职业康复个案管理对慢性精神分裂症患者的临床应用与研究

王莉　朱锦烨　陈春兰　钟古华　王桃　梁雪玲

【摘要】 目的：探究職业康复个案管理对慢性精神分裂症患者的临床应用效果。方法：选取2017年6月-2018年7月在本院住院治疗的慢性精神分裂症患者100例。按照随机数字表法将其分为研究组及对照组，各50例。对照组采用常规药物治疗及一般的康复护理，研究组在对照组的基础上实施职业康复个案管理治疗。比较两组治疗前后的精神症状（PANSS评分）、护理情况（NOSIE-30评分）、社会功能（SSFPI评分）及日常生活能力（ADL评分）。结果：治疗3、6个月，两组PANSS各维度评分及总分均低于治疗前，且研究组均低于对照组，差异均有统计学意义（P<0.05）;治疗3、6个月，两组NOSIE-30、SSFPI、ADL评分均高于治疗前，且研究组均高于对照组，差异均有统计学意义（P<0.05）。结论：对慢性精神分裂症患者进行职业康复个案管理治疗，能够显著改善患者精神症状，提高其认知能力、社会功能及日常生活能力，对进一步改善患者生活质量、减轻家庭负担及帮助患者回归社会具有重要意义，值得在临床广泛推广应用。

【关键词】 职业康复个案管理; 慢性精神分裂症; 临床效果

【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

精神分裂症作为一种常见的复发率及致残率很高的慢性重性精神疾病，可导致患者出现社会功能减退、孤僻退缩、缺乏主动性及人际交往能力差等不良行为，严重影响患者的生活质量及社会功能，并加重其家庭经济负担。目前常采用抗精神病药物对该类患者进行治疗，但由于该方法起效较慢，且对上述不良行为治疗效果并不理想[1]。因此，如何促进患者病情的恢复，降低其病耻感，提高患者社功能，使患者能够早日回归家庭及社会[2-3]，及降低其复发率是相关工作人员研究的重点。为此，本院根据目前较为先进的精神康复模式，结合实际工作内容，采用职业康复个案管理模式对住院慢性精神分裂症患者进行系统的护理康复，以期改善患者生活质量及社会功能，提高患者的身心康复水平，帮助患者回归社会。为探究其临床效果，特选取2017年6月-2018年7月在本院进行治疗的慢性精神分裂症患者100例进行对比研究，现报道如下。