家庭协同护理对首发精神分裂症患者依从性的影响研究
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摘要
目的分析家庭协同护理联合药物自我管理对首发精神分裂症患者依从性的影响。方法将124例首发精神分裂症患者按随机数字表法分为对照组和观察组,对照组采用常规护理,观察组采用家庭协同护理联合药物自我管理;观察12个月,记录自知力与治疗态度问卷(ITAQ)分值、平均用药依从率、阴性和阳性症状量表(PANSS)分值、12个月时精神分裂症复发率。结果 (1)干预6个月、12个月时,观察组ITAQ分值提高且高于同时点的对照组(p<0.05);12个月时ITAQ分值较同组6个月时降低(p<0.05)。(2)干预6个月、12个月时,观察组平均用药依从率显著提高且高于对照组(p<0.05);对照组干预12个月时较6个月时降低(p<0.05)。(3)干预6个月、12个月时,观察组PANSS分值均低于对照组且低于干预前(p<0.05);干预6个月时对照组PANSS分值降低(p<0.05)。(4)观察组观察12个月时的复发率为22.58%,对照组为54.84%,(χ~2=13.49,p=0.0002)。结论家庭协同护理联合药物自我管理能持续改善首发精神分裂症患者自知力及治疗态度,提高远期依从率,缓解症状,减少复发。
Objective To analyze the influence of family cooperative care combined with drug self-management on the treatment compliance of first-episode schizophrenia patients. Methods A total of 124 first-episode schizophrenia patients were divided into the control group and observation group using random number table method. The control group was given routine care, and the observation group was given family cooperative care combined with drug self-management. Insight and Treatment Attitude Questionnaire(ITAQ) score, mean medication compliance rate, Positive and Negative Syndrome Scale(PANSS) score, and recurrence rate at 12 months of intervention were recorded. Results The ITAQ score of the observation group at 6 and 12 months of intervention was higher than that before intervention and that of control group(p<0.05). The ITAQ score at 12 months of intervention was lower than that at 6 months of intervention(p<0.05). At 6 and 12 months of intervention, the average medication compliance rate of the observation group was significantly higher than that of the control group(p<0.05). In the control group, the average medication compliance rate at 12 months of intervention was lower compared with that at 6 months of intervention(p<0.05). The PANSS score of the observation group at 6 and 12 months of intervention was lower than that of control group and also than that before intervention(p<0.05). The recurrence rate was 22.58% in the observation group at 12 months of intervention, 54.84% in the control group(χ~2=13.49,p=0.0002). Conclusion Family cooperative care combined with drug self-management can improve insight and treatment attitude of first-episode schizophrenic patients, improve long-term treatment compliance rate, relieve symptoms and reduce recurrence.
Objective To analyze the influence of family cooperative care combined with drug self-management on the treatment compliance of first-episode schizophrenia patients. Methods A total of 124 first-episode schizophrenia patients were divided into the control group and observation group using random number table method. The control group was given routine care, and the observation group was given family cooperative care combined with drug self-management. Insight and Treatment Attitude Questionnaire(ITAQ) score, mean medication compliance rate, Positive and Negative Syndrome Scale(PANSS) score, and recurrence rate at 12 months of intervention were recorded. Results The ITAQ score of the observation group at 6 and 12 months of intervention was higher than that before intervention and that of control group(p<0.05). The ITAQ score at 12 months of intervention was lower than that at 6 months of intervention(p<0.05). At 6 and 12 months of intervention, the average medication compliance rate of the observation group was significantly higher than that of the control group(p<0.05). In the control group, the average medication compliance rate at 12 months of intervention was lower compared with that at 6 months of intervention(p<0.05). The PANSS score of the observation group at 6 and 12 months of intervention was lower than that of control group and also than that before intervention(p<0.05). The recurrence rate was 22.58% in the observation group at 12 months of intervention, 54.84% in the control group(χ~2=13.49,p=0.0002). Conclusion Family cooperative care combined with drug self-management can improve insight and treatment attitude of first-episode schizophrenic patients, improve long-term treatment compliance rate, relieve symptoms and reduce recurrence.
引文
1邹海欧,李峥,王红星,等.精神分裂症患者自我管理量表的编制[J].中国心理卫生杂志,2014,28(1):51-56.
2 Yang GJ,Murray JD,Repovs G,et al.Altered global brain signal in schizophrenia[J].Proceedings of the National Academy of Sciences,2014,111(20):7438-7443.
3周斌,顾益玮.自我管理培训对慢性精神分裂症社区患者用药依从性的影响:在中国上海的一项单盲随机对照试验[J].上海精神医学,2014,26(6):332-338.
4林建葵,周永梅,潘胜茂,等.精神分裂症患者照顾者精神卫生知识需求调查分析[J].现代临床护理,2015,21(6):11-14.
5练亚芬,章秋萍,傅丽娟.自我管理技能训练对精神分裂症患者生活质量影响的随访研究[J].中国慢性病预防与控制,2015,23(2):126-129.
6郭玮.自我管理训练对首发精神分裂症患者出院后生活质量的影响[J].精神医学杂志,2014,27(1):42-44.
7 Mc Evoy JP,Freter S,Everett G,et al.Insight in schizophrenia:its relationship to acute psychopathology[J].J Nerv Ment Dis,1989,177(1):43-47.
8刘双,李峥,邹海欧,等.社区精神分裂症患者亚群分类研究[J].中华护理杂志,2016,51(3):275-279.
9蒋菊芳,裴建琴,张紫娟,等.延续性自我管理教育对精神分裂症合并糖尿病患者用药依从性与自我效能的效果观察[J].中国实用护理杂志,2017,33(15):1155-1159.
10石贺敏,张云淑,严保平,等.精神分裂症首次发病患者未治期的影响因素分析[J].临床精神医学杂志,2015,21(3):153-155.
11陈玉明,冯辉,庄晓伟,等.精神分裂症患者家属照料负担和生存质量及其相关因素[J].中国心理卫生杂志,2017,31(3):203-207.
12姚建军,吴越,杨雀屏,等.家庭干预对社区精神分裂症患者暴力行为的疗效及家属心理状况的影响[J].中国康复,2016,31(5):327-330.
13 Sun J,Tang Y,Lim KO,et al.Abnormal dynamics of EEGoscillations in schizophrenia patients on multiple time scales[J].IEEE Transactions on Biomedical Engineering,2014,61(6):1756-1764.
14刘浉妍,罗兴伟,赵伟,等.慢性精神分裂症家属照护体验及负担的质性研究[J].中国临床心理学杂志,2015,23(2):262-267.
15龚定宏.认知团体心理治疗干预社区慢性精神分裂症患者家庭照料者疗效[J].中国健康心理学杂志,2017,25(7):984-988.
16樊学文,曾德志,顾桂英.家庭环境和家庭功能与精神分裂症复发的关系[J].实用预防医学,2014,21(12):1519-1521.
17李彦博.精神分裂症患者人文关怀管理的临床效果观察[J].医院管理论坛,2015,32(1):39-41.
2 Yang GJ,Murray JD,Repovs G,et al.Altered global brain signal in schizophrenia[J].Proceedings of the National Academy of Sciences,2014,111(20):7438-7443.
3周斌,顾益玮.自我管理培训对慢性精神分裂症社区患者用药依从性的影响:在中国上海的一项单盲随机对照试验[J].上海精神医学,2014,26(6):332-338.
4林建葵,周永梅,潘胜茂,等.精神分裂症患者照顾者精神卫生知识需求调查分析[J].现代临床护理,2015,21(6):11-14.
5练亚芬,章秋萍,傅丽娟.自我管理技能训练对精神分裂症患者生活质量影响的随访研究[J].中国慢性病预防与控制,2015,23(2):126-129.
6郭玮.自我管理训练对首发精神分裂症患者出院后生活质量的影响[J].精神医学杂志,2014,27(1):42-44.
7 Mc Evoy JP,Freter S,Everett G,et al.Insight in schizophrenia:its relationship to acute psychopathology[J].J Nerv Ment Dis,1989,177(1):43-47.
8刘双,李峥,邹海欧,等.社区精神分裂症患者亚群分类研究[J].中华护理杂志,2016,51(3):275-279.
9蒋菊芳,裴建琴,张紫娟,等.延续性自我管理教育对精神分裂症合并糖尿病患者用药依从性与自我效能的效果观察[J].中国实用护理杂志,2017,33(15):1155-1159.
10石贺敏,张云淑,严保平,等.精神分裂症首次发病患者未治期的影响因素分析[J].临床精神医学杂志,2015,21(3):153-155.
11陈玉明,冯辉,庄晓伟,等.精神分裂症患者家属照料负担和生存质量及其相关因素[J].中国心理卫生杂志,2017,31(3):203-207.
12姚建军,吴越,杨雀屏,等.家庭干预对社区精神分裂症患者暴力行为的疗效及家属心理状况的影响[J].中国康复,2016,31(5):327-330.
13 Sun J,Tang Y,Lim KO,et al.Abnormal dynamics of EEGoscillations in schizophrenia patients on multiple time scales[J].IEEE Transactions on Biomedical Engineering,2014,61(6):1756-1764.
14刘浉妍,罗兴伟,赵伟,等.慢性精神分裂症家属照护体验及负担的质性研究[J].中国临床心理学杂志,2015,23(2):262-267.
15龚定宏.认知团体心理治疗干预社区慢性精神分裂症患者家庭照料者疗效[J].中国健康心理学杂志,2017,25(7):984-988.
16樊学文,曾德志,顾桂英.家庭环境和家庭功能与精神分裂症复发的关系[J].实用预防医学,2014,21(12):1519-1521.
17李彦博.精神分裂症患者人文关怀管理的临床效果观察[J].医院管理论坛,2015,32(1):39-41.