家庭醫生責任制管理對社區精神疾病患者康復的效果研究

宋德寬　張永生　黃成

【摘要】 目的：研究并探討家庭醫生制服務在社區精神分裂癥患者康復中的應用效果。方法：于2011年3月-2013年12月采用整群抽樣法在本社區內選取100例慢性精神分裂癥患者作為研究對象，采取計算機單盲分組法分為對照組和觀察組，各50例。對照組采取常規社區管理，觀察組在常規社區管理基礎上實施家庭醫生制服務，比較兩組的陽性和陰性癥狀評分（PANSS）、精神殘疾評分（WHO-DAS Ⅱ）、社會功能缺陷篩選量表（SDSS）評分、自知力與治療態度量表（ITAQ）評分、康復狀態量表（MRSS）評分、生活質量評分以及復發情況。結果：兩組干預6個月后的PANSS評分、WHO-DAS Ⅱ評分、SDSS評分、MRSS評分均明顯低于干預前（P<0.05），ITAQ評分明顯高于干預前（P<0.05），而觀察組干預后的各項指標均明顯優于對照組（P<0.05）。觀察組的生活質量評分均高于對照組（P<0.05），復發率低于對照組（P<0.05）。結論：在精神分裂癥患者社區管理中采用家庭醫生制服務，可有效緩解精神障礙，改善社會功能和生活質量，還可減少復發，有利于促進精神分裂癥患者走向社會。

【關鍵詞】 精神分裂癥； 社區管理； 家庭醫生制服務

Study on the Effect of Family Doctor Responsibility System on Rehabilitation of Patients with Mental Disorders in Community/SONG De-kuan，ZHANG Yong-sheng，HUANG Cheng.//Medical Innovation of China，2017，14（15）：137-140

【Abstract】 Objective：To study and explore the effect of family doctor responsibility system on rehabilitation of patients with mental disorders in community.Method：From March 2011 to December 2013，100 chronic schizophrenia patients in the community were selected by the stratified sampling method as the research objects，the patients were divided into the control group and the observation group according to the single blind grouping method，the control group was taken with conventional community management，the observation group was taken with family physician service based on routine community management.The positive and negative symptom score（PANSS），mental disability score（WHO-DAS Ⅱ），social disability screening schedule（SDSS）score，self-knowledge force and treatment attitude questionnaire（ITAQ） score，rehabilitation status scale（MRSS） score，score of life quality and recurrence of two groups were compared.Result：The PANSS score，WHO-DAS Ⅱ score，SDSS score and MRSS score of two groups after the intervention 6 months were significantly lower than those before intervention（P<0.05），the ITAQ score of two groups was significantly higher than that before intervention（P<0.05），and such indicators of the observation group after the intervention were significantly better than those of the control group（P<0.05）.The scores of life quality of the observation group were higher than those of the control group（P<0.05），and the recurrence rate of the observation group was lower than that of the control group（P<0.05）.Conclusion：Using the family doctor service system on the schizophrenia patients in community management can effectively alleviate the mental disorder，improve social function and quality of life and also reduce the recurrence，it is conducive to promoting schizophrenia patients toward society.