消除隔阂计划对社区精神分裂症患者预后及生存质量的影响

孙一颖; 孙喜蓉; 傅伟忠; 秦虹云; 裴瑜; 张洁; 袁杰; 卢瑛

doi:10.19428/j.cnki.sjpm.2018.18379

消除隔阂计划对社区精神分裂症患者预后及生存质量的影响

Elimination of Barriers Initiative for Schizophrenia in community:Its effect study on prognosis and life quality for patients

摘要

摘要:
目的探讨消除隔阂计划(Elimination of Barriers Initiative, EBI)对社区精神分裂症患者自尊心、服药依从性、精神病性症状及生存质量的影响。
方法病例来自浦东新区精神病防治管理系统，按整群随机抽样的方法抽取符合要求的400例患者进行病耻感基线调查，按系统抽样方法从中抽取90例，再按简单随机抽样方法，抽取45例为干预组，另45例为对照组。对干预组患者进行EBI干预，另45例为常规社区精神病康复管理。使用Rosenberg自尊心量表、自知力与认知态度(ITAQ)、汉密尔顿抑郁量表(HAMD)和简明精神病量表(The Brief Psychiatric Rating Scale, BPRS)来评价干预组和对照组患者干预前与干预第6、12和18个月的自尊心、自知力与认知态度、抑郁症状及精神病性症状的得分变化；使用世界卫生组织(WHO)生存质量简明量表(WHO quality of Life-BREF)评价两组患者生存质量的变化。
结果在实施干预后的第6个月、12个月、18个月，干预组患者的HAMD和BPRS得分改善情况优于对照组(均P < 0.05), Rosenberg、ITAQ和生存质量得分提升情况显著高于对照组(均P < 0.05)。
结论建立一支EBI“医院-社区”相结合的精神分裂症康复服务团队实施EBI干预，能有效地改善患者自尊心，服药依从性及精神症状，可较好地改善患者的生存质量。

Abstract:
Objective To discuss the effect of the (Elimination of Barriers Initiative, EBI) on self-esteem, medication compliance, psychiatric symptoms and quality of life of patients with schizophrenia in community.
Methods From Shanghai Pudong mental disease network, by using the cluster sampling and simple random sampling method, according to the inclusion criterion, a total of 400 patients were chosen for the baseline survey.By using systematic sampling, 90 patients selected were divided into two groups of 45 patients:intervention and control.The intervention group was treated by EBI, and the other by general care.Evaluating the score changes of the self-esteem, attitude for treatment, depression symptom and psychiatric symptoms and quality of life at 6 months, 12 months and 18 months after intervention by using the Rosenberg Self-esteem Scale(RSES), the Insight and Treatment Attitude Questionnaire (ITAQ), the Hamilton Depression Scale (HAMD) and the Brief Psychiatric Rating Scale (BPRS).The WHO quality of Life-BREF scale was used to analyze score changes of quality of life between the two groups.
Results The HAMD and BPRS scores in intervention group were significantly lower than those in control group at 6 months, 12 months and 18 months after intervention(P < 0.05);Rosenberg scores, ITAQ scores and quality of life score were higher than those in control group(P < 0.05).
Conclusion To build a " hospital-community" combination schizophrenia rehabilitation service team for implementation of EBI intervention improves patient′s self-esteem, medication compliance, psychiatric symptoms, and quality of life.

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