不同个案管理员对社区精神分裂症患者康复效果影响的对照研究  

Comparison of two types of case management for community-based schizophrenia rehabilitation

作　　者：刘锐[1] 傅礼洪 林雪平[1] 康迅 梁仕栋[1] 贺彩霞 Liu Rui;Fu Lihong;Lin Xueping;Kang Xun;Liang Shidong;He Caixia(The Third People' s Hospital of Foshan, Foshan528000, China;Fukang Medical Social Service Orgnization, Foshan528000, China)

机构地区：[1]佛山市第三人民医院,广东佛山528000 [2]佛山市福康社会工作服务中心,广东佛山528000

出　　处：《四川精神卫生》2017年第5期441-445,共5页Sichuan Mental Health

基　　金：佛山市科技局立项课题(2015AB004261)

摘　　要：目的比较社工和护士两类不同个案管理员对社区精神分裂症患者康复效果的影响,为有针对性地开展社区服务提供参考。方法选取佛山市两个不同城市社区共96例精神分裂症患者为研究对象,按社区分为两组,分别由精神专科护士(护士组)和社工(社工组)担任个案管理员,开展为期1年的个案管理研究。使用简明精神病评定量表(BPRS)、世界卫生组织残疾评定量表第2版(WHO-DASⅡ)在入组时、入组第3、6、9、12月时测评两组康复情况,结束时采用自编服务满意度评价表测评服务满意度。结果个案管理后,护士组BPRS评分低于社工组(F=7.326,P<0.05);两组WHO-DASⅡ总评分比较差异无统计学意义(F=0.300,P>0.05),护士组"与他人相处"分项评分低于社工组(F=6.189,P<0.05),社工组"家务活动"分项评分低于护士组(F=4.173,P<0.05),社工组"社会参与"分项评分低于护士组(F=4.065,P<0.05);护士组和社工组患者疾病复发率比较差异无统计学意义(8.33%vs.10.41%,χ~2=0.123,P>0.05)。护士组在"服务满意度评估病情控制有效性"上满意度更高(χ~2=9.216,P<0.05),社工组在"减轻家庭照看负担"上满意度更高(χ~2=7.935,P<0.05)。结论精神专科护士和社工作为个案管理员可能均有利于提升社区精神分裂症患者的康复效果。ObjectiveTo investigate the efficacy of social workers and nurses as case managers on the rehabilitation in patients with schizophrenia,and to provide references for community patient management.MethodsA one-year project was conducted in two different local communities,with nurses and social workers as case managers.Using Brief Psychiatric Rating Scale(BPRS),WHO Disability Assessment Schedule2.0(WHO-DAS II)and self-made satisfaction scale to evaluate the rehabilitation and service satisfaction of the two groups.ResultsAfter case management,the BPRS score of the nurses group was significantiy lower than the social workers group(F=7.326,P<0.05),the total scores of the WHO-DAS II was no significant difference between the two groups(F=0.300,P>0.05),as for the subscale,the scores of getting along with people(F=6.189,P<0.05)was significantly lower in nurse group,the scores of life activities-household(F=4.173,P<0.05)and participation in society(F=4.065,P<0.05)were significantly lower in social workers group.The relapse rate difference of the two groups was not significant.Patients were more satisfied with disease controlling in nurse group(χ2=9.216,P<0.05),and more satisfied with reducing the burden of family care in social workers group(χ2=7.935,P<0.05).ConclusionBoth nurses and social workers can improve the rehabilitation effect using different methods in patients with schizophrenia.

关 键 词：精神分裂症 个案管理员 康复 护士 社工 

分 类 号：R749.3[医药卫生—神经病学与精神病学]