摘要
目的探讨家庭医生服务模式在社区抑郁症防治中的应用效果,以总结抑郁症有效的社区防治措施。方法选择2015年1月至2016年8月期间深圳市龙华区中心医院黎光社区健康服务中心管理的68例社区抑郁症患者为研究对象,根据随机数表法将其分为观察组和对照组,每组34例,对照组患者予以常规宣教及医院随访,观察组患者应用家庭医生服务模式,干预时间为6个月。比较两组患者干预前后的汉密顿抑郁量表(HAMD)及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分的变化。结果干预后,观察组患者的HAMD评分为(11.29±2.08)分,明显低于对照组的(13.56±3.62)分,差异具有统计学意义(P<0.05);干预后,观察组患者WHOQOLBREF量表中的生理、心理、社会关系领域评分分别为(18.58±3.19)分、(16.64±3.39)分、(15.74±3.05)分,明显高于对照组的(15.28±2.64)分、(14.09±2.83)分、(13.25±2.47)分,差异均有统计学意义(P<0.05)。结论抑郁症患者在社区管理中应用家庭医生服务模式,可以有效提高患者的临床疗效,改善患者的生活质量。
Objective To explore the application effect of family doctor service model in the prevention and control of community depression, and to summarize effective community prevention and treatment measures for depression. Methods From January 2015 to August 2016, 68 patients with depression in Liguang Community Health Service Center, Shenzhen Longhua District Central Hospital were selected and assigned, according to random number table, into observation group and control group, each with 34 patients. The control group was treated with routine education and hospital follow-up, and the observation group received family doctor service, both for 6 months. The two groups were compared before and after intervention on changes in Hamilton Depression Scale(HAMD) and WHOQOL-BREF score.Results After the intervention, the HAMD score of observation group was(11.29 ± 2.08), significantly lower than(13.56±3.62) in the control group(P<0.05); the physical, psychological and social relations in WHOQOL-BREF scale were(18.58 ± 3.19),(16.64 ± 3.39),(15.74 ± 3.05) in observation group, significantly higher than(15.28 ± 2.64),(14.09 ±2.83),(13.25±2.47) in the control group(P<0.05). Conclusion The application of family doctor service in community management of depression can effectively improve the clinical efficacy and improve the quality of life of the patients.
引文
[1]庄伟强,张芬,周宁.广州市部分社区老年人抑郁症状发生率调查及危险因素的病例对照[J].中国实用医药, 2015, 10(15):286-288.
[2]范荣.抑郁症药物治疗中不同停药方法对复发的影响[J].基层医学论坛, 2017, 21(29):4098-4099.
[3]杨忠,张惠清.不同剂量阿立哌唑联合舍曲林治疗抑郁症86例临床分析[J].海南医学, 2013, 24(16):2357-2359.
[4]陆强,汤义平,陈文斌,等.抑郁症患者生活质量调查[J].浙江医学,2011, 33(6):945-947.
[5]叶爱明,汤义平,孙颖.护理质量常态化管理对抑郁症患者心理、认知功能及生活质量的影响[J].中国现代医生, 2015, 53(28):155-157, 160.
[6]许明智,李文波,贾福军.汉密顿抑郁量表的因素结构研究[J].中国行为医学科学, 2006, 15(3):277-278.
[7] SILVA COURA A, ALVES NOGUEIRA C, ALVES FP, et al. Quality of life of caregivers of octogenarians:a study using the WHOQOLBREF[J]. Invest Educ Enferm, 2015, 33(3):529-538.
[8]秦碧勇,戴立磊,郑艳.认知功能受损、共病数量对老年抑郁症患者生活质量的影响[J].海南医学, 2016, 27(16):2594-2598.
[9]段艳平,陈林,刘艳红,等.伴精神病性特征抑郁症患者自杀未遂的危险因素[J].中国心理卫生杂志, 2013, 27(5):357-361.
[10]欧秋明,邓思灵.米氮平联合草酸艾司西酞普兰片治疗抑郁症的临床疗效及安全性评价[J].中国临床药理学杂志, 2015, 31(13):1252-1254.
[11]石贞仙,闫欣.抑郁症患者管理研究进展[J].中国护理管理, 2016,16(1):5-9.
[12]吴惠娟,赵刚,沈鉴清,等.老年抑郁症患者的社区管理研究[J].医院管理论坛, 2013, 30(6):57-59.
[13] LEMOULT J, KIRCANSKI K, PRASAD G, et al. Negative self-referential processing predicts the recurrence of major depressive episodes[J]. Clin Psychol Sci, 2017, 5(1):174-181
[14]汪志良,王慧,张惠琴.家庭医生制服务的研究与实践[J].中华全科医师杂志, 2013, 12(7):508-509.
[15]邓莉,张平华.家庭医生签约服务在老年慢性疾病健康管理中的应用效果评价[J].现代医药卫生, 2016, 32(15):2400-2401.
[16]宋德宽,张永生,黄成.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[J].中国医学创新, 2017, 14(15):137-140.