主动式社区干预对精神分裂症出院患者的康复效果评价  

Evaluationofrehabilitationeffect of assertive community treatment on discharged patients with schizophrenia

作　　者：陈春梅[1] 王彦凤[1] 蔡军[1] 朱益[1] 朱有为[1] 周卿[2] 张伟波[1] CHEN Chunmei;WANG Yanfeng;CAI Jun(Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心防治科,上海200030 [2]上海市徐汇区精神卫生中心防治科,200232

出　　处：《安徽医学》2021年第8期847-850,共4页Anhui Medical Journal

基　　金：上海市公共卫生体系建设三年行动计划重点学科建设计划项目(项目编号:GWV-10.1-XK18);上海交通大学中国医院发展研究院2019年度医院管理建设项目(项目编号:CHDI-2019-B-20);2020年上海市“医苑新星”青年医学人才培养计划资助(沪卫人事〔2021〕99号)。

摘　　要：目的探讨主动式社区干预对精神分裂症出院患者康复的效果。方法选择上海市徐汇区精神卫生中心出院的精神分裂症患者265例,采用随机数字表法将患者分为对照组(133例)和干预组(132例),对照组给予常规社区精神卫生服务,干预组在此基础上到社区精神康复机构接受主动式社区干预,干预一年后随访,比较两组患者的不良结局发生率、病情加重率、应急处置率、危险行为发生率及住院率等指标差异。结果干预1年后随访,干预组发生不良结局事件的比例(6.61%比16.92%)、病情加重率(1.65%比11.54%)、应急处置率(4.13%比15.38%)、危险行为发生率(2.48%比12.31%)及住院率(4.13%比10.77%)均低于对照组,差异均有统计学意义(P<0.05)。结论主动式社区干预可减少精神分裂症出院患者病情加重、应急处置、危险行为及再住院等不良事件的发生,有利于促进患者康复。Objective To investigate the rehabilitation effect of assertive community treatment on discharged patients with schizophrenia.Methods A total of 265 schizophrenic patients newly discharged from Xuhui District Mental Health Center were selected and divided into control group(133 cases)and intervention group(132 cases)by random number table method.The intervention group received assertive community treatment in mental rehabilitation institutions,while the control group received routine community mental health services.Follow-up evaluation was conducted one year after intervention to compare the incidence of adverse outcomes,exacerbation rate,emergency response rate,incidence of risky behaviors and hospitalization rate between the two groups.Results Up to one year’s follow-up,the proportion of adverse outcome events,exacerbation rate,emergency response rate,incidence of risky behaviors and hospitalization rate in the intervention group were all lower than those in the control group(6.61%vs 16.92%,1.65%vs 11.54%,4.13%vs 15.38%,2.48%vs 12.31%,4.13%vs10.77%,respectively),and the differences were statistically significant(P<0.05).Conclusions The assertivecommunity intervention can reduce the occurrence of adverse outcome events such as exacerbation,emergency management,risky behavior and readmission in discharged patients with schizophrenia,and effectively promote the recovery of patients.

关 键 词：主动式社区干预 精神分裂症 康复 

分 类 号：R749.3[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]