医院-社区-家庭联动模式干预对精神分裂症患者出院康复期的影响研究OA
Impact of Hospital-Community-Family Linkage Model Intervention on Patients with Schizophrenia during the Post-Discharge Rehabilitation Period
目的 探讨医院-社区-家庭联动护理模式对康复期精神分裂症患者出院后 6 个月内非计划再住院率、日常生活能力(activity of daily living scale,ADL)、简明精神病评定量表(brief psychiatric rating scale,BPRS)及社会功能缺陷筛选量表(social disability screening schedule,SDSS)的改善效果.方法 采用随机数字表法进行对照试验,纳入 2022 年 1 月—2023 年 1 月某三级甲等精神病专科医院符合标准的康复期精神分裂症出院患者98 例,随机分为干预组(n=49)和对照组(n=49).对照组接受常规延续护理,包括电话随访、复诊时间提醒等;干预组实施医院-社区-家庭联动干预,包括动态健康管理、社区康复活动及家庭督导等.采用重复测量方差分析的方法比较两组患者不同时间点的康复效果.结果 出院 6 个月后,干预组的非计划再住院率为 6.12%,显著低于对照组(42.86%),组间比较差异具有统计学意义(χ2=18.732,P<0.001).重复测量方差分析显示时间与组别交互效应、时间主效应及组别主效应在 ADL(F=13.753/40.338/24.172,P<0.001),SDSS(F=15.117/25.338/10.612,P<0.001)和BPRS(F=27.289/74.970/70.157,P<0.001)评分中均显著;干预组与对照组在出院6 个月时ADL评分(14.32±1.14,21.77±4.68),SDSS评分(2.98±2.05,7.26±2.88)及BPRS评分(19.30±2.24,33.82±5.59),评分均显著优于对照组(P<0.05).结论 医院-社区-家庭联动护理模式可有效降低康复期精神分裂症患者非计划再住院率,提升日常生活能力.
Objective To explore the effects of a hospital-community-family linkage nursing model on the unplanned readmission rate,Activity of Daily Living Scale(ADL),Brief Psychiatric Rating Scale(BPRS),and Social Disability Screening Schedule(SDSS)scores of patients with convalescent schizophrenia within 6 months after discharge.Methods A randomized controlled trial was conducted using a random number table.Ninety-eight eligible patients with convalescent schizophrenia discharged from a tertiary-grade a psychiatric hospital between January 2022 and January 2023 were enrolled and randomly assigned to an intervention group(n=49)and a control group(n=49).The control group received routine continuous care,including telephone follow-ups and reminders f or re-examinations.The intervention group received hospital-community-family linkage interventions,including dynamic health management,community rehabilitation activities,and family supervision.Repeated measures analysis of variance(ANOVA)was used to compare rehabilitation outcomes at different time points between the two groups.Results At 6 months post-discharge,the unplanned readmission rate was 6.12% in the intervention group,significantly lower than that in the control group(42.86%)(χ2=18.732,P<0.001).Repeated measures ANOVA revealed significant time and group interaction effects,time main effects,and group main effects for:ADL(F=13.753/40.338/24.172,P<0.001),SDSS(F=15.117/25.338/10.612,P<0.001),BPRS(F=27.289/74.970/70.157,P<0.001).At 6 months,the intervention group showed significantly better outcomes than controls in:ADL(14.32±1.14,21.77±4.68;P<0.05),SDSS(2.98±2.05,7.26±2.88;P<0.05),BPRS(19.30±2.24,33.82±5.59;P<0.05).Conclusion The hospital-community-family linkage nursing model can effectively reduce the unplanned readmission rate and improve the daily living ability of patients with convalescent schizophrenia.
谭澍;曾静;马润娟;尹文卅
昆明医科大学附属精神卫生中心护理部,云南 昆明 650032昆明医科大学附属精神卫生中心护理部,云南 昆明 650032昆明医科大学附属精神卫生中心护理部,云南 昆明 650032昆明医科大学附属精神卫生中心护理部,云南 昆明 650032
医药卫生
精神分裂症医院-社区-家庭联动非计划再住院率
SchizophreniaIntegrated hospital-community-family careUnplanned readmission rate
《昆明医科大学学报》 2026 (1)
107-113,7
云南省科技厅基础研究计划项目(202501AY070001-231)云南省教育厅科学研究基金(2025J0266)
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