精神分裂症患者综合职业技能相关因素的横断面评估(英文)

背景国外一些研究显示职业技能训练能提高精神分裂症患者的社会功能,改善生活质量。国内对精神分裂症患者职业技能与功能状态关系的研究相对较少。目的以综合职业技能评定量表(Comprehensive Occupational Therapy Evaluation Scale,COTE)评估住院以及刚出院的精神分裂症患者的职业功能,评价患者综合职业技能与人口学特征、临床症状及认知功能的关系。方法由经过培训的临床医生对64例精神分裂症患者(35例住院患者、29刚出院的门诊患者)进行评估,评估工具包括COTE,阳性和阴性症状量表(Positive and Negative Syndrome Scale,PANSS)以及包括威斯康星卡片分类测验(Wisconsin Card Sorting Test,WCST)、注意力持续操作测验(Continuous Perfomance Test,CPT),成人韦氏智力测验(Wechsler Adult Intelligence Scale,WAIS)中的数字符号项目,连线测验A和连线测验B在内的成套神经心理测验。结果患者的COTE 总分及一般行为、人际交往和任务行为3个维度的因子分与PANSS总分及其阳性症状分、阴性症状分和一般病理分均相关(秩相关系数范围为0.40~0.90)。COTE各指标与PANSS阴性症状分的相关性比其与PANSS阳性症状分的相关性强。COTE评分也与CPT的评分相关,并与WAIS中的数字符号项目得分,和WCST的部分项目结果相关。逐步回归分析显示,反映患者职业技能的4个COTE指标主要与PANSS总分或阴性症状分相关,其次与完成连线测验B所用时间、CPT漏报次数以及患者的受教育程度相关。结论住院及刚出院精神分裂症患者的职业技能与其精神症状的严重程度密切相关,也与患者的认知功能和受教育年限有一定关系。

Cross-sectional assessment of the factors associated with occupational functioning in patients with schizophrenia

Background： Studies from other countries indicate that occupational skills training can improve the social functioning and quality of life for patients with schizophrenia, but there is little research about the relationship of occupational skills and the functional status of patients in China. Aim： Use a translated Chinese version of the Comprehensive Occupational Therapy Evaluation scale （COTE） to evaluate occupational functining in inpatients and recently discharged patients with schizophrenia and assess the relationship of occupational functioning to demographic, clinical and cognitive measures. Methods： Thirty-five inpatiens and 29 recently discharged outpatients with schizophrenia were evaluated by trained clinicals using the COTE, the Positive and Negative Syndrome Scale （PANSS） and a neuropsychological battery that included the Wisconsin Card Sorting Test （WCST）, the Continuous Perfomance Test （CPT）, the digit symbol-coding subtest from the Wechsler Adult Intelligence Scale （WAIS）, and Trail Making Test parts A and B （TMT-A, TMT-B）. Results： The total score on the COTE and the three COTE dimensional scores （evaluating general behavior, interpersonal communication and task behavior） were all strongly correlated with the PANSS total score and the PANSS positive symptom, negative symptom and general pathology subscale scores （ranked correlation coefficients range from 0.40 to 0.90）. The correlationship of the COTE measures was significantly greater with the PANSS negative symptom score than with the PANSS positive symptom score. The COTE scores were also significantly correlated with the Continuous Performance Test measures, the WAIS digit symbol-coding test scores and some, but not all, of the measures derived from the TMT-A, the TMT-B, and the WCST. Mutiple regression analyses found that the four COTE measures of occupational functioning were most strongly associated with either the PANSS total score or the PANSS negative symptom score and secondarily associated with time to complete TMT-B, the CPT measure on number of omissions, and the respondent＇s years of education. Conclusion： Occupational functioning measures of inpatients and closely related to the severity of psychiatric symptoms and, to a duration of education. recently discharged outpatients with schizophrenia are esser extent, with cognitive functioning measures and duration of education.