行为技能训练对社区与住院精神分裂症患者康复效果的对照研究

摘要

目的:探讨行为技能训练对社区与住院精神分裂症患者康复的影响.方法:对2008年1-12月社区组、住院组精神分裂症患者进行随机抽样,各选取22例,实施行为技能训练,并应用"日常生活能力量表(ADL)"、"简明精神病量表(BPRS)"和"Morning Side康复状态量表(MRSS)"分别于训练前及第12周末测定他们的康复状态.结果:训练前两组间ADL、BPRS、MRSS总分比较差异无显著性意义(P＞0.05).训练后12周末,ADL、BPRS、MRSS两组量表总分分别与训练前比较均有显著性差异(P＜0.01);两组间比较:MRSS社区组的量表总分低于住院组,差异有显著性意义(P＜0.05);ADL、BPRS的总分差异均无显著性意义(P＞0.05).单因素方差分析:组别、性别、文化程度、依从性、性格均不是影响各期ADL、BPRS、MRSS量表总分的因素;病程对各期ADL总分的影响有显著性意义(P＜0.05),病程越长,ADL总分越高;年龄对各期BPRS总分的影响有明显显著性意义(P＜0.01),年龄越小,总分分值越低;住院次数、婚姻对各期MRSS总分的影响有显著性意义(P＜0.05).干预时间对ADL、BPBS、MRSS量表总分的影响有显著的显著性意义(P＜0.01),训练时间越长,各总分分值越低.结论:对社区与住院精神分裂症患者实施行为技能训练,有利于提高他们的生活自理能力和社会功能;行为技能训练对社区患者的康复状态更理想;持续性技能训练,可以降低疾病复发,对促进他们的康复水平具有更积极意义.%Objective:To explore the effect of behavioral skill training on recovery of schizophrenic patients in communities and in hospital.Method:Twenty-two patients randomly, from January to December in 2008, with schizophrenic in hospital and in communities were enrolled respectively in behavioral skill training. Activities of daily living(ADL), brief psychiatric rating scale(BPRS) and moming side rehabilitation status scale(MRSS) were used to determine their conditions of rehabilitation before training and after the 12th week of training.Result:Before training, the differences of each total score of ADL,BPRS and MRSS between the two groups were not statistically significant(P＞0.05). But, after the 12th week of training, the differences were statistically significant(P＜0.01). According to the compare between the two groups, the total scores of' MRSS from communities group were lower than that from hospital group. And there were statistically significant differences(P＜0.05). However, the total scores of ADL and BPRS had not(P＞0.05). The single factor variance analysis showed that each total scores of ADL, BPRS or MRSS did not be influenced by category, sex, education, compliance or character.And The effect of the course of disease was statistically significant on various total scores of ADL(P＜0.05). In the term of single factor analysis, the effects of age on the total scores of BPRS were significantly different (P＜0.01).The lower the age was, the smaller the score was. The hospitalization time and marriage had significant influences on the total scores of MASS(P＜0.05). And the effects of length of intervention on the total scores of ADL, BPRS and MRSS were more significantly different(P＜0.01).The longer the period of training was, the less the scores were.Conclusion:The implementation of behavioral skill training on schizophrenia patients of communities and hospital would be helpful f'or improving patient's self-care skill and social function. And it had better influence on the rehabilitation. The continuous skill training was more beneficial for their recovery and could restrict the recurrence of disease.