的精神分裂症患者98例,分为干预组48例和对照组50例。2组均接受常规药物治疗和定期访视,干预组在此基础上接受为期6个月的患者-家属-专家服务模式干预。干预前后采用阳性与阴性症状量表(PANSS)、社会功能缺陷筛选量表(SDSS)、自知力与治疗态度问卷(ITAQ)对2组进行测评,评估干预效果。同时统计干预组服务绩效评价得分与干预效果改善量的关系。结果:干预后3及6个月,PANSS评分中阴性症状评分、一般精神病理症状评分、PANSS总分及SDSS评分干预组均呈逐渐下降趋势(均P<0.05),且各时间点均低于对照组(均P<0.05);不同时间点2组间PANSS评分阳性症状评分差异无统计学意义;干预后3及6个月干预组ITAQ评分均呈逐渐升高趋势(均P<0.05),且各时间点均高于对照组(均P<0.05);对照组治疗前后各时间点PANSS各项评分、SDSS评分及ITAQ评分比较均差异无统计学意义。干预后6个月,SDSS改善量、阴性量表改善量、一般精神改善量以及PANSS改善量,高绩效评价组均高于低绩效评价组(均P<0.05);ITAQ改善量及阳性量表改善量,2组间未见显著性差异。结论:患者-家属-专家服务模式可以改善社区精神分裂症患者的阴性症状、社会功能及自知力,同时绩效评价能促进干预效果改善。
英文摘要:
  Objective: To examine the intervention effects of the user-family-expert service model on symptoms, social functioning, and self-awareness in community-based schizophrenia patients. To explore the relationship between service performance evaluation and the amount of improvement in intervention effects in this model. Methods: Totally, 98 patients with schizophrenia who were included in the National Information System for Severe Mental Disorders in Chongqing were selected as research subjects, and divided into intervention group (48 cases) and control group (50 cases). Patients in both groups received conventional medication and regular visits, and the intervention group received a 6-month user-family-expert service model intervention additionally. Positive And Negative Syndrome Scale (PANSS), Social Disability Screening Schedule (SDSS), Insight and Treatment Attitude Questionnaire (ITAQ) were adopted before and after the intervention and the intervention effects were assessed. The relationship between the service performance evaluation scores in the intervention group and the amount of improvement in the intervention effect was also statistically analyzed. Results: The negative symptom scores, general psychopathological symptom scores of PANSS, total PANSS scores and SDSS scores at 3rd and 6th month after the intervention showed a gradual decrease in the intervention group (all P<0.05), and lower than those in the control group at all time points (all P<0.05). The difference in positive symptom scores of the PANSS between the two groups at different time points was not statistically significant. The ITAQ scores in the intervention group at the 3-month and 6-month time points after the interven-tion showed a gradual increase (all P<0.05), and higher than those in the con-trol group at all time points (all P<0.05). There was no statistically significant difference in the PANSS scores, SDSS scores and ITAQ scores in the control group at each time point before and after treatment. No significant differences were found between the two groups in the improvement of SDSS, negative scale, general mental improvement, and PANSS at the time point of 6th month after the intervention. Conclusion: The user-family-expert service model can improve negative symptoms, social functioning, and self-awareness for patients with schizophrenia in the community, while performance evaluation can promote the improvement of intervention outcomes.
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