开放式管理对抑郁症住院患者康复的研究

目的探讨开放式管理模式对抑郁症患者的康复效果。方法将168例抑郁症患者按入院顺序分成观察组和对照组，在常规治疗和护理的基础上对观察组采用开放式管理模式，对照组采用传统的封闭式管理模式。采用汉密尔顿抑郁量表（HAMD）分别评估患者在入院时、住院2周末、住院4周末、住院6周末、出院2周末的评分，以观察疗效；利用护士住院病人观察量表（NOSIE）分别评估患者在入院时、出院时各因子变化，了解社会功能恢复情况。结果（1）两组患者HAMD评分比较，入院时无差异（P〉0．05），第2周末起两组HAMD评分均显著下降（P〈0．01），且观察组评分低于对照组（P〈0．05），出院2周时两组患者评分结果比较，观察组评分低于对照组（P〈0．01）。（2）两组患者在入院时NOSIE各因子分比较无差异（P〉0．05），但出院时，两组患者NOSIE的各因子分比较有差异，其中社会能力、社会兴趣、个人整洁因子评分出院时观察组评分高于对照组（P〈0．01）；激惹、精神病性症表现、退缩、抑郁因子评分出院时观察组低于对照组（P〈0．01）。结论抑郁症住院患者实施开放管理模式减少患者的住院天数，也促进了患者的总体康复。

Research on Rehabilitation Effectiveness of Open-ward Management in Hospitalized Patients with Depression

Objective To investigate the rehabilitation effectiveness of open-ward management for hospitalized patients with depression. Methods According to their hospitalization order, 168 patients with depression were divided into the observation group （83 patients） with open- ward management service and the control group （85 ones） with closed-end management on the basis of routine treatment and care. Hamilton Depression Scale （HAMD） was used to assess the mental condition at the admission, the end of 2＂d week, 4＇h week and 6th week of the hospitalization and the end of 2＂d week after discharge. The Nurses＂ Observation Scale for Inpatient Evaluation （NOSIE） was used to compare the factors at admission and discharge and investigate the rehabilitation effects. Results 1） No difference was found in HAMD score between the two groups at baseline （p〉0.05）; from the 2＂d week of hospitalization, HAMD score of both groups decreased significantly （p〈0.05） and the open-ward group was significantly lower （p〈0.05）; the score was still lower for observation group at the end of 2＂d week after discharge （P〈0.01）. 2） No difference was observed in NOSIE score between the two groups at baseline （p〉0.05）; when discharged from hospital, the score of the open-ward group increased more sharply in the three factors, including social function, social interest and personal cleanliness （p〈0.01） and decreased more significantly in the four factors including irritability, psychotic disorders performance, withdrawals and depression （p〈0.01）. Conclusion Implementation of the ope~-ward management could reduce the length of stay for hospitalized patients with depression and at the same time contribute to the overall rehabilitation of patients.