基于戴明环管理模式的社区精神康复对慢性精神分裂症患者生存质量的影响  

Effects of community mental rehabilitation based on Deming cycle model on quality of life of schizophrenia patients

作　　者：冯为[1] 杨雀屏[1] 李世明 方芳 陈佳 张紫娟[1] Feng Wei;Yang Queping;Li Shiming;Fang Fang;Chen Jia;Zhang Zijuan(Department of Social Prevention and Control,The Affiliated Wuxi Mental Health Center of Nanjing Medical University,Wuxi,Jiangsu 214151,China)

机构地区：[1]南京医科大学附属无锡市精神卫生中心社会防治办公室,214151

出　　处：《中国基层医药》2019年第18期2215-2219,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：南京医科大学科技发展基金面上项目(2015NJMU132).

摘　　要：探讨基于戴明环(PDCA)管理模式构建的社区精神康复策略对慢性精神分裂症生存质量的影响.方法 2016年1月至2017年6月,在无锡市同意纳入社区严重精神障碍管理治疗网络管理的慢性精神分裂症患者中选取符合入组条件的患者100 例,采用随机数字表法分为观察组(50 例)和对照组(50例),两组均提供常规的社区精神卫生服务,观察组同时另给予基于PDCA模式构建的社区精神康复策略干预,分别随访观察1年.在干预开始前、干预1年末分别采用精神分裂症患者生存质量量表(SQLS)、社会功能缺陷筛选量表(SDSS)、家庭关怀度指数(APGAR)进行评定.结果干预1年末,观察组患者的生存质量总分、心理社会维度、动力和精力维度、症状和副作用评分分别为(41.27 ±10.54)分、(38.37 ±10.84)分、(35.43 ±7.46)分、(20.71 ±7.34)分,较对照组[(51.98 ±7.43)分、(48.73 ±8.72)分、(47.67 ±6.98)分、(29.79 ±8.64)分]和干预前[(54.37 ±5.87)分、(49.78 ±4.73)分、(48.57 ±6.87)分、(33.17 ±10.42)分]均明显降低(t=5.87、5.27、8.47,5.66、7.68、6.82、9.16、6.91,均P<0.05);干预1年末,观察组社会功能评分[(6.78 ±2.84)分]均明显低于对照组[(8.83 ±2.73)分]和干预前[(8.97 ±2.18)分](t=3.68、4.33,均P<0.05),家庭社会关怀指数评分[(8.75 ±2.04)分]均明显高于对照组[(7.04 ±2.36)分]和干预前[(6.76 ± 2.14)分](t=-3.88、-4.76,均P<0.05). SDSS评分与SQLS评分呈正相关(r=0.41,P<0.05),APGAR评分与SQLS评分呈负相关(r=-0.35,P<0.05).结论基于PDCA模式的社区精神康复策略能提高患者社会功能和家庭社会关怀度,有效改善精神分裂症患者的生存质量,有效促进患者康复.Objective To study the influence of community mental rehabilitation based on Deming Cycle (PDCA) management model on the quality of life of patients with chronic schizophrenia .Methods From January 2016 to June 2017,100 patients with chronic schizophrenia who agreed to community management in Wuxi were randomly divided into study group(n=50) and control group(n=50).Both two groups received traditional community mental health services ,meanwhile,the study group was provided with community mental rehabilitation based on PDCA model.All the patients were followed up for 1 year.The quality of life scales(SQLS),social disability screening schedule (SDSS) and family care index(APGAR) were assessed before and after one -year intervention.Results At the end of one year after intervention ,the scores of total quality of life ,psychosocial dimension ,motive and energy dimension , symptom and side effects in the observation group were (41.27 ±10.54) points,(38.37 ±10.84) points,(35.43 ± 7.46) points,(20.71 ±7.34) points,respectively, which were lower than those in the control group [(51.98 ± 7.43)points,(48.73 ±8.72)points,(47.67 ±6.98)points,(29.79 ±8.64)points] and before intervention [(54.37 ± 5.87)points,(49.78 ±4.73)points,(48.57 ±6.87)points,(33.17 ±10.42) points]( t=5.87,5.27,8.47,5.66, 7.68,6.82,9.16,6.91,all P<0.05).At the end of one year after intervention ,the social function score [(6.78 ± 2.84)points] of the observation group was significantly lower than that of the control group [(8.83 ±2.73) points] and before intervention[(8.97 ±2.18)points](t=3.68,4.33,all P<0.05),and the family social care index score [(8.75 ±2.04) points] was significantly higher than that of the control group [(7.04 ±2.36) points] and before intervention[(6.76 ±2.14)points]( t=-3.88,-4.76,all P<0.05).There was a positive correlation between SDSS score and SQLS score (r=0.41,P<0.05).There was a negative correlation between SQLS score and SDSS score(r=-0.35,P<0.05).Conclusion The community mental rehabilitation strategy ba

关 键 词：精神分裂症 社区卫生服务 康复 疾病管理 生活质量 

分 类 号：R749.3[医药卫生—神经病学与精神病学]