家庭医生责任制管理对社区精神疾病患者康复的效果研究

宋德宽　张永生　黄成

【摘要】 目的：研究并探討家庭医生制服务在社区精神分裂症患者康复中的应用效果。方法：于2011年3月-2013年12月采用整群抽样法在本社区内选取100例慢性精神分裂症患者作为研究对象，采取计算机单盲分组法分为对照组和观察组，各50例。对照组采取常规社区管理，观察组在常规社区管理基础上实施家庭医生制服务，比较两组的阳性和阴性症状评分（PANSS）、精神残疾评分（WHO-DAS Ⅱ）、社会功能缺陷筛选量表（SDSS）评分、自知力与治疗态度量表（ITAQ）评分、康复状态量表（MRSS）评分、生活质量评分以及复发情况。结果：两组干预6个月后的PANSS评分、WHO-DAS Ⅱ评分、SDSS评分、MRSS评分均明显低于干预前（P<0.05），ITAQ评分明显高于干预前（P<0.05），而观察组干预后的各项指标均明显优于对照组（P<0.05）。观察组的生活质量评分均高于对照组（P<0.05），复发率低于对照组（P<0.05）。结论：在精神分裂症患者社区管理中采用家庭医生制服务，可有效缓解精神障碍，改善社会功能和生活质量，还可减少复发，有利于促进精神分裂症患者走向社会。

【关键词】 精神分裂症； 社区管理； 家庭医生制服务

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.