社区干预对康复期精神分裂症患者社会功能的影响

目的评价一种社区干预方法对康复期精神分裂症患者社会功能的影响。方法采用分层抽样的方法在白银市抽取20个社区,采用随机数字表法将186例生活在社区的康复期精神分裂症患者分为研究组和对照组各93例,两组实际完成研究的例数分别为90例和84例。对研究组给予社区管理和系统的社会功能康复训练,对照组仅采用原有的个案管理的模式。分别在干预前、干预3月末和干预6月末进行阳性和阴性症状量表(PANSS)、社会功能缺陷筛选量表(SDSS)和日常生活能力量表(ADL)评定。结果干预前两组PANSS、SDSS、ADL评分差异均无统计学意义(P均0.05);干预后经重复测量方差分析,PANSS总评分和阴性症状量表、一般精神病理量表评分的组间主效应、时间主效应有统计学意义(P均0.01),阳性症状量表评分的时间主效应有统计学意义(P0.05);SDSS、ADL的组间主效应和时间主效应有统计学意义(P均0.01),SDSS的交互作用有统计学意义(P0.01),研究组SDSS评分在不同时间点差异有统计学意义(P0.01)。结论与个案管理比较,社区干预方法能够更有效地改善康复期精神分裂症患者的社会功能和部分残留的精神症状。

Effect of community intervention on social function of schizophrenia in rehabilitation period

Objective To evaluate the effect of community intervention on social function of schizophrenia patients in rehabilitation period. Methods Using the method of stratified sampling,twenty communities were extracted from Baiyin city and 186 patients who live in the communities which were schizophrenia in rehabilitation period randomly divided into the research group(93 cases) and the control group(93 cases). 90 cases in the research group completed the study and 84 cases in the control group. The research group was be trained with community management and systematic social functional rehabilitation,and the control group only received the original case management model. Positive and Negative Syndrome Scale(PANSS),Social Disability Screening Schedule(SDSS) and Activity of Daily Living Scale( ADL)were assessed before and after intervention for 3 months and 6 months. Results Before intervention,there was no statistical significant difference in the scores of PANSS、SDSS、ADL of the two groups(P > 0. 05). The repeated measures analysis of variance indicated that the group main effect and the time main effect were statistically significant in score of PANSS, Scale for Assessment of Negative Symptoms(SANS)and the General Psychiatric Scale after intervention(P <0. 01),and the time main effect had statistical significance in score of Scale for Assessment of Positive Symptoms(SAPS)(P <0. 05). The group main effect and the time main effect were statistically significant in score of SDSS and ADL(P <0.01). The interaction effect of SDSS was statistically significant (P <0. 01). In the study group,the score of SDSS was statistically significant at different time(P <0. 01). Conclusion Compared with case management,community intervention method can be more effective to improve the social function of patients with schizophrenia in rehabilitation period and part of the remaining mental symptoms.