本文選題：病例管理　切入點：精神分裂癥　出處：《中國全科醫(yī)學》2014年22期 　論文類型：期刊論文

【摘要】：目的探討個案管理培訓對鄉(xiāng)村精神衛(wèi)生服務(wù)能力的影響。方法于2011年4月—2012年4月,采用簡單隨機抽樣法選取新鄉(xiāng)縣合河鄉(xiāng)、大召營鄉(xiāng)經(jīng)過省級全科醫(yī)師培訓并取得全科醫(yī)師資格的41名鄉(xiāng)村醫(yī)生,選取由鄉(xiāng)衛(wèi)生院隨訪管理的精神分裂癥患者82例及其相應(yīng)的患者家屬116名。采用隨機數(shù)字表法將鄉(xiāng)村醫(yī)生、精神分裂癥患者分為研究組和對照組,其中鄉(xiāng)村醫(yī)生研究組21名,對照組20名;精神分裂癥患者研究組42例,對照組40例�；颊呒覍俑鶕�(jù)患者分組情況相應(yīng)的分為研究組56名和對照組60名。兩組鄉(xiāng)村醫(yī)生均進行基本培訓,研究組在此基礎(chǔ)上進行個案管理培訓;兩組患者均進行精神疾病健康教育,研究組在此基礎(chǔ)上進行綜合干預;兩組患者家屬均進行家屬護理教育,研究組在此基礎(chǔ)上參與針對患者制定的個案管理計劃。采取病例測驗問卷評定兩組醫(yī)生對精神疾病的識別能力;于干預前后對兩組患者進行社會功能缺陷篩選量表(SDSS)評分;采用精神衛(wèi)生與心理保健知識問卷對兩組患者家屬進行精神衛(wèi)生與心理保健知識知曉率調(diào)查。結(jié)果研究組精神分裂癥復發(fā)率為2.4%(1/42),低于對照組的7.5%(3/40)(χ2=4.046,P0.05)。研究組醫(yī)生診斷陽性癥狀為主的精神分裂癥、躁狂癥及陰性癥狀為主的精神分裂癥正確率高于對照組(P0.05);對陽性癥狀為主的精神分裂癥、躁狂癥及陰性癥狀為主的精神分裂癥的癥狀識別率高于對照組(P0.05);提出的陽性癥狀為主的精神分裂癥、躁狂癥及陰性癥狀為主的精神分裂癥治療建議正確率高于對照組(P0.05)。干預后,研究組患者職業(yè)工作、家庭內(nèi)活動、自理能力、興趣和關(guān)心評分均低于對照組(P0.05)。不同文化程度和不同年齡患者SDSS評分比較,差異有統(tǒng)計學意義(P0.05)。研究組患者家屬精神衛(wèi)生基本知識和精神衛(wèi)生紀念日回答正確率分別為76.8%(43/56)、17.8%(10/56),分別高于對照組的38.3%(23/60)、8.3%(5/60)(χ2=4.328、4.124,P0.05)。結(jié)論個案管理培訓對鄉(xiāng)村精神衛(wèi)生綜合服務(wù)能力的提高、精神分裂癥患者社會功能的恢復具有促進作用。
[Abstract]:Objective to explore the effect of case management training on rural mental health service ability. Methods from April 2011 to April 2012, a simple random sampling method was used to select Hehe Township in Xinxiang County. The 41 rural doctors in Dazhaoying Township who have been trained as provincial general practitioners and who have obtained the qualifications of general practitioners, A total of 82 schizophrenic patients and their corresponding family members were selected from rural health centers. The rural doctors and schizophrenia patients were divided into study group and control group with 21 rural doctors in the study group. 20 patients in the control group, 42 patients in the schizophrenia study group and 40 patients in the control group. The family members of the patients were divided into the study group (56 cases) and the control group (60 cases) according to the patients' grouping. The study group conducted case management training on this basis; the two groups of patients were given mental health education, and the study group conducted comprehensive intervention on this basis; the families of the two groups of patients carried out family nursing education. On this basis, the study group participated in the case management plan for patients. A case test questionnaire was used to assess the ability of two groups of doctors to recognize mental illness, and before and after intervention, two groups of patients were evaluated with SDSS. Mental health and mental health knowledge questionnaire were used to investigate the awareness rate of mental health and mental health care knowledge in the families of the two groups. Results the relapse rate of schizophrenia in the study group was 2.44 / 42, which was lower than that in the control group (7.5 / 40) (蠂 ~ 24.046 / P 0.05). The doctor in the study group diagnosed the disease. Positive symptoms of schizophrenia, The correct rate of schizophrenia with mania and negative symptoms was higher than that of control group (P 0.05). The rate of symptom recognition in patients with mania and negative symptoms was higher than that in control group (P 0.05), and the correct rate of suggested treatment for schizophrenia with positive symptoms, mania and negative symptoms was higher than that of control group (P 0.05). The scores of occupational work, family activities, self-care ability, interest and care in the study group were lower than those in the control group (P 0.05). The SDSS scores of patients with different education levels and different ages were compared. The difference was statistically significant (P 0.05). The correct rate of mental health basic knowledge and mental health anniversary in the study group was 76.843 / 56 / 17.810 / 56, respectively, which was higher than that in the control group (38.33 / 60 / 8.33 / 5 / 60) (蠂 ~ (2) 4.3284.124P0.05N). Conclusion case management training can improve the ability of comprehensive service of rural mental health. The recovery of social function in patients with schizophrenia can promote the recovery of social function.
【作者單位】： 新鄉(xiāng)醫(yī)學院第二附屬醫(yī)院防治科;
【基金】：“686”項目:中央支付地方重性精神疾病管理治療項目
【分類號】：R749

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