全科团队康复服务对社区精神分裂症患者的影响  

GP team rehabilitation service:Its effect on community schizophrenic patients

作　　者：陈优[1] 安孝群[1] 胡满基[1] 杜宇锋[1] 郑琰婷[1] 肖艳红[1] CHEN You;AN Xiao-qun;HU Man-ji;DU Yu-feng;ZHENG Yan-ting;XIAO Yan-hong(Shanghai Yangpu District Mental Health Center,Shanghai 200083,China)

机构地区：[1]上海市杨浦区精神卫生中心

出　　处：《上海预防医学》2019年第5期405-409,共5页Shanghai Journal of Preventive Medicine

基　　金：上海市杨浦区2013—2015卫计委重点专科项目(2013AA002-5);上海市残联2014年度科研鼓励项目(2014-14);上海市杨浦区卫生计生系统青年骨干项目(2017—2019)

摘　　要：【目的】研究全科团队参与的康复服务对社区精神分裂症患者的症状、疾病家庭负担及病耻感的影响。【方法】将上海市某区12个街镇120名社区慢性稳定期精神分裂症患者按照街道为单位方便分组:干预组60人与对照组60人(对照组脱落1人),干预组每周接受由全科团队提供的主动式康复服务2次,共12周,对照组仅接受社区随访和一般康复指导治疗,在干预前及第4、8、12周对两组患者及家属采用阳性和阴性症状量表(PANSS)、疾病家庭负担量表(FBS)、病耻感量表等进行评估,结果用SPSS13.0统计软件进行分析。【结果】干预前各项量表差异均无统计学意义。通过两两比较第8周末、12周干预组的PANSS总分、阳性因子分、一般精神病理分均较对照组显著下降(P<0.05或P<0.01),第12周干预组PANSS阴性因子分较照组显著下降(P<0.01);干预前后患者病耻感量表总分具交互效应(P<0.01);第8周家庭娱乐以及家庭总负担低于对照组(P<0.05)。【结论】全科团队参与的社区康复服务提供更全面和多层次服务,可以改善精神分裂症患者的精神症状、减少患者病耻感、增强病人的日常生活能力,减轻疾病家庭负担。[Objective]To study the effect of rehabilitation service participated in by the GP team for schizophrenic patients in communities.[Methods]A total of 120 chronic stable schizophrenic patients selected from 12 streets and towns in a community of Shanghai were divided into two groups(60 in each):intervention and control.The intervention group received active rehabilitation service from GP team twice a week,for a total of 12 weeks and the control group only community follow-up and general rehabilitation guidance treatment.The patients and their family members were evaluated with the Positive and Negative Syndrome Scale(PANSS),Family Burden Scale of Disease(FBS),Scale of Stigma in People with Mental Illness(SSPMI)before and at 4,8,12 weeks after intervention.[Results]Before intervention,there was not statistical difference found in each scale of the two groups.Through pairwise comparison,at the end of the 8 week and at 12 weeks,PANSS total score,positive factor score and general psychopathology score all remarkably dropped as compared with those of the control group(P<0.05 or P<0.01);at 12 weeks,in the intervention group,PANSS negative factor score remarkably dropped as compared with those of the control group(P<0.01).Before and after intervention,patients′stigma scores had interacted effect(P<0.01);at 8 weeks,home entertainment and total family burden were lower than those of the control group(P<0.01).[Conclusion]Community rehabilitation service participated in by GP team not only improves part of the psychiatric symptoms of chronic schizophrenic patients,but also reduces their feeling of stigma,and relieves their family burden.

关 键 词：精神分裂症 全科团队 社区康复 阳性和阴性症状量表 疾病家庭负担量表 病耻感量表 

分 类 号：R749.3[医药卫生—神经病学与精神病学]