社区干预对精神分裂症患者社会功能及生存质量的影响

目的探讨以患者为中心的“患者-家属-社区居民”模式的社区干预对精神分裂症患者社区康复的影响。方法将精神分裂症患者随机分成干预组和对照组，对干预组患者及其家属、社区居民实施群体干预和个别指导，对照组只给予一般健康指导，共干预1年。采用家庭社会关怀度指数问卷（APGAR）、社会功能缺陷量表（SDSS）和生活质量综合评定问卷（GQOL1～74）对干预效果进行评定。结果实施干预后，干预组患者的社会功能缺陷程度明显降低，与干预前及两组间比较，均有显著性意义（P〈0．01）。患者得到较多的家庭、社会支持，家庭社会关怀度显著提高（P〈0．01）。患者生活质量与家庭社会支持度的相关性分析，除物质生活维度，其余3个维度即躯体功能（r=0．34、P〈0．01）、心理功能（r=0．36P〈0．01）、社会功能（r=0．28，P〈0．05）均与家庭社会关怀度呈正相关，患者生活质量明显提高（P〈0．01）。结论及时的社区干预可有效提高精神分裂症患者的社会功能和生活质量。

Effects of community intervention on social function and quality of life in patients with schizophrenia

Objective To explore the effects of community intervention （ patient - family - community resident mode） on rehabilitation in patients with schizophrenia. Methods A total of 136 patients with schizophrenia were ran- domly divided into study group and control group for the study of 1 year. The patients of study group, their families and community residents were given intervention and individual guidance. While the patients of control group were only given general health guidance. All the patients were assessed with family APGAR index（ APGAR）, Social Disability Screening Schedule（SDSS） and General Quality of Life Inventory （GQOLI -74）. Results After intervention, social disability in study group significantly reduced, there had significant differences between two groups. The patients of study group had more family and social support, thus family and social care significandy increased. The scores of physical function, physiological function and social function had significantly positive relation with the degree of family and social care. Quality of life in patients of study group had significantly improved. Conclusion Timely community interventions could improve social function and quality of life in patients with schizophrenia.