Intervention effect of family support services in Changning district of Shanghai on family members of patients with severe mental disorders
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摘要:
目的 探讨家属支援服务干预对于提高社区严重精神障碍患者的康复效果和改善家属的心理健康状况及家庭负担的作用。 方法 采取多阶段随机抽样方法，在抽到的2个社区中将符合严重精神障碍诊断标准的患者随机抽取100例患者，随后根据性别、年龄、诊断在其他几个社区中随机匹配100例符合严重精神障碍诊断标准的患者纳入对照组。严格按照患者和家属纳入标准设立对照组和干预组。 结果 200组研究对象患者平均年龄（48.27±12.67）岁，家属平均年龄（63.61±13.19）岁。干预后各时点对照组日常生活能力量表（activity dailyliving scale，ADL）评分均高于干预组（均有P<0.05）。干预后各时点对照组社会功能缺陷表（social disability screening schedule，SDSS）评分均高于干预组（均有P<0.05）。干预后各时点干预组与对照康复状态量表（morningside rehabilitation status scale，MRSS）评分差异均无统计学意义（均有P>0.05）。干预后各时点对照组患者家属心理健康状况症状（精神症状）自评量表（self-reporting inventory，SCL-90）评分均高于干预组（均有P<0.05）。干预后各时点对照组家庭负担量表（family burden scale of diseases，FBS）评分均高于干预组（均有P<0.05）。 结论 本次干预措施确实提高社区严重精神障碍患者康复效果和改善家属心理和家庭负担，应建立一支专业的家属支援服务工作团队。 Abstract:Objective To explore the effect of family support service intervention on improving the rehabilitation of patients with severe mental disorders in community and the mental health status and family burden of family members. Methods Using multi-stage random sampling method, 100 patients who met the diagnostic criteria of severe mental disorders were randomly selected from two communities, and then 100 patients who met the diagnostic criteria of severe mental disorders were randomly matched according to gender, age and diagnosis in other communities into the control group. The control group and intervention group were set up strictly according to the inclusion criteria of patients and their families. Results The average age of the 200 groups was (48.27±12.67) years, and the average age of the family members was (63.61±13.19) years. After intervention, the activity dailyliving scale (ADL) scores of the control group were higher than those of the intervention group at all time points (all P<0.05). After intervention, the social disability screening schedule (SDSS) scores of the control group were higher than those of the intervention group at all time points (all P<0.05). After intervention, there was no significant difference in the morningside rehabilitation status scale (MRSS) score between the intervention group and the control group at all time points (all P>0.05). After intervention, the SCL-90(self-reporting inventory) scores of the mental health of the family members in the control group were higher than those in the intervention group at all times (all P<0.05). After intervention, the family burden scale of diseases (FBS) scores of the control group were higher than those of the intervention group at all time points (all P<0.05). Conclusions The intervention measures did improve the rehabilitation effect of severe mental disorder patients in community and the psychological and family burden of family members. A professional family support service team should be established. -
Key words:
- Family support service /
- Severe mental disorder /
- The patient /
- Family members /
- Intervention
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表 1 干预组与对照组患者的一般人口学资料比较
Table 1. Comparison of general demographic data between intervention group and control group
项目 干预组(n=100) 对照组(n=100) χ2值 P值 性别 0.000 1.000 男 46 46 女 54 54 年龄(岁) 0.024 0.999 ≤30 12 12 31~ 43 42 51~ 42 43 ≥71 3 3 文化程度 6.478 0.262 文盲 2 0 小学 4 3 初中 27 40 中专/高中 53 44 大专 8 5 大学本科 6 8 职业 14.498 0.070 无业 5 0 退休 0 1 工人 1 1 技术人员 1 4 服务人员 9 3 商业人员 2 0 警察/军人 50 48 其他 31 42 职员 1 1 婚姻 0.431 0.934 在婚 34 31 离婚 10 12 丧偶 4 5 未婚 52 52 居住情况 0.096 0.756 非独居 94 95 独居 6 5 年均收入(万元) 1.702 0.427 ≤2 38 30 2.1~ 56 65 ＞5 6 5 精神疾病类别 0.000 1.000 精神分裂症 99 100 双向情感障碍 1 0 患病时间(年) 3.745 0.442 ＜10 12 15 10~ 37 47 20~ 30 21 30~ 16 14 ≥40 5 3 过去一年内住院次数(次) 6.014 0.111 0 85 82 1 9 16 2 2 2 3 4 0 既往肇事史 5.048 0.168 无 93 96 轻度滋事 6 2 肇事 1 0 肇祸 0 2 治疗方式 0.124 0.733 门诊 96 95 住院 4 5 目前病情 0.000 1.000 稳定 100 99 基本稳定 0 1 
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表 2 干预组与对照组患者家属的一般人口学资料比较
Table 2. Comparison of general demographic data of family members of patients in intervention group and control group
项目 干预组(n=100) 对照组(n=100) χ2值 P值 性别 0.501 0.479 男 54 49 女 46 51 年龄(岁) 2.909 0.406 ≤30 3 1 31~ 11 11 51~ 50 60 ≥71 36 28 文化程度 8.231 0.067 文盲 1 2 小学 9 9 初中 28 45 中专/高中 41 37 大专 10 3 大学本科 11 4 职业 4.551 0.715 退休 8 6 工人 2 0 技术人员 4 3 服务人员 3 3 办事员 6 3 商业人员 13 11 无业 3 2 机关企事业人员 61 71 其他 0 1 婚姻 1.331 0.722 在婚 75 81 离婚 4 2 丧偶 17 14 未婚 4 3 年均收入(万元) 3.853 0.146 ≤2 27 19 2.1~ 64 64 ＞5 9 17 与患者关系 5.098 0.277 配偶 27 25 父母 58 50 子女 6 10 兄弟姐妹 9 12 其他近亲 0 3
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表 3 干预组与对照组患者ADL评分比较(x±s)
Table 3. Comparison of ADL scores between intervention group and control group(x±s)
组别 干预前 干预3个月 干预6个月 干预组(n=100) 17.65±4.12 14.21±3.29 11.12±2.24 对照组(n=100) 18.16±6.54 17.71±6.51 16.81±5.91 t值 -0.660 -4.798 -9.003 P值 0.510 ＜0.001 ＜0.001
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表 4 干预组与对照组患者SDSS评分比较(x±s)
Table 4. Comparison of SDSS scores between intervention group and control group(x±s)
组别 干预前 干预3个月 干预6个月 干预组(n=100) 14.46±3.89 11.83±3.52 9.21±3.57 对照组(n=100) 14.56±4.58 14.16±5.22 13.23±4.92 t值 -0.166 -3.701 -6.613 P值 0.868 ＜0.001 ＜0.001
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表 5 干预组与对照组患者MRSS评分比较(x±s)
Table 5. Comparison of MRSS scores between intervention group and control group(x±s)
组别 干预前 干预3个月 干预6个月 干预组(n=100) 38.21±29.34 29.22±20.38 26.42±14.48 对照组(n=100) 31.31±33.70 30.18±21.01 29.49±15.23 t值 1.544 -0.328 -1.461 P值 0.124 0.743 0.146
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表 6 干预组与对照组家属SCL-90评分比较(x±s)
Table 6. Comparison of SCL-90 scores of family members between intervention group and control group(x±s)
组别 干预前 干预3个月 干预6个月 干预组(n=100) 28.12±29.38 20.81±14.92 14.22±9.33 对照组(n=100) 27.01±30.31 26.15±18.13 24.84±17.27 t值 0.263 -2.274 -5.410 P值 0.793 0.024 ＜0.001
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表 7 干预组与对照组家属FBS评分比较(x±s)
Table 7. Comparison of FBS scores between intervention group and control group(x±s)
组别 干预前 干预3个月 干预6个月 干预组(n=100) 13.91±10.01 10.51±6.32 7.82±4.25 对照组(n=100) 12.82±9.64 12.64±8.31 11.95±8.15 t值 0.784 -2.040 -4.493 P值 0.434 0.043 ＜0.001
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