摘要
目的通过社区精神科医师对患者及其家属进行药物自我处置技能训练,了解患者服药依从性的改善情况。方法对符合入组标准的56例社区精神分裂症患者及其家属分组进行技能训练并布置作业,由家属督促患者完成。培训结束后兼职医师定期上门指导并开通电话咨询服务。研究前后1年分别与社区中50例不经培训的对照组患者进行药物依从性、FIS、PANSS、MRSS、ITAQ评分比较。结果研究前两组服药依从性无显著差异(χ2=0.08,P>0.05);1年后,干预组患者的服药依从性明显好于对照组(χ2=20.72,P<0.001),其中完全依从率较前提高了19.6%,不依从率则降低了7.1%。患者的服药依从性与患者的受教育程度(r=0.233,P<0.05)、发病次数(r=0.401,P<0.01)、住院次数(r=0.451,P<0.01)、自知力(r=-0.241,P<0.05)、PANSS总分(r=0.272,P<0.01)、MRSS总分(r=0.207,P<0.05)显著相关。结论定期对患者及家属进行康复知识教育,从而提高患者的服药依从性,对于稳定病情、降低精神残疾大有裨益。
Objective Through training the patients and their families self-handling skills by the community psychiatrist to understand the improvement of these patients＇ medication compliance.Methods First of all,training the part-time community psychiatrists self-handling drug skills in twelve towns by the community psychiatrist trained by our hospital,and then trained the 56 community patients with schizophrenia and their families in accordance with the standards into the group self-handling drug skills by part-time community psychiatrists in groups,and arranged the tasks that finished by patients under the supervision of their family members.Each group included 3~5 patients with schizophrenia and 3~5 their family members twice a week,every 90~120 minutes,lasted for 2 weeks.When the training finished,part-time physicians provided regular on-site guidance and telephone counseling services.One year before and after the study,We compare the scores of drug compliance,FIS,PANSS,MRSS,ITAQ with 50 communities which were not trained.Results There was no significant difference before study（χ2=0.08,P0.05）;One year later,the patient＇s medication adherence in intervention group was significantly better than that in group which were not trained（χ2=20.72 P 0.001）,which fully comply rate increased over 19.6 percent,non-compliance rate was reduced 7.1 percentage points.The patient＇s medication compliance was significantly relevant with the patients＇ education（r=0.233,P0.05）,disease frequency,（r=0.401,P0.01）frequency of hospitalization（r=0.451,P0.01）,insight（r=-0.241,P0.05）,PANSS total score（r=0.272,P0.01）,MRSS score（r=0.207,P0.05）.Conclusion We should give patients and their families regular rehabilitation knowledge and education,let them recognize the importance and necessity of medication to improve patient medication compliance.It is better for condition stability,reduce mental disability.
出处
《中国健康心理学杂志》
2012年第10期1477-1479,共3页
China Journal of Health Psychology
