CAJ | 학술논문

目的：探讨社区个案管理对佛山市顺德区有肇事肇祸倾向的重性精神疾病患者社会功能、生活质量和家庭负担的影响。方法：将有肇事肇祸倾向的重性精神疾病患者分成干预组和对照组，对干预组实施个案管理模式，而对照组仅维持原来的社区随访服务。用简明精神病量表（BPRS）、社会功能缺陷筛查量表（SDSS）、Morning Side 康复状态量表（MRSS）、生活质量量表和家庭负担会谈量表（FIS）评定两组患者的精神症状、社会功能、生活质量和家庭负担，并计算两组患者的肇事肇祸率。结果：在干预12个月后，干预组 BPRS 评分[（32.51±4.03）和（34.18±4.46）]、SDSS 评分[（7.51±2.90）和（7.99±4.16）]、MRSS 评分[（56.09±20.61）和（58.74±22.30）]和 FIS 量表评分[（35.20±10.31）和（37.28±14.24）]显著低于对照组（P <0.05或 P <0.01），而干预组生活质量量表评分（13.32±4.75）显著高于对照组[（12.58±4.97）（P <0.05）]；干预组的肇事肇祸率（12.6%）显著低于对照组（18.2%， P <0.05）。结论：对有肇事肇祸倾向的重性精神疾病患者实施个案管理，能有效改善患者的精神症状，降低肇事肇祸率，改善社会功能和生活质量，减轻患者的家庭负担。
목적：탐토사구개안관리대불산시순덕구유조사조화경향적중성정신질병환자사회공능、생활질량화가정부담적영향。방법：장유조사조화경향적중성정신질병환자분성간예조화대조조，대간예조실시개안관리모식，이대조조부유지원래적사구수방복무。용간명정신병량표（BPRS）、사회공능결함사사량표（SDSS）、Morning Side 강복상태량표（MRSS）、생활질량량표화가정부담회담량표（FIS）평정량조환자적정신증상、사회공능、생활질량화가정부담，병계산량조환자적조사조화솔。결과：재간예12개월후，간예조 BPRS 평분[（32.51±4.03）화（34.18±4.46）]、SDSS 평분[（7.51±2.90）화（7.99±4.16）]、MRSS 평분[（56.09±20.61）화（58.74±22.30）]화 FIS 량표평분[（35.20±10.31）화（37.28±14.24）]현저저우대조조（P <0.05혹 P <0.01），이간예조생활질량량표평분（13.32±4.75）현저고우대조조[（12.58±4.97）（P <0.05）]；간예조적조사조화솔（12.6%）현저저우대조조（18.2%， P <0.05）。결론：대유조사조화경향적중성정신질병환자실시개안관리，능유효개선환자적정신증상，강저조사조화솔，개선사회공능화생활질량，감경환자적가정부담。
Objective:To explore the efficacy of community case management on social function,life quality and family burden in severe psychosis patients with trouble-making inclination in Shunde district of Fos-han city. Method:The severe psychosis patients with trouble-making inclination were assigned into interven-tion group and control group. The intervention group received case managements for 1 year,while the control group maintained the original community serve. The psychiatric symptom,social function,life quality and family burden of all patients were evaluated with brief psychiatric rating scale( BPRS),social disability screening schedule(SDSS),morning side rehabilitation status scale(MRSS)quality of life scale and burden on the family of interview schedule(FIS). Results:At the end of one year,the scores of BPRS[(32. 51 ±4. 03)vs(34. 18 ± 4. 46)],SDSS[(7. 51 ± 2. 90)vs(7. 99 ± 4. 16)],MRSS[(56. 09 ± 20. 61)vs(58. 74 ± 22. 30)]and FIS [(35. 20 ± 10. 31)vs(37. 28 ± 14. 24)]in intervention group were obviously less than those in control group (P < 0. 05 or P < 0. 01),while the score of quality of life scale(13. 32 ± 4. 75)was obviously higher than that in control group[(12. 58 ± 4. 97),(P < 0. 05)]. The rate of causing trouble in intervention group(12. 6% ) was obviously lower than that of control group(18. 2% ,P < 0. 05). Conclusion:Case management contrib-utes to the reduction of psychiatric symptoms,causing trouble rate and family burden,and to the improvement of social function and life quality for severe psychosis patients with trouble-making inclination.