CAJ | 학술논문

目的：探究精神分裂症患者实施以家庭为中心的干预方案对其病情预后及照顾者情绪状态的影响，并为这类患者群体提供优质医疗服务积累经验。方法选取我院精神科于2010年5月～2011年12月“痊愈出院”的精神分裂症患者160例，设为对照组，出院后给予抗精神病药物长期维持治疗且做好院前健康宣教。选取我院精神科于2012年1月～2013年8月“痊愈出院”的精神分裂症患者180例，设为研究组，在对照组基础上开展以家庭为中心的干预措施。并对两组患者开展为期1年的追踪随访，并记录两组患者干预期间临床症状改善程度、社会功能恢复情况、用药依从性及疾病复发率，同时比较两组家庭照护者的心理状况。结果两组患者在出院当天BPRS及SDSS值差异无统计学意义（P＞0.05）；研究组患者出院后第3、6、12个月末的BPRS及SDSS评分均低于对照组（P＜0.05）。两组家庭照护者在出院当天的SCL-90评分差异无统计学意义（P＞0.05）；干预后12个月末，研究组家庭照护者的各项SCL-90评分均低于对照组（P＜0.05)。干预后第12个月末，研究组服药依从性高于对照组（P＜0.05），病情复发率低于对照组（P＜0.05）。结论以家庭为中心的干预方案应用于精神分裂症患者，可有效改善患者预后，并能缓解照护者负性情绪，取得较为可观的临床成效。
목적：탐구정신분렬증환자실시이가정위중심적간예방안대기병정예후급조고자정서상태적영향，병위저류환자군체제공우질의료복무적루경험。방법선취아원정신과우2010년5월～2011년12월“전유출원”적정신분렬증환자160례，설위대조조，출원후급여항정신병약물장기유지치료차주호원전건강선교。선취아원정신과우2012년1월～2013년8월“전유출원”적정신분렬증환자180례，설위연구조，재대조조기출상개전이가정위중심적간예조시。병대량조환자개전위기1년적추종수방，병기록량조환자간예기간림상증상개선정도、사회공능회복정황、용약의종성급질병복발솔，동시비교량조가정조호자적심리상황。결과량조환자재출원당천BPRS급SDSS치차이무통계학의의（P＞0.05）；연구조환자출원후제3、6、12개월말적BPRS급SDSS평분균저우대조조（P＜0.05）。량조가정조호자재출원당천적SCL-90평분차이무통계학의의（P＞0.05）；간예후12개월말，연구조가정조호자적각항SCL-90평분균저우대조조（P＜0.05)。간예후제12개월말，연구조복약의종성고우대조조（P＜0.05），병정복발솔저우대조조（P＜0.05）。결론이가정위중심적간예방안응용우정신분렬증환자，가유효개선환자예후，병능완해조호자부성정서，취득교위가관적림상성효。
ObjectiveTo explore the influence of family-centered intervention on prognosis and psychological condition for schizophrenic patients and collect experience of providing high-quality medical service for this group of patients. Methods 160 patients with Schizophrenia who were recovered from the department of psychiatry in our hospital from May 2010 to December 2011 were selected as control group, and they were given long-term antipsychotics and after discharging from hospital and health education before leaving hospital. 180 patients with schizophrenia who were recovered from the department of psychiatry in our hospital from January 2012 to August 2013 were selected as research group, which was further treated with family-centered intervention. Improvement of clinical symptom, social function, medication compliance and recurrence rate of two groups were recorded after one year's follow-up visit, and the psychological conditions of family tenders of two groups were compared.Results The differences in BPRS and SDSS between two groups were not statistically significant on the day of discharge (P>0.05). BPRS and SDSS scores of research group at the end of third month, sixth month and twelfth month after discharging were all lower than those of control group (P<0.05). The difference in SCL-90 score of family tenders of two groups on the day of discharge was not statistically significant (P>0.05). The SCL-90 score of family tender of research group after twelve months' intervention was lower than that of control group (P<0.05). Medication compliance of research group after twelve months' intervention was higher than that of control group (P<0.05). The recurrence rate of research group was lower than that of control group (P<0.05). Conclusion The application of family centered intervention in schizophrenic patients can improve prognosis and alleviate tenders’ negative emotion, which can achieve great clinical effect.