社区精神分裂症患者居家生活技能训练对照研究

目的探讨居家生活技能训练对社区精神分裂症患者的康复效果。方法将2013年深圳市光明新区参与精神残疾人服药管理及补贴项目中的74名精神分裂症患者随机分为训练组(37例,其中脱落3例)和对照组(37例,其中脱落1例),训练组持续20周每周3次的居家生活技能训练,对照组仅进行常规随访,两组都维持药物治疗。使用世界卫生组织残疾评定量表第2版中文版(WHO disability sssessment schedule 2.0,WHO-DASⅡ)及简明精神病量表(brief psychiatric rating scale,BPRS)对研究对象干预前后进行心理评定。除脱落病例外,计量资料采用t检验,计数资料采用χ2检验及Fisher精确概率分析,等级资料比较用秩和检验,P0.05为差异有统计学意义。结果训练组的WHO-DASⅡ总分减分值大于对照组(-2.00±1.63、-1.11±1.06,t=-2.714,P0.05),其中生活活动维度(-0.47±0.71、-0.11±0.58,t=-2.328,P0.05)和社会参与维度(-1.24±1.42、-0.67±0.83,t=-2.036,P0.05)减分值大于对照组,其他维度变化值与对照组差异无统计学意义(P0.05);训练组的BPRS中的激活性因子增分值(1.29±1.43、-0.17±2.32,t=3.189,P0.05)大于对照组,BPRS及其他因子变化值与对照组差异无统计学意义(P0.05)。结论居家生活技能训练对社区精神分裂症患者社会功能有改善作用,是有效的社区康复措施。

A controlled study of home living skills training among patients with schizophrenia in community

Objective To explore the efficacy of home living skills training on the rehabilitation Schizophrenics in community. Methods 74 cases of schizophrenia participating the program of medication management and allowance for the mentally disabled in New Guangming district of Shenzhen city were randomly divided into training group（37 eases with 3 dropout cases） and control group（37cases with 1 dropout cases ） in 2013. Training group received home living skills training 3 times per week for 20 consecutive weeks, while control group received regular interview, both group were treated with antipsychotics. WHO - DAS Ⅱ （ WHO disability assessment schedule 2.0） and BPRS （ brief psychiatric rating scale） were used for psychological assessment in both groups. In addition to the dropout cases, measurement data were processed by t - test, count data by Х＆2 test and Fisher exact probability analysis, comparison of ranked data by rank sum test. The result of P 〈 0.05 was considered statistically significant. Results Decreased WHO - DAS Ⅱ score was higher in training group than in control group （ - 2.00 ± 1.63, - 1.11 ± 1.06, t = - 2. 714,P 〈 0.05 ）. Scores of living activity dimension （ - 0.47 ± 0.71 vs - 0.11 ± 0.58, t = - 2. 328, P 〈 0.05 ） and society participation dimension （ - 1.24 ± 1.42 vs - 0.67 ± 0.83, t = - 2. 036 ,P 〈 0.05 ） were higher than those in control group. Scores of other dimension changes in training group showed no statistical difference from those in the controls（ P 〉 0.05 ）. In training group, the increased score of activation factor in BPRS （ 1.29 ± 1.43 vs - 0.17 ± 2.32, t = 3. 189, P 〈 0.05 ） was higher than that in control group, while BPRS and scores of other factors showed no statistically significant difference （ P 〉 0.05 ）. Condusions Home living skills training is an effective means for community rehabilitation, for it can improve social function of patients with schizophrenia.