个案管理对严重精神障碍患者服药依从性和家庭疾病负担的影响  

Effect of case management on medication compliance and family disease burden in patients with severe mental disorders

作　　者：张银玲[1] 张代江[1] 谭小林[1] 罗兴刚 赵科[1] 王一曲 ZHANG Yin-ling;ZHANG Dai-jiang;TAN Xiao-lin;LUO Xing-gang;ZHAO Ke;WANG Yi-qu(Psychiatry Department,Chongqing Mental Health Center,Chongqing 401147,China)

机构地区：[1]重庆市精神卫生中心精神科,401147

出　　处：《临床精神医学杂志》2020年第5期321-323,共3页Journal of Clinical Psychiatry

基　　金：重庆市卫生和计划生育委员会资助项目(2017MSXM122)。

摘　　要：目的:探索个案管理对严重精神障碍患者服药依从性和家庭疾病负担的影响。方法:采用Zelen's设计随机对照研究方法将240例社区严重精神障碍患者分为个案管理组(125例)和对照组(115例)。个案管理组采用个案管理方案制定康复计划;对照组采用常规每3个月1次上门康复指导服务。干预前及干预后3、6、12个月时采用Morisky用药依从性问卷(MMAS-8)、疾病家庭负担量表(FBS)进行评估。结果:两组分别有120例、111例患者完成1年期观察。干预后个案管理组MMAS-8评分明显提高,FBS评分明显降低;两组服药依从性和家庭疾病负担评分的组间效应(F=8.634,49.044;P均<0.01)、时间效应(F=354.248,116.230;P均<0.01)、交互效应(F=437.965,58.562;P均<0.01)显著。结论:个案管理可以提高严重精神障碍患者的服药依从性,降低家庭疾病负担。Objective:To explore the effect of case management on medication compliance and family disease burden in patients with severe mental disorders.Method:240 patients with severe mental disorder were randomized into case management group(n=125)and control group(n=115)by a randomized controlled study based on Zelen's design.Case management group were provided a case management plan to develop a rehabilitation plan,and the control group were routinely given home rehabilitation guidance service once every 3 months.At baseline and 3,6 and 12 months after intervention,Morisky Medication Compliance Questionnaire(MMAS-8)and Family Burden Scale of Diseases(FBS)were used to evaluate patients.Results:120 and 111 patients in the two groups completed one-year observation respectively.MMAS-8 score significantly increased and FBS score significantly decreased after intervention in the case management group.There were significant differences in medication compliance and family burden scores between the two groups(F=8.634,49.044,P<0.01),time main effect(F=354.248,116.230,P<0.01),and interaction effect(F=437.965,58.562,P<0.01).Conclusion:Case management can improve the medication compliance and reduce the family burden in patients with severe mental disorders.

关 键 词：严重精神障碍 服药依从性 家庭疾病负担 

分 类 号：R749[医药卫生—神经病学与精神病学]