職業(yè)康復(fù)個案管理對慢性精神分裂癥患者的臨床應(yīng)用與研究

王莉　朱錦燁　陳春蘭　鐘古華　王桃　梁雪玲

【摘要】 目的：探究職業(yè)康復(fù)個案管理對慢性精神分裂癥患者的臨床應(yīng)用效果。方法：選取2017年6月-2018年7月在本院住院治療的慢性精神分裂癥患者100例。按照隨機數(shù)字表法將其分為研究組及對照組，各50例。對照組采用常規(guī)藥物治療及一般的康復(fù)護理，研究組在對照組的基礎(chǔ)上實施職業(yè)康復(fù)個案管理治療。比較兩組治療前后的精神癥狀（PANSS評分）、護理情況（NOSIE-30評分）、社會功能（SSFPI評分）及日常生活能力（ADL評分）。結(jié)果：治療3、6個月，兩組PANSS各維度評分及總分均低于治療前，且研究組均低于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）;治療3、6個月，兩組NOSIE-30、SSFPI、ADL評分均高于治療前，且研究組均高于對照組，差異均有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論：對慢性精神分裂癥患者進行職業(yè)康復(fù)個案管理治療，能夠顯著改善患者精神癥狀，提高其認(rèn)知能力、社會功能及日常生活能力，對進一步改善患者生活質(zhì)量、減輕家庭負(fù)擔(dān)及幫助患者回歸社會具有重要意義，值得在臨床廣泛推廣應(yīng)用。

【關(guān)鍵詞】 職業(yè)康復(fù)個案管理; 慢性精神分裂癥; 臨床效果

【Abstract】 Objective：To explore the clinical effect of occupational rehabilitation case management on patients with chronic schizophrenia.Method：A total of 100 patients with chronic schizophrenia hospitalized in our hospital from June 2017 to July 2018 were selected.According to the random number table method，they were divided into study group and control group，50 cases in each group.The control group was treated with routine drug therapy and general rehabilitation nursing，while study group was treated with occupational rehabilitation case management on the basis of control group.The psychiatric symptoms（PANSS score），nursing status（NOSIE-30 score），social function（SSFPI score）and activity of daily life（ADL score）before and after treatment between two groups were compared.Result：After treatment 3 and 6 months，the each score of PANSS and total scores in two groups were lower than those of before treatment，and those in study group were lower than those of control group，the differences were statistically significant（P<0.05）.After 3 and 6 months of treatment，the scores of NOSIE-30，SSFPI and ADL in two groups were higher than those of before treatment，and those in study group were higher than those of control group，the differences were statistically significant（P<0.05）.Conclusion：Occupational rehabilitation case management therapy for chronic schizophrenia patients can significantly improve their mental symptoms，cognitive ability，social function and daily living ability，it is of great significance to further improve the quality of life of patients，reduce family burden and help patients return to society，it is worth popularizing and applying widely in clinical practice.

【Key words】 Occupational rehabilitation case management; Chronic schizophrenia; Clinical effect

First-authors address：Jiangmen Third Peoples Hospital，Jiangmen 529000，China

doi：10.3969/j.issn.1674-4985.2019.10.026

精神分裂癥作為一種常見的復(fù)發(fā)率及致殘率很高的慢性重性精神疾病，可導(dǎo)致患者出現(xiàn)社會功能減退、孤僻退縮、缺乏主動性及人際交往能力差等不良行為，嚴(yán)重影響患者的生活質(zhì)量及社會功能，并加重其家庭經(jīng)濟負(fù)擔(dān)。目前常采用抗精神病藥物對該類患者進行治療，但由于該方法起效較慢，且對上述不良行為治療效果并不理想[1]。因此，如何促進患者病情的恢復(fù)，降低其病恥感，提高患者社功能，使患者能夠早日回歸家庭及社會[2-3]，及降低其復(fù)發(fā)率是相關(guān)工作人員研究的重點。為此，本院根據(jù)目前較為先進的精神康復(fù)模式，結(jié)合實際工作內(nèi)容，采用職業(yè)康復(fù)個案管理模式對住院慢性精神分裂癥患者進行系統(tǒng)的護理康復(fù)，以期改善患者生活質(zhì)量及社會功能，提高患者的身心康復(fù)水平，幫助患者回歸社會。為探究其臨床效果，特選取2017年6月-2018年7月在本院進行治療的慢性精神分裂癥患者100例進行對比研究，現(xiàn)報道如下。