CAJ | 학술논문

目的探讨支持性就业(SE)服务对精神分裂症患者职业康复的疗效.方法将108例符合入组标准的精神分裂症患者,采用区组随机数字表法分为研究组与对照组.研究组54例,在药物维持治疗基础上接受SE服务；对照组54例,在药物维持治疗基础上只接受一般的门诊和随访服务.采用工作社交技巧评估量表(Wsss)评定患者找寻工作与职业保持相关的社交能力；用阳性与阴性症状量表(PANSS)评定精神症状的严重性,同时在入组后第6个月末时统计2组找到竞争性就业岗位的患者数和平均工作天数.结果 (1)在入组后第6个月末评估时研究组WSSS总分高于对照组,阴性症状因子分低于对照组,均差异有统计学意义(均P＜0.00).同组比较:第6个月末研究组WSSS总分高于基线评估时,PANSS总分与阴性症状因子低于基线评估时,均差异有统计学意义(P＜0.01 ～0.05);第6个月末对照组阴性症状因子也低于基线评估时,差异有统计学意义(P＜0.01).(2)入组后第6个月末时2组就业情况比较:研究组先后有20例(37.03％)找到了竞争性的工作岗位,平均工作天数为(35.11±12.71)d,对照组有6例(11.11％)找到了竞争性的工作岗位,平均工作天数为(20.15 ±8.04)d,两组差异有统计学意义(x2=9.93,P＜0.01；t=2.70,P＜ 0.05).结论 SE服务可以改善精神分裂症患者获得与保持竞争性就业岗位的能力,提高就业率,同时对阴性症状的改善也有一定的疗效.
목적 탐토지지성취업(SE)복무대정신분렬증환자직업강복적료효.방법 장108례부합입조표준적정신분렬증환자,채용구조수궤수자표법분위연구조여대조조.연구조54례,재약물유지치료기출상접수SE복무；대조조54례,재약물유지치료기출상지접수일반적문진화수방복무.채용공작사교기교평고량표(Wsss)평정환자조심공작여직업보지상관적사교능력；용양성여음성증상량표(PANSS)평정정신증상적엄중성,동시재입조후제6개월말시통계2조조도경쟁성취업강위적환자수화평균공작천수.결과 (1)재입조후제6개월말평고시연구조WSSS총분고우대조조,음성증상인자분저우대조조,균차이유통계학의의(균P＜0.00).동조비교:제6개월말연구조WSSS총분고우기선평고시,PANSS총분여음성증상인자저우기선평고시,균차이유통계학의의(P＜0.01 ～0.05);제6개월말대조조음성증상인자야저우기선평고시,차이유통계학의의(P＜0.01).(2)입조후제6개월말시2조취업정황비교:연구조선후유20례(37.03％)조도료경쟁성적공작강위,평균공작천수위(35.11±12.71)d,대조조유6례(11.11％)조도료경쟁성적공작강위,평균공작천수위(20.15 ±8.04)d,량조차이유통계학의의(x2=9.93,P＜0.01；t=2.70,P＜ 0.05).결론 SE복무가이개선정신분렬증환자획득여보지경쟁성취업강위적능력,제고취업솔,동시대음성증상적개선야유일정적료효.
Objective To investigate the effects of supported employment(SE) on the vocational rehabilitation for schizophrenic rehabilitants.Methods 108 schizophrenic rehabilitants with stable conditions were recruited and randomly allocated into the control group and experimental group.Fifty-four cases in the control group received the general outpatient service and follow-up service with drug maintenance therapy and 54 cases in the experimental group received SE with drug maintenance therapy.At the baseline and the end of the sixth month,all of the 108 cases were assessed by the Positive and Negative Syndrome Scale (PANSS) and Work-related Social Skills Scale (WSSS) respectively.The competitive employment rate and average working days of the two groups were evaluated at the end of the sixth month.Results There was no significant difference in the total score of WSSS,and the total score of PANSS and its sub-scores on the Positive Scale,Negative Scale and General Psychopathological Scale betweeu the two groups at the baseline(P＞ 0.05).At the cnd of the sixth months,significant differences (P＜0.01 ～ 0.05) were found in the total score of WSSS,the sub-score of the Negative Scale,the competitive employment rate and the average working days((35.11 ± 12.71) d vs(20.15 ± 8.04) d) between the experimental and control groups.Conclusion SE can increase the employment rate of schizophrenic rehabilitants,improve their abilities to acquire and maintain competitive employment,and meanwhile relieve their negative symptoms.