精神分裂症患者知情权和选择权的分时分级应用研究

目的 探讨让住院精神分裂症患者享受知情权和选择权的最佳时机及不同时间让患者享受知情权和选择权的最佳程度.方法 把精神分裂症患者在住院过程中享受知情权和选择权的时间分为入院时,入院后1周、2周、3周和4周5个时间点(分时);再把让患者享受知情权和选择权的程度分为不知情、部分知情、知情3个等级(分级);观察不同时间点让患者享受相同程度知情权和选择权和同一时间让患者享受不同程度知情权和选择权,对患者病情(合作程度)的影响.结果 患者在入院时、入院后1周,让患者不知情、部分知情、知情,其住院合作率A0组63.64%、B0组45.45%、C0组32.73%,3组间差异有极显著性(χ2=21.30,P<0.01);A1组56.43%、B1组52.38%、C1组42.45%,3组间亦差异有显著性(χ2=6.18,P<0.05);PANSS、SI和MAOS量表的分值逐渐升高,差异有显著性(P<0.05或0.01);2周后让患者知情、部分知情、不知情,各组住院合作率接近, PANSS、SI和MAOS量表的分值亦较接近,差异无显著性(P>0.05).结论 可以根据患者病情和法定监护人要求,让患者在不同的时间(分时),享受不同程度(分级)的知情权和选择权;分时分级让患者享受知情权和选择权的方法,操作简单、灵活,适合我国国情,对实际临床工作具有更重要的实用价值和理论价值.

The exploratory about time-share and ranking for right to know the fact and selection of schizophrenic

Objective The best juncturest is exploratory that is to enjoyment right to know the fact and selection for schizophrenic. The best extentest is exploratory that is to enjoyment right to know the fact and selection with different time for schizophrenic. Methods The time was divided for on admission,hospitalization one week,hospitalization tow weeks, hospitalization three weeks and hospitalization four weeks five piece time section (time-share)about enjoymenting right to know the fact and selection of schizophrenic;and to enjoymenting right to know the fact and selection of schizophrenic extent was divided for not to know the fact, mere-know the fact and know the fact (ranking).The pathogenetic condition of schizophrenic were evaluated letting enjoyment identical extent right to know the fact and selection at different time and enjoyment identical time right to know the fact and selection at different extent for PANSS,SI and MAOS. Results The rate of schizophrenic cooperation was that A0 group was 63.64%,B0 group was 45.45%,C0 group was 32.73%,the difference had significance(χ2=21.30,P<0.01);A1 group was 56.43%,B1 group was 52.38%,C1 group was 42.45%, the difference had significance(χ2=6.18, P<0.05),at not to know the fact,mere-know the fact and know the fact when on admission, hospitalization one week. The score of PANSS,SI and MAOS are to heighten. The difference had significance (P<0.05 or 0.01).The rate of schizophrenic cooperation were approximation at not to know the fact,mero-know the fact and know the fact since two hospitalization weeks. The score of PANSS,SI and MAOS were approximation. The difference had not significance (P>0.05). Conclusion The schizophrenic are divided time-share and ranking enjoyment right to know the fact and selection according to patient's condition and the guardian to be stipulated by laws. The schizophrenic time-share and ranking for right to know the fact and selection method procedure simple and agility. The method suit our country. The methods have practical and theory value for actuality clinical work.