2010-2012年广州市越秀区重性精神病人护理者负担社区干预效果分析

目的评估广州市越秀区重性精神病患者实施社区综合干预实施干预后护理者负担情况的改善效果，分析影响效果的因素。方法2010～2012年，在广州市越秀区5条行政街确诊为精神分裂症、心境障碍、分裂情感性精神病、偏执性精神障碍患者中，选择有肇事肇祸危险倾向的1～5级患者139例进行社区干预，并在干预前、接受干预2年时使用Zarit护理者负担量表进行调查与评价。结果干预前调查145人，干预后凋查139人，护理负担量表总分，干预前为（48．69±13．86）分，干预后为（45．56±15．18）分（P〈0．05），其中个人负担分干预前为（35．49±10．06）分，干预后为（33．24±10．29）分（P〈O．05），责任负担干预前为（13．20±4．39）分，干预后为（12．32±5．44）分（P〉0．05）。多元线性回归分析，无家族史者个人负担维度得分、护理负担量表总分干预前后改变值大（P〈0．05）；家庭年收入越多者，责任负担维度得分干预前后改变值大（P〈0．05）。结论实施社区综合干预对改善重性精神病人护理者负担有着积极的作用。

Analysis on Effect of Community Intervention in Burden of Care for Patients with Severe Psychosis, Yuexiu District, Guangzhou City ,20102012

Objective To evaluate the effect of improvement on the burden of care by implementation of community intervention in severe psychotics before and after the intervention,and analyze the influencing factors. Methods A total of 139 patients of schizophrenia,mood disorder, schizoaffective psychosis and paranoid disorder from five sub-districts se- lected by random in Yuexiu district were selected as the objects of study. They were judged as violent grading standards 1- 5 levels. The patients were followed up and carried on the scores of Zarit nursing burden scale survey respectively before being intervened and over 2 years. Results There were 145 patients before intervention,and 139 after intervention. The total scores of Zarit nursing burden scale were 48.69± 13.86 before intervention and 45.56± 15.18 after intervention（ P 〈0.05）. Individual burden scale scores were 35.49±10.06 before intervention and 33.24±10.29 after intervention（ P 〈 0.05）. Responsible burden scale scores were 13.20± 4.39 before intervention and 12.32±5.44 after intervention （ P 〉 0.05 ）. By multiple linear regression analysis, among those with no family history, the scores in personal burden and burden of care before and after intervention, the change values of scale scores were larger （ P 〈0.05） ;among those with more an nual household income,the change values of burden scores were larger before and after intervention （ P 〈0.05）. Con- clusion Implementation of community intervention plays a positive role in improving the patients＂ burden of care with se- vere psychosis.