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主动式社区干预对精神分裂症患者生活质量的作用及其影响因素
张伟波朱红霞王彦凤朱益周卿蔡军
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摘要:
目的 探究该社区干预模式对社区精神分裂症患者生活质量的影响。方法 选择215例登 记在册的稳定期社区精神分裂症患者,采用随机数字表法分为干预组和对照组。干预组接受主动式社 区干预;对照组接受常规社区精神卫生服务,干预12 个月后随访12 个月。在入组时、入组6 个月、12 个 月以及24 个月时分别对干预组和对照组进行精神分裂症患者生活质量量表(SQLS)评估。结果 SQLS 的心理社会分量表存在显著的组别主效应(F=7.687,P< 0.01),干预组明显低于对照组(P < 0.05)。随 着时间增加,各分量表分呈下降趋势(P< 0.05)。心理社会、动力/ 精力两个分量表存在组别和干预时间 的交互作用(F 分别为3.049、16.257,均P< 0.05)。生活质量总评分变化的广义估计方程分析显示,主 动式社区干预及其时间效应、住院次数和危险行为次数是影响因素。干预组平均比对照组低7.509 分, 且差异有统计学意义(χ2=14.533,P< 0.01);干预组存在时间效应,SQLS 评分随时间而改变,而对照组 则无时间效应;住院次数每增加一次,SQLS评分则平均增加1.930 分(χ2=13.003,P< 0.01);危险行为发 生次数每增加一次,SQLS评分则平均增加4.448 分(χ2=12.386,P< 0.01)。结论 对社区精神分裂症患 者进行主动式社区干预,可以改善其生活质量。
关键词:  精神分裂症  生活质量  主动式社区干预
DOI:10.3969/j.issn.1009-6574.2019.04.007
基金项目:上海市卫生计生系统重要薄弱学科建设计划(2015ZB0405),上海市卫生和计划生育委员 会科研课题(20164Y0100),上海市公共卫生体系建设三年行动计划(GWIV-6)
Effects of assertive community treatment on the quality of life in schizophrenia patients and itsinfluence factor
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Abstract:
Objectives To explore the effects of assertive community treatment on the quality of life in schizophrenia patients and its influencing factors. Methods A total of 215 registered stable schizophrenia patients in community were recruited and divided into intervention group and control group by random number table. The intervention group received assertive community treatment, while the control group received routine community mental health services. After 12 months of intervention, the patients were followed up for 12 months. The intervention group and the control group were assessed with the Schizophrenia Quality of Life Scale( SQLS) at the time of admission, 6 months, 12 months and 24 months after admission, respectively. Results There was significant group main effect in psychosocial subscale( F=7.687,P<0.01), and it was lower in the intervention group than in the control group( P<0.05). With the increase of time, the scores of subscales showed a downward trend( P < 0.05). There was interaction between groups and intervention time in psychosocial and motivation/ energy subscales( F=3.049,16.257;P<0.05). Generalized estimation equation analysis of total quality of life score change showed that active community intervention and its time effect, number of hospitalizations and number of risky behaviors were the influencing factors. The total quality of life score of intervention group was 7.509, lower than that of control group, and the difference was statistically significant( χ2=14.533,P< 0.01). The intervention group had time effect, and the SQLS score changed with time, while the control group had no time effect. Every time the number of hospitalizations increased, the average score of SQLS increased by 1.930 points( χ2=13.003, P< 0.01). The average score of SQLS increased by 4.448 points for every increase in the number of dangerous behaviors( χ2=12.386,P < 0.01). Conclusions Assertive Community Treatment can improve the quality of life of schizophrenia
Key words:  Schizophrenia  Quality of life  Assertive community treatment

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