医院-社区一体化随访对精神分裂症患者社会功能的影响  

Impacts of hospital-community integration follow-up mode on social function for schizophrenia patients

作　　者：姚秀凤[1] 苏天勋 杨婕[1] 侯洁生 何燕飞[1] 赵斌斌 YAO Xiufeng;SU Tianxun;YANG Jie;HOU Jiesheng;HE Yanfei;ZHAO Binbin(Department of Integrated Chinese and Western Medicine,Zhaoqing NO.3 People's Hospital,Guangdong,Zhaoqing 526060,China)

机构地区：[1]广东省肇庆市第三人民医院中西医结合科,广东肇庆526060

出　　处：《中国医药科学》2020年第19期221-224,235,共5页China Medicine And Pharmacy

基　　金：广东省肇庆市科技创新指导类项目(201704030708)。

摘　　要：目的探讨医院-社区一体化随访模式对精神分裂症患者社会功能的影响。方法选取2017年1月~2018年6月在我院心身科和中西医结合科住院经系统治疗达到临床痊愈出院的148例精神分裂症患者(简明精神病评定量表≤28),其中有120例患者社会功能评定量表(SDSS)≥2分,将148例患者随机分为随访干预组和对照组,每组各74例,两组患者均在医生指导下规范服药,到门诊或当地社区医院免费发药点取药,随访干预组由研究组成员牵头,联合社区精防医生进行为期1年的随访干预。观察两组患者入组时、随访干预半年、1年后病情、社会功能的情况,比较两组患者随访干预1年后的复发率和再住院率。结果148例精神分裂症患者中有120例社会功能评定量表(SDSS)≥2分,社会功能缺陷发生率为81.08%,以责任心和计划性、职业和工作、对外界的兴趣和关心、社会活动和社会性退缩方面缺陷较重,两组患者入组时BPRS、SDSS总分比较,差异无统计学意义(P>0.05);随访干预组的BPRS、SDSS总分在随访干预半年、1年均低于对照组,差异有统计学意义(P<0.01);随访干预组复发14例,复发率为18.92%,低于对照组复发29例,复发率为39.19%,差异有统计学意义(χ^2=7.400,P<0.05);随访干预组再住院8例,再住院率为10.81%,低于对照组再住院23例,再住院率为31.08%,差异有统计学意义(χ2=9.176,P<0.05)。结论医院-社区一体化随访对稳定精神分裂症患者病情,促进社会功能恢复,降低复发率和再住院率具有积极的作用。Objective To investigate the impacts of hospital-community integration follow-up mode on social function for schizophrenia patients.Methods From January 2017 to June 2018,148 schizophrenia patients(BPRS≤28)who were hospitalized in psychosomatic department and department of integrated Chinese and western medicine of our hospital and were clinically recovered and discharged after systematic treatment,of which 120 patients were rated by social disability screening schedule(SDSS)≥2 points.148 patients were randomly divided into the follow-up intervention group(n=74)and the control group(n=74).Patients in both groups were prescribed to take medicine regularly under the guidance of doctors and were distributed drugs at outpatient clinics or local community hospitals free of charge.The follow-up intervention group was led by members of the study group and was treated by one-year follow-up interventions combined with community intensive follow-up doctors.The condition and social function of the two groups of patients were observed at the time of admission,half a year after follow-up interventions,and one-year after follow-up interventions.The relapse rate and readmission rate of the two groups of patients after one-year follow-up interventions were compared.Results Among 148 schizophrenia patients,120 had an SDSS of≥2 points,and the incidence rate of social disability was 81.08%.The disability was more serious in terms of responsibility and planning,occupation and work,interest and concern for the outside world,social activities and social withdrawal.There was no significant difference between the total scores of BPRS and SDSS when the two groups of patients were admitted(P>0.05).The total scores of BPRS and SDSS in the follow-up intervention group were lower than those in the control group for half a year and one year,respectively,and the differences were statistically significant(P<0.01).The relapse rate(n=14,18.92%)in the follow-up intervention group was lower than that in the control group(n=29,39.19%),and the

关 键 词：社区一体化 随访干预 精神分裂症 社会功能 

分 类 号：R749.3[医药卫生—神经病学与精神病学]