家庭防治模式对农村慢性精神病患者认知、社会功能的研究

目的:探讨家庭防治模式对慢性精神病患者的社会认知功能和直接医疗成本的影响。方法:按入组标准对236名社会精神病患者(实际完成者215人),采用定期入户随访,中间门诊和电话随访的形式,进行为期一年的家庭防治干预。采用自制一般情况调查表、社会功能缺陷量表(SDSS)、简易智力状态量表(MMSE)对干预前、5个月、10个月时的情况进行评估,进行自身前后对照研究。结果:家庭防治干预前,干预5个月后、10个月后:①社会功能(SDSS)逐步改善(F=5.391,P<0.01);②认知功能(MMSE)大部分逐渐改善(P<0.01);③进行一年家庭防治直接医疗花费为102.6¹4 521.23元,平均(729.55±1 709.94)元。结论:对慢性精神病开展家庭防治模式可以降低医疗费用,有效改善患者的社会功能,值得进一步探索推广,但认知功能的全面改善需要更综合持久的过程。

Study on family control model on social function and cognitive function of rural patients with chronic mental illness

Objective：To explore effects of family control model on social and cognitive function,and direct medical cost for patients with chronic mental illness. Methods：According to inclusion criteria,the family prevention interventions were conducted on 236 community mental patients（215 people completed）by regular home follow-up,outpatient and telephone follow-up for one year. Before and 5 and 10 months after the intervention,these patients were assessed with the self-made questionnaire,social disability screening schedule（SDSS）,and mini mental state examination（MMSE）. Results：Compared with those before the intervention,5 and 10 months after the intervention：（1）the social function（SDSS）was significantly improved（F=5. 391,P﹤0. 01）;（2）most significant improvement in cognitive function（MMSE）were made（P﹤0. 01）;（3）the direct medical cost of the family prevention was 102. 6-14521. 23 yuan with an average of 729. 55±1709. 94 yuan. Conclusions：The family control model for the patients with chronic mental illness can reduce medical expenses and improve their social function. Therefore,this model is worthy of further exploration and promotion. It should improve the model for the overall improvement of cognitive function.