多维度康复模式对社区精神分裂症患者的干预效果研究

摘要

Objective To investigate the intervention effects of multidimensional rehabilitation model on community patients with schizophrenic, and to further explore the suitable rehabilitation model for Chinese patients with schizophrenia.Methods 103 patients with schizophrenia who received treatment in Yulin Community Health Service Center and outpatient clinic of Huaxi Mental Health Center from June 2010 to September 2012 were selected.All the patients were divided into study group ( n =59 ) and control group ( n =44 ) by random number table method.Control group adopted conventional community rehabilitation mode, while study group used multidimensional rehabilitation model.Two groups were intervened for 2 years.Positive and Negative Syndrome Scale ( PANSS ) , Social Disability Screening Schedule ( SDSS ) and Family Interview Schedule ( FIS) were applied to evaluate the results.Results During the experiment, the duration of 5 patients′participation was less than 50% and thus they were excluded; subjects in control group had all completed follow -up and psychological assessment.Therefore, 98 patients were finally included in the study, including 54 patients in study group and 44 in control group.The effective recovery rate of social function in study group after intervention was significantly higher than that in control group (P<0.05) .PANSS, SDSS and FIS scores were not significantly different between two groups before intervention (P>0.05); PANSS, SDSS and FIS scores in study group after intervention were significantly lower than those in control group (P<0.05) .Conclusion The multidimensional rehabilitation model has obtained good effects on rehabilitation of patients with schizophrenia (including improvement of psychiatric symptoms, rehabilitation of social function, reducing of family burden). At the same time, in order to implement localized multidimensional rehabilitation model, comprehensive considerations of local policies, local characteristics, and the quality and ability level of rehabilitation workers are needed.%目的：分析多维度康复模式对社区精神分裂症患者的干预效果，并进一步探索适合我国精神分裂症患者的康复模式。方法选取2010年6月—2012年9月在玉林社区卫生服务中心及华西心理卫生中心门诊就诊的精神分裂症患者103例，采用随机数字表法将所有患者分为研究组（ n＝59）和对照组（ n＝44）。对照组采用常规社区康复方式，研究组采用多维度康复模式。两组均干预2年，采用阳性与阴性症状量表（ PANSS）、社会功能缺陷筛选量表（ SDSS）、家庭负担会谈量表（ FIS）进行效果评定。结果研究组试验期间有5例患者参与时间小于50％，故剔除；对照组全部完成随访和心理评估。故本研究最终纳入患者98例，其中研究组54例，对照组44例。研究组干预后社会功能有效恢复率高于对照组，差异有统计学意义（ P＜0．05）。两组干预前PANSS、 SDSS、 FIS评分间差异均无统计学意义（P＞0．05）；而研究组干预后PANSS、 SDSS、 FIS评分均低于对照组，差异有统计学意义（P＜0．05）。结论多维度康复模式在精神分裂症患者的康复方面（包括改善精神症状、恢复社会功能、减轻家庭负担方面）取得了较好的疗效。同时要实行本土化的多维度康复模式，需全面考虑地方政策、地方特点、康复工作者的素质与能力水平等。