多部门联动管理模式在严重精神障碍患者延续护理中的应用
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摘要
目的探讨多部门联动管理模式在严重精神障碍患者延续护理中的应用效果。方法选取严重精神障碍患者97例为研究对象,其中对照组52例,干预组45例,对照组实施常规护理,干预组在对照组基础上实施由医院护理部、区精神卫生疾病控制分中心、社区卫生服务中心、街镇居委会、街镇阳光心园组成的联动管理模式,干预结束后比较两组患者规律服药率、病情稳定率、社会功能及延续护理满意度。结果干预后,干预组患者规律服药率、病情稳定率、社会功能及对延续护理的满意度评分均高于对照组(P<0.01或P<0.05)。结论多部门联动管理模式能有效提高患者的服药依从性,促进患者病情稳定,改善其社会功能,切实提高患者对延续护理的满意度。
Objective To explore the application effect of multi-sector linkage management mode in continuous nursing care of patients with severe mental disorders.Methods Selected 97 patients with severe mental disorders as the research object,52 cases in control group,while the other 45 in intervention group.The control group received routine nursing,and the intervention group were given extra linkage management implemented by nursing department,the district CDC sub-center of mental health,community health service centers,street and town residents' committees,sunshine mind garden program of street communities.Compared two groups of patients after the intervention treatment,in regards to patients' regular medication,stability,social function and nursing satisfaction.Results The intervention group's conventional medication rate,disease stability rate,social function and continuous nursing satisfaction score were higher than those of the control group(P<0.01 or P<0.05).Conclusion Multi-sector linkage management model can effectively improve patient medication compliance,promote stability of disease,improve social function,and effectively improve patient satisfaction with continuous nursing care.
Objective To explore the application effect of multi-sector linkage management mode in continuous nursing care of patients with severe mental disorders.Methods Selected 97 patients with severe mental disorders as the research object,52 cases in control group,while the other 45 in intervention group.The control group received routine nursing,and the intervention group were given extra linkage management implemented by nursing department,the district CDC sub-center of mental health,community health service centers,street and town residents' committees,sunshine mind garden program of street communities.Compared two groups of patients after the intervention treatment,in regards to patients' regular medication,stability,social function and nursing satisfaction.Results The intervention group's conventional medication rate,disease stability rate,social function and continuous nursing satisfaction score were higher than those of the control group(P<0.01 or P<0.05).Conclusion Multi-sector linkage management model can effectively improve patient medication compliance,promote stability of disease,improve social function,and effectively improve patient satisfaction with continuous nursing care.
引文
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[17] 潘志清,陆宾,林卫霞,等.“医院-社区-家庭”一体化干预在社区精神病患者中应用研究[J].现代诊断与治疗,2017,28(3):546-547.
[18] 谭焕君,朱艳清,顾慧英.“医院-社区-家庭”一体化护理改善社区精神病患者生活质量及依从性的效果研究[J].实用临床医药杂志,2015,19(2):11-13.DOI:10.7619/jcmp.201502004.
[19] 刘寿娟.精神病人病情复发与服药依从性的关系及护理对策[J].内蒙古中医药,2010,29(20):141-142.
[20] 原曼,尹安春,梁战华,等.基于信息-动机-行为技巧模型的个体化用药管理方案在帕金森病患者中的应用[J].中国护理管理,2018,18(2):179-184.DOI:10.3969/j.issn.1672-1756.2018.02.009.
[21] 佘生林,易文英,范敏珍,等.精神分裂症稳定期个人与社会功能水平影响因素研究[J].河北医药,2013,35(24):3749-3750.DOI:10.3969/j.issn.1002-7386.2013.24.032
[22] 尹华卿.社区多部门系统干预模式对慢性精神分裂症患者症状、社会功能及生存质量的干预效果研究[J].中国全科医学,2018,21(16):1998-2000.DOI:10.3969/j.issn.1007-9572.2018.16.019.
[23] 邹素芬.精神分裂症患者出院延续护理的需求和干预措施[J].中国卫生标准管理,2016,7(36):186-188.DOI:10.3969/j.issn.1674-9316.2016.36.109.
[24] 黎敏,朱晓丹,赵雅静,等.精神分裂症患者对延续护理需求的调查分析[J].广东医学,2018,39(9):1402-1404.
[25] 王超,韩芳,黎丽燕.延续性护理在精神科的应用现状与进展[J].齐鲁护理杂志,2018,24(1):100-103.DOI:10.3969/j.issn.1006-7256.2018.01.041.
[2] 中华人民共和国国家卫生和计划生育委员会.重性精神疾病管理治疗工作规范(2012年版)[EB/OL].(2012-04-12)[2018-06-08].http://www.nhfpe.gov.en/jkj/s5888/201204/16ebc4949bfe5041979eb31070fc3ae5bf.shtml,2012.
[3] 石佳佳.涪陵区肇事肇祸精神患者行政管控问题调研报告[D].重庆:西南政法大学,2014.
[4] 骆名进,孙晓花,宋海东,等.杭州市社区精神卫生资源投入现况分析[J].浙江预防医学,2015,27(1):103-105.
[5] 姚付新,杨甫德,李娟,等.中国2004年以来精神卫生服务的发展与问题[J].中国心理卫生杂志,2015,29(5):331-335.DOI:10.3969/j.issn.1000-6729.2015.05.006.
[6] 郑宏,陈思路,牛昕,等.社区综合服务团队对精神分裂症患者家庭的干预效果分析[J].中国全科医学,2013,16(1):90-92.DOI:10.3969/j.issn.1007-9572.2013.01.028.
[7] LIBERMAN R P,MUESER K T,WALLACE C J.Social skills training for schizophrenic individuals at risk for relapse [J].The American Journal of Psychiatry,1986,143(4):523-526.
[8] 姜雅琴,蔡军,张伟波,等.程式化技能训练对社区精神分裂症患者康复效果的1年随访[J].临床精神医学杂志,2015,25(5):312-313.
[9] 王勋,马宁,王立英,等.2014年全国严重精神障碍患者管理信息分析[J].中华精神科杂志,2016,49(3):182-184.DOI:10.3760/cma.j.issn.1006-7884.2016.03.12.
[10] 张明园.精神分裂症的复发及其评估[J].中华精神科杂志,2012,45(1):4-6.DOI:10.3760/cma.j.issn.1006-7884.2012.01.003.
[11] 张明园,何燕玲.精神科量表评定手册[M].长沙:湖南科学技术出版社,2015:311-313.
[12] 曾秀丽,陆秀萍,周爱花,等.出院精神分裂症患者服药依从性影响因素分析[J].护理研究,2016,30(6B):2138-2139.DOI:10.3969/j.issn.1009-6493.2016.17.029.
[13] 沈渔邨.精神病学[M].第5版.北京:人民卫生出版社,2010:995-1001.
[14] SHAKEEL M,KHESS C R J,SREERAJ V S,et al.Medication adherence in schizophrenia:a hospital based cross sectional study of family related factors[J].Journal of Psychosocial Rehabilitation & Mental Health,2017(5):1-5.
[15] WANG X,ZHANG W,MA N,et al.Adherence to antipsychotic medication by community-based patients with schizophrenia in China:a cross-sectional study[J].Psychiatric Services,2016,67(4):431-433.
[16] 胡康勇,叶海标,陈宏爱.医院-社区-家庭一体化模式在严重精神障碍患者管理中的应用[J].海南医学,2018,20(10):1389-1390.DOI:10.3969/j.issn.1003-6350.2018.10.017.
[17] 潘志清,陆宾,林卫霞,等.“医院-社区-家庭”一体化干预在社区精神病患者中应用研究[J].现代诊断与治疗,2017,28(3):546-547.
[18] 谭焕君,朱艳清,顾慧英.“医院-社区-家庭”一体化护理改善社区精神病患者生活质量及依从性的效果研究[J].实用临床医药杂志,2015,19(2):11-13.DOI:10.7619/jcmp.201502004.
[19] 刘寿娟.精神病人病情复发与服药依从性的关系及护理对策[J].内蒙古中医药,2010,29(20):141-142.
[20] 原曼,尹安春,梁战华,等.基于信息-动机-行为技巧模型的个体化用药管理方案在帕金森病患者中的应用[J].中国护理管理,2018,18(2):179-184.DOI:10.3969/j.issn.1672-1756.2018.02.009.
[21] 佘生林,易文英,范敏珍,等.精神分裂症稳定期个人与社会功能水平影响因素研究[J].河北医药,2013,35(24):3749-3750.DOI:10.3969/j.issn.1002-7386.2013.24.032
[22] 尹华卿.社区多部门系统干预模式对慢性精神分裂症患者症状、社会功能及生存质量的干预效果研究[J].中国全科医学,2018,21(16):1998-2000.DOI:10.3969/j.issn.1007-9572.2018.16.019.
[23] 邹素芬.精神分裂症患者出院延续护理的需求和干预措施[J].中国卫生标准管理,2016,7(36):186-188.DOI:10.3969/j.issn.1674-9316.2016.36.109.
[24] 黎敏,朱晓丹,赵雅静,等.精神分裂症患者对延续护理需求的调查分析[J].广东医学,2018,39(9):1402-1404.
[25] 王超,韩芳,黎丽燕.延续性护理在精神科的应用现状与进展[J].齐鲁护理杂志,2018,24(1):100-103.DOI:10.3969/j.issn.1006-7256.2018.01.041.