摘要
背景精神分裂症作为一种高患病率疾病,其导致的职业功能和社会功能损害给患者家庭及社会带来了沉重的负担。目前,国内多采用医护主导的家长式决策职业培训模式,虽然有助于改善患者的社会功能,但可能影响患者参与治疗的主动性和依从性,因此,亟需探索一种新的干预方法以改善患者的治疗依从性与社会功能。目的探讨共享决策导向的职业培训对住院精神分裂症患者社会功能的影响,以期为患者的康复治疗提供参考。方法连续选取2024年1月—6月在成都市温江区第三人民医院住院的、符合《国际疾病分类(第10版)》(ICD-10)精神分裂症诊断标准的68例患者为研究对象,采用随机数字表法分为研究组和对照组各34例。两组均接受常规康复训练,研究组在此基础上接受为期12周、每周2次、每次2 h的共享决策导向的职业培训。于干预前、干预第4周和12周,采用一般自我效能感量表(GSES)、精神疾病患者病耻感量表(SSMI)、住院精神病患者社会功能评定量表(SSFPI)、住院精神病人康复疗效评定量表(IPROS)进行评定。结果最终共63例患者完成本研究,其中研究组30例、对照组33例。重复测量方差分析结果显示,研究组和对照组GSES、SSMI、SSFPI和IPROS评分的时间效应和交互效应均有统计学意义(F=20.451、16.022;26.193、12.944;23.957、5.023;11.776、3.985,P<0.05或0.01),组别效应均无统计学意义(F=0.188、0.742、1.878、0.474,P均>0.05)。干预第12周,两组GSES、SSMI、SSFPI和IPROS评分比较,差异均有统计学意义(t=2.618、-2.292、2.485、-2.185,P均<0.05)。结论共享决策导向的职业培训可能有助于改善精神分裂症患者的社会功能。
Background As a high prevalence disorder,schizophrenia has caused significant burden to family and society due to the impairment of occupational and social function.Currently,the dominant vocational training model in China follows a paternalistic,clinician-led decision-making approach.Although it improves patients'social function to some extent,it undermines their autonomy and treatment adherence.Therefore,it is urgently necessary to explore a new intervention method to enhance treatment compliance and social function in patients.Objective To explore the impact of shared decision-making oriented vocational training on social function in hospitalized schizophrenia patients,so as to provide references for rehabilitation interventions.Methods A total of 68 patients diagnosed with schizophrenia according to the International Classification of Diseases,tenth edition(ICD-10)criteria were consecutively enrolled from January to June 2024 at The Third People's Hospital of Wenjiang Distric,Chengdu.Participants were randomly allocated into the research group(n=34)and the control group(n=34)using a random number table method.Both groups received routine rehabilitation training,while the research group received shared decision-making oriented vocational training for 12 weeks,2 times a week for 2 hours each time.Before and at the 4th and 12th week of intervention,two groups were evaluated by General Self-Efficacy Scale(GSES),Stigma Scale for Mental Illness(SSMI),Scale of Social function of Psychosis Inpatients(SSFPI)and Inpatient Psychiatric Rehabilitation Outcome Scale(IPROS).Results A total of 63 participants completed the study,with 30 cases in the research group and 33 cases in the control group.Repeated measures ANOVA revealed statistically significant time effects and interaction effects in both groups for GSES,SSMI,SSFPI and IPROS scores(F=20.451,16.022;26.193,12.944;23.957,5.023;11.776,3.985,P<0.05 or 0.01),while no significant group effects were observed(F=0.188,0.742,1.878,0.474,P>0.05).At the 12th week of intervention,there were statistically significant differences in GSES,SSMI,SSFPI and IPROS scores between the two groups.Conclusion Shared decision-making oriented vocational training may help to improve social function in patients with schizophrenia.
作者
江春艳
帅久红
邓鸿远
郑俊华
苟春凤
杨晓莉
童德英
冯浩
黄霞
高茹
Jiang Chunyan;Shuai Jiuhong;Deng Hongyuan;Zheng Junhua;Gou Chunfeng;Yang Xiaoli;Tong Deying;Feng Hao;Huang Xia;Gao Ru(The Third People's Hospital of Wenjiang District,Chengdu,Chengdu 611130,China;Chengdu Wenjiang District People's Hospital,Chengdu 611130,China)
出处
《四川精神卫生》
2025年第3期229-234,共6页
Sichuan Mental Health
基金
2023年成都市医学科研课题立项项目(项目名称:个性化职业技能培训模式对提升住院康复期精神障碍患者自我效能感的研究,项目编号:2023468)。
关键词
精神分裂症
住院患者
共享决策
职业培训
社会功能
Schizophrenia
Inpatients
Shared decision-making
Vocational training
Social function
