摘要
目的观察社区服药无缝连接管理模式对精神分裂症患者的疗效,为优化精神分裂症社区管理与治疗模式提供参考。方法选择社区管理的精神分裂症患者100名,分为社区服药无缝连接管理组和常规社区管理组(每组各50例)。分别在基线、干预后6个月和干预后12个月行阳性和阴性症状量表(PANSS)、社会功能缺陷筛选量表(SDSS)、自知力与治疗态度问卷测评,重复测量方差分析比较不同时间段两组各量表评分差异。结果两组基线时各量表评分无显著差异。干预组在第6个月PANSS总分、阳性量表总分和阴性量表总分均显著低于对照组(49.30±11.67 vs 61.12±17.48,9.24±3.44 vs 12.72±5.95,14.02±3.78 vs 16.58±6.98);干预组在第12个月PANSS总分、阳性量表总分和阴性量表总分均显著低于对照组(44.68±8.47 vs 57.86±16.08,8.12±2.24 vs 11.26±5.36,12.86±3.25 vs16.24±6.88);重复测量方差分析结果显示:控制了时间效应后,干预措施对PANSS、阳性量表、阴性量表和SDSS量表评分具有显著影响(P<0.05);两组干预后ITAQ量表评分、复发率差异无统计学差异,服药依从性干预组高于对照组(P=0.006)。结论在社区康园工疗站网络完善的地区,实施社区服药无缝连接管理模式对精神分裂症患者的疗效显著优于常规管理。
Objective To investigate the effects of community based integrated medicine management model on patients with schizophrenia,and provide evidence to improve the quality of community based mental health service. Method100 patients was enrolled and allocated into intervention group and general control group(50 for each group). A blanket of instruments include positive and negative symptom scales(PANSS),social function deficit screening scale(SDSS),and self-knowledge and treatment attitude questionnaires(ITAQ)were administrated at baseline,after 6 months and after 12 months. Repeated variance analysis employed to detect the effects at different time. Results There were no significant difference of the scores of instruments assessed at baseline. Those patients in intervention group had significant lower total score of PANSS,positive scale,and negative scale than patients in control group after six months(49.30±11.67 vs 61.12±17.48,9.24±3.44 vs 12.72±5.95,14.02±3.78 vs 16.58±6.98),respectively. Those patients in intervention group had significant lower total score of PANSS,positive scale,and negative scale than patients in control group after twelve months(44.68±8.47 vs 57.86±16.08,8.12±2.24 vs 11.26±5.36,12.86±3.25 vs16.24±6.88),respectively. The repeated variance analysis showed significant reduction of total score of PANSS,positive scale,negative scale,and SDSS in intervention group under controlling of time variable(P<0.05). There were no significant in the ITAQ score and relapse rate,but with higher anti-psychotic medication compliance in intervention group than that in control(P=0.006). Conclusion In the area where the network of community health care facilities is well-developed,the implementation of the seamless connection mode of community medication management is effective and feasible for patients with schizophrenia.
作者
张卫敏
王文菁
何旺有
宋洋
刘伟锋
王婉文
王立
王志忠
ZHANG Weimin;WANG Wenjing;HE Wangyou(Parvyu the third people's hospital of Guangzhou,Guangzhou 510000,China)
出处
《国际精神病学杂志》
2019年第5期850-853,共4页
Journal Of International Psychiatry
基金
广州市番禺区科技计划项目(编号:2014-Z03-4)
