社区管理对精神分裂症致残患者康复的影响  

Effects of community management on the rehabilitation of disabled patients with schizophrenia Effect of community management on rehabilitation of schizophrenic disabled patients

作　　者：杜义敏[1] 王立峰[1] 张培[1] 赵世磊 李平[1] 吴丽霞 高秀花 DU Yimin;WANG Lifeng;ZHANG Pei(Department of Psychosis,The Eighth Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050081,China)

机构地区：[1]河北省石家庄市第八医院精一科,050081

出　　处：《河北医药》2020年第23期3547-3551,共5页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划项目(编号:171462143)。

摘　　要：目的探讨社区管理对精神分裂症致残患者的康复作用,为推动社区重性精神疾病管理提供理论参考。方法100例精神分裂症致残患者出院后,随机分为对照组和试验组,每组50例,对照组失访5例,试验组失访2例。试验组在6个月内实行社区管理,6个月后对2组阴性症状量表、蒙特利尔认知评估量表、社会功能缺陷筛选量表、社会支持评定量表、家庭疾病负担量表进行测评。结果6个月来试验组门诊每人就医次数高于对照组(P<0.01),复发率低于对照组,差异均有统计学意义(P<0.05)。6个月来试验组阴性症状量表评分无明显改变,蒙特利尔认知评估量表评分和社会支持评定量表评分均升高(P<0.05),社会功能缺陷筛选量表评分和家庭疾病负担评分降低(P<0.05),且各评分均与对照组比较差异有统计学意义(P<0.01)。结论社区管理能提高精神分裂症致残患者主动就医次数,减少复发,防止阴性症状加重、改善患者认知症状,提高社会支持,有利于社会功能的恢复,减轻家庭负担,值得在精神分裂症康复治疗中进行推广。Objective To investigate the effects of community management on rehabilitation of disabled patients with schizophrenia,and to provide a theoretical reference for promoting the management of severe mental illness in the community.Methods After discharging from hospital,the 100 patients with disability duw to schizophrenia were randomly divided into control group and experimental group,with 50 cases in each group.Five cases in the control group and 2 cases in the experimental group were lost to follow-up.Community management was implemented in the experimental group within 6 months.After 6 months,negative symptom scale,Montreal cognitive assessment(MoCA)scale,social function defect screening scale(SDSS),social support rating scale(SSRS),and family burden scale of disease(FBS)were evaluated in both groups.Results In the past 6 months,the number of outpatient visits per person in the experimental group was significantly higher than that in control group(P<0.01),and the recurrence rate was significantly lower than that in control group(P<0.05).There were no significant changes in negative symptom scale scores in experimental group within 6 months,however,the MoCA scale scores and the SSRS scores were significantly increased(P<0.05).In addition,SDSS scores and FBS were significantly decreased(P<0.05),and there were significant differences in the scores of differemnt rating scales between the two groups(P<0.01).Conclusion Community management can increase the number of active medical treatments for disabled patients with schizophrenia,reduce recurrences,prevent aggravation of negative symptoms,improve patients’cognitive symptoms,and improve social support,and it is conducive to the recovery of social functions and reduces family burdens.Therefore,it is worthy of popularization in the rehabilitation of patients with schizophrenia.

关 键 词：社区管理 精神分裂症 残疾 社会功能 家庭负担 

分 类 号：R749.3[医药卫生—神经病学与精神病学]