社区严重精神障碍患者动态监护及同伴支持服务模式研究
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摘要
目的探究社区严重精神障碍患者动态监护及同伴支持服务模式(新型管护方案)对患者社区康复和生活质量的影响。方法随机抽取某社区内管理的严重精神障碍患者50例作为研究对象,通过自身对照比较新型管护方案实施前、实施后1年,患者病情控制率和生活质量情况。结果实施前疾病控制率为62.00%,实施新型管护方案1年后病情控制率为80.00%,差异有统计学意义(χ~2=3.934,P<0.05);实施后患者的生理功能(79.0±22.5)分、社会功能(64.2±11.5)分、生理职能(49.5±10.4)分、情感职能(69.5±19.2)分、生命活力(69.1±9.5)分等5个指标得分均高于实施前,差异均有统计学意义(均P<0.05)。此外,患者对监护及同伴支持服务模式总体满意度显著提高,实施前、后分别为70.00%和96.00%,差异有统计学意义(χ~2=11.977,P<0.05)。结论社区严重精神障碍患者的动态监护及同伴支持服务模式(新型管护方案)能有效提升社区管护效果,值得推广应用。
Objective To explore the effect of the pattern of dynamic monitoring and peer support services(new management and care plan) on the rehabilitation and quality of life of community patients with severe mental disorders. Methods Fifty patients with severe mental disorders managed in a community were randomly selected as the study subjects, and a self comparison of the patients' disease control rates and quality of life were made before and one-year after the implementation of the new management and care plan. Results The baseline disease control rate was 62.00%, and the disease control rate one year after implementing the new management and care plan was 80.00%, with a statistically significant difference(χ~2=3.934,P<0.05). Physiological function(79.0±22.5), social function(64.2±11.5), physiological role(49.5±10.4), emotional role(69.5±19.2) and vitality(69.1±9.5)of the patients after implementing the plan were all higher than their baselines, showing statistically significant differences(all P<0.05). In addition, the rate of overall satisfaction with dynamic monitoring and peer support services in the patients was significantly increased, with a statistically significant difference in the satisfaction rates before and after implementing the plan(70.00% vs. 96.00%, χ~2=11.977, P<0.05). Conclusions Implementing dynamic monitoring and peer support services(new management and care plan) in the community patients with severe mental disorders can effectively improve the effect of community management and care, and it is worthy of being promoted and applied.
Objective To explore the effect of the pattern of dynamic monitoring and peer support services(new management and care plan) on the rehabilitation and quality of life of community patients with severe mental disorders. Methods Fifty patients with severe mental disorders managed in a community were randomly selected as the study subjects, and a self comparison of the patients' disease control rates and quality of life were made before and one-year after the implementation of the new management and care plan. Results The baseline disease control rate was 62.00%, and the disease control rate one year after implementing the new management and care plan was 80.00%, with a statistically significant difference(χ~2=3.934,P<0.05). Physiological function(79.0±22.5), social function(64.2±11.5), physiological role(49.5±10.4), emotional role(69.5±19.2) and vitality(69.1±9.5)of the patients after implementing the plan were all higher than their baselines, showing statistically significant differences(all P<0.05). In addition, the rate of overall satisfaction with dynamic monitoring and peer support services in the patients was significantly increased, with a statistically significant difference in the satisfaction rates before and after implementing the plan(70.00% vs. 96.00%, χ~2=11.977, P<0.05). Conclusions Implementing dynamic monitoring and peer support services(new management and care plan) in the community patients with severe mental disorders can effectively improve the effect of community management and care, and it is worthy of being promoted and applied.
引文
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[2] 王天兰.严重精神障碍患者的监护及其管理[J].深圳中西医结合杂志,2014,24(8):162-163.
[3] 张琼婷,陈浩,鞠康,等.上海市长宁区社区精神障碍患者家属监护状况的横断面评估[J].上海精神医学,2015,27(1):18-26.
[4] 骆焕荣,王文军,陈艺军,等.社区严重精神障碍患者的技术管理与指导模式探讨[J].中国初级卫生保健,2015,29(1):41-43.
[5] 汤世明,王晓萍,宫璇,等.湖北省严重精神障碍患者网络管理现状研究[J].中国慢性病预防与控制,2015,23(9):641-645.
[6] Jenkinson C,Stewart-Brown S,Petersen S,et al.Assessment of the SF-36 version 2 in the United Kingdom[J].J Epidemiol Community Health,1999,53(1):46-50.
[7] 刘玲,张枭,王春辉,等.农村中老年高血压患者生活质量及影响因素分析[J].中国公共卫生,2011,27(2):155-157.
[8] 贾丽娜,袁平,王小燕,等.福州市城区老年人生存质量现状及影响因素分析[J].中国公共卫生,2011,27(9):1165-1167.
[9] 王红妹,李鲁,沈毅.中文版SF-36量表用于杭州市区居民生命质量研究[J].中华预防医学杂志,2001,35(6):365-367.
[10] 李鲁,王红妹,沈毅.SF-36健康调查量表中文版的研制及其性能测试[J].中华预防医学杂志,2002,36(2):109-113.
[11] 李鹃,王宏.SF-36量表第二版应用于重庆市区居民生命质量研究的信效度检验[J].第四军医大学学报,2009,30(14):1342-1344.
[12] Wang L,Zhou JC,Yu XQ,et al.Psychosocial rehabilitation training in the treatment of schizophrenia outpatients:a randomized,psychosocial rehabilitation training and monomedication-controlled study [J].Pak J Med Sci,2013,29(2):597-600.
[13] 邱继红,程雪,杨辉,等.程式化社会技能训练模式在精神分裂症患者中的应用效果[J].中国当代医药,2016,23(1):61-63.
[14] 张宴萍,于小月,殷濛濛,等.小组工作在上海郊区精神分裂症患者社区康复中的运用[J].实用预防医学,2018,25(1):90-92.
[15] Boothroyd RI,Fisher EB.Peers for progress:promoting peer support for health around the world [J].Fam Pract,2010,27(Suppl 1):162-168.
[16] Pfeiffer PN,Heisler M,Piette JD,et al.Efficacy of peer support interventions for depression:a meta-analysis [J].Gen Hosp Psychiatry,2011,33(1):29-36.
[17] 新昕,马宁.重性精神疾病同伴支持服务现状[J].中国公共卫生,2014,30(5):572-575.