上海精神医学
上海精神醫學
상해정신의학
SHANGHAI ARCHIVES OF PSYCHIATRY
2014年
2期
81-87
,共7页
精神分裂症%社区精神卫生服务%自我保健%康复%随机对照试验%盲法评估
精神分裂癥%社區精神衛生服務%自我保健%康複%隨機對照試驗%盲法評估
정신분렬증%사구정신위생복무%자아보건%강복%수궤대조시험%맹법평고
schizophrenia%community mental health services%self-care%rehabilitation%randomized controlled trial%blind assessment
目标：评估自我管理训练对社区精神分裂症成年患者的效果。<br> 方法：总共招募了201例慢性精神分裂症患者（平均病程17.4年），并随机分为自我管理干预组（n=103）和常规治疗对照组（n=98）。自我管理训练包括每周一次小组会议，为期6个月，讨论和模拟基本的自我管理能力，然后进行24个月的每月小组助推会议，社区卫生工作人员回顾患者的自我管理清单。两名对分组单盲的精神科医生评估参与者基线和登记后6个月、30个月的症状和社会功能，采用简明精神病评定量表（BPRS），社会功能缺陷筛选量表（SDSS）和Morningside康复状态量表（MRSS）。总共有194人（干预组99人和对照组95人）完成2.5年的随访。使用末次观察结转法的意向性治疗分析进行分析。
目標：評估自我管理訓練對社區精神分裂癥成年患者的效果。<br> 方法：總共招募瞭201例慢性精神分裂癥患者（平均病程17.4年），併隨機分為自我管理榦預組（n=103）和常規治療對照組（n=98）。自我管理訓練包括每週一次小組會議，為期6箇月，討論和模擬基本的自我管理能力，然後進行24箇月的每月小組助推會議，社區衛生工作人員迴顧患者的自我管理清單。兩名對分組單盲的精神科醫生評估參與者基線和登記後6箇月、30箇月的癥狀和社會功能，採用簡明精神病評定量錶（BPRS），社會功能缺陷篩選量錶（SDSS）和Morningside康複狀態量錶（MRSS）。總共有194人（榦預組99人和對照組95人）完成2.5年的隨訪。使用末次觀察結轉法的意嚮性治療分析進行分析。
목표：평고자아관리훈련대사구정신분렬증성년환자적효과。<br> 방법：총공초모료201례만성정신분렬증환자（평균병정17.4년），병수궤분위자아관리간예조（n=103）화상규치료대조조（n=98）。자아관리훈련포괄매주일차소조회의，위기6개월，토론화모의기본적자아관리능력，연후진행24개월적매월소조조추회의，사구위생공작인원회고환자적자아관리청단。량명대분조단맹적정신과의생평고삼여자기선화등기후6개월、30개월적증상화사회공능，채용간명정신병평정량표（BPRS），사회공능결함사선량표（SDSS）화Morningside강복상태량표（MRSS）。총공유194인（간예조99인화대조조95인）완성2.5년적수방。사용말차관찰결전법적의향성치료분석진행분석。
Aim: Evaluate the effectiveness of self-management training in community-dwelling adults with schizophrenia. <br> Methods:A total of 201 individuals with chronic schizophrenia (mean duraiton of illness of 17.4 years) were recruited and randomized into the self-management interveniton group (n=103) and treatment-as-usual control group (n=98). The self-management training involved weekly group sessions for 6 months in which basic self-management skills were discussed and modelled followed by monthly group booster sessions for 24 months in which a community health worker reviewed patients’ self-management checklist journals. Two psychiatrists who were blind to group assignment evaluated the symptoms and social functioning of participants at baseline and 6 months and 30 months after enrollment using the Brief Psychiatric Rating Scale (BPRS), Social Disability Screening Schedule (SDSS), and Morningside Rehabilitation Status Scale (MRSS). A total of 194 individuals (99 from the interveniton group and 95 from the control group) completed the 2.5-year follow-up. Intention-to-treat analysis with the last observation carried forward method was used for analysis. <br> Results:Compared to the control group, the interveniton group had lower mean scores in the BPRS, SDSS and MRSS at both follow-up points. The scores in the interveniton group conitnued to improve during the maintenance phase of the treatment from 6 months to 30 months atfer enrollment. <br> Conclusion:Self-management training is an effecitve method to improve symptoms and social funcitoning among individuals with chronic schizophrenia living in the community. Atfer six months of weekly training in self-management skills, monthly booster sessions reviewing patients’ daily checklist of illness-related symptoms events are suffcient to maintain the beneifcial effects of the training. Further study of the long-term cost-effecitveness of this method is needed.
