精神分裂症患者药物处置干预效果探讨
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摘要
目的提高精神分裂症患者服药依从性和药物管理水平。方法将80例住院治疗的稳定期精神分裂症患者随机分为对照组(40例)与干预组(40例)。对照组给予常规治疗护理;干预组在常规治疗护理基础上增加药物处置培训,出院时分发服药盒、服药卡,出院后每周发送短信提醒患者按时服药。结果干预4周后干预组药物管理知识、精神病情阳性症状评分及总分显著优于对照组(均P<0.05),出院3个月后服药依从性显著高于对照组(P<0.01)。结论对稳定期精神分裂症患者实施药物处置培训,可提高其药物自我管理水平和服药依从性,从而改善相关临床症状。
Objective To enhance medication adherence and management ability of patients with schizophrenia. Methods Eighty stable patients with schizophrenia were randomized into a control group and an intervention group of 40, receiving either routine nursing care or a medication management promotion program in which drug storage box and card was distributed at discharge, and text message was sent every week to remind patients to take medicine on time after discharge. Results After 4 weeks of intervention, the intervention group had better medication management knowledge, lower total Positive and Negative Symptoms Scale score and positive symptoms score, and higher medication adherence compared with the control group(P<0.05,P<0.01). Conclusion The medication management promotion program can effectively enhance medication self-management and adherence of patients with stable schizophrenia, thus to alleviate their symptoms.
Objective To enhance medication adherence and management ability of patients with schizophrenia. Methods Eighty stable patients with schizophrenia were randomized into a control group and an intervention group of 40, receiving either routine nursing care or a medication management promotion program in which drug storage box and card was distributed at discharge, and text message was sent every week to remind patients to take medicine on time after discharge. Results After 4 weeks of intervention, the intervention group had better medication management knowledge, lower total Positive and Negative Symptoms Scale score and positive symptoms score, and higher medication adherence compared with the control group(P<0.05,P<0.01). Conclusion The medication management promotion program can effectively enhance medication self-management and adherence of patients with stable schizophrenia, thus to alleviate their symptoms.
引文
[1]中华人民共和国国家卫生和计划生育委员会.关于印发《中国慢性病防治工作规划(2012-2015年)》的通知[EB/OL].(2015-03-13)[2018-03-13].http://www.moh.gov.cn/zhuzhan/wsbmgz/201304/b8de7b7415ca4996b3567e5a09e43300.shtml.
[2]Caseiro O,Pérez-Iglesias R,Mata I,et al.Predicting relapse after a first episode of non-affective psychosis:a three-year follow-up study[J].J Psychiatr Res,2012,46(8):1099-1105.
[3]崔虹,何夏君,丁寒琴,等.个案管理对社区精神分裂症患者服药依从性和生活质量的影响[J].护理学杂志,2014,29(23):77-79.
[4]王正君,周郁秋,杨军,等.精神科护士主导的依从性干预对精神分裂症患者临床结局影响的Meta分析[J].中华护理杂志,2017,52(8):958-966.
[5]何梅,杨冰香,陈晓莉.依从性治疗对精神疾病患者服药依从性及临床效果的系统评价[J].中国循证医学杂志,2016,16(2):183-190.
[6]黄淑仪,顾惠英,陈晶晶,等.药物自我处置训练配合信息化随访对控制精神分裂症患者复发率的价值研究[J].中国医药科学,2018,8(13):213-216.
[7]王向阳,熊云珍,龙洁,等.药物自我处置程式训练对精神分裂症患者服药依从性及社会功能的影响[J].中国医药导报,2017,14(8):123-126.
[8]中华医学会.临床诊疗指南·精神病学分册[M].北京:人民卫生出版社,2004:35,109.
[9]Cleary A,Dowling M.Knowledge and attitudes of mental health professionals in Ireland to the concept of recovery in mental health:aquestionnaire survey[J].J Psychiatr Ment Health Nurs,2009,16(6):539-545.
[10]World Health Organization.WHO quality rights:service standards and quality in mental health care[EB/OL].(2016-10-19)[2018-12-20].http://www.who.int/mental_health/policy/quality rights/infosheet_hrs_day.pdf/.
[11]Hesse K,Klingberg S.Psychosis:cognitive behavioral treatment strategies[J].Psychother Psychosom Med Psychol,2018,68(11):481-494.
[12]何燕玲,张明园.阳性和阴性综合征量表(PANSS)及其应用[J].临床精神医学杂志,1997,7(6):353-355.
[13]崔静怡.精神分裂症患者家属对抗精神病药物管理的现状分析[J].护士进修杂志,2009,24(1):62-63.
[14]Kane J M,Kishimoto T,Corell C U.Non-adherence to medication in patients with psychotic disorders:epidemiology,contributing factors and management strategies[J].World Psychiatry,2013,12(3):216-226.
[15]赖群清,伍业光,张为,等.60例长期住院慢性精神分裂症患者PANSS评定结果报告[J].中国民政医学杂志,2002,14(2):97-113.
[16]耿在香,王艳红,杜爱英,等.群组管理健康教育对住院慢性精神分裂症患者康复及社会功能的影响[J].护理学杂志,2018,33(6):84-86.
[2]Caseiro O,Pérez-Iglesias R,Mata I,et al.Predicting relapse after a first episode of non-affective psychosis:a three-year follow-up study[J].J Psychiatr Res,2012,46(8):1099-1105.
[3]崔虹,何夏君,丁寒琴,等.个案管理对社区精神分裂症患者服药依从性和生活质量的影响[J].护理学杂志,2014,29(23):77-79.
[4]王正君,周郁秋,杨军,等.精神科护士主导的依从性干预对精神分裂症患者临床结局影响的Meta分析[J].中华护理杂志,2017,52(8):958-966.
[5]何梅,杨冰香,陈晓莉.依从性治疗对精神疾病患者服药依从性及临床效果的系统评价[J].中国循证医学杂志,2016,16(2):183-190.
[6]黄淑仪,顾惠英,陈晶晶,等.药物自我处置训练配合信息化随访对控制精神分裂症患者复发率的价值研究[J].中国医药科学,2018,8(13):213-216.
[7]王向阳,熊云珍,龙洁,等.药物自我处置程式训练对精神分裂症患者服药依从性及社会功能的影响[J].中国医药导报,2017,14(8):123-126.
[8]中华医学会.临床诊疗指南·精神病学分册[M].北京:人民卫生出版社,2004:35,109.
[9]Cleary A,Dowling M.Knowledge and attitudes of mental health professionals in Ireland to the concept of recovery in mental health:aquestionnaire survey[J].J Psychiatr Ment Health Nurs,2009,16(6):539-545.
[10]World Health Organization.WHO quality rights:service standards and quality in mental health care[EB/OL].(2016-10-19)[2018-12-20].http://www.who.int/mental_health/policy/quality rights/infosheet_hrs_day.pdf/.
[11]Hesse K,Klingberg S.Psychosis:cognitive behavioral treatment strategies[J].Psychother Psychosom Med Psychol,2018,68(11):481-494.
[12]何燕玲,张明园.阳性和阴性综合征量表(PANSS)及其应用[J].临床精神医学杂志,1997,7(6):353-355.
[13]崔静怡.精神分裂症患者家属对抗精神病药物管理的现状分析[J].护士进修杂志,2009,24(1):62-63.
[14]Kane J M,Kishimoto T,Corell C U.Non-adherence to medication in patients with psychotic disorders:epidemiology,contributing factors and management strategies[J].World Psychiatry,2013,12(3):216-226.
[15]赖群清,伍业光,张为,等.60例长期住院慢性精神分裂症患者PANSS评定结果报告[J].中国民政医学杂志,2002,14(2):97-113.
[16]耿在香,王艳红,杜爱英,等.群组管理健康教育对住院慢性精神分裂症患者康复及社会功能的影响[J].护理学杂志,2018,33(6):84-86.