社区综合康复对慢性精神分裂症患者的家庭负担及照料者心理健康的对比研究

摘要

目的：：探讨社区综合康复对慢性精神分裂症患者家庭负担及其主要照料者心理健康的影响。方法：将200例患者随机分为4组，每组各50例。因各种原因22例患者在观察期脱落，最后认知行为治疗组患者48例、家庭治疗组患者46例、职业康复组患者40例及对照组患者44例；对所有患者进行干预治疗，共1年；症状自评量表(SCL-90)和家庭负担会谈量表(FBS)进行治疗前后评估。结果：①前3组患者治疗后SCL-90总分及强迫、人际、抑郁、焦虑因子分均低于治疗前(P<0.05)；对照组患者SCL-90躯体化、人际因子分治疗后高于治疗前(P<0.01)；②前3组患者治疗后FBS总分、因子分(经济负担、家庭日常活动、家庭娱乐活动和家庭关系)均低于治疗前(P<0.01)。结论：慢性精神分裂症患者家庭负担与其主要照料者的心理健康密切相关；认知行为治疗、家庭治疗和职业康复均能有效减轻慢性精神分裂症患者的家庭负担，改善其主要照料者的心理健康水平。%Objective:To study effects of community comprehensive rehabilitation on their family burden and main caregivers of patients with chronic schizophrenia. Methods: 178 patients with chronic schizophrenia were randomly assigned to experimental group (cognitive behavioral therapy group, n=48), family therapy group (n=46), vocational rehabilitation intervention group (n=40) and control group (n=44). All the patients received intervention treatment for 1 year and were evaluated with symptom checklist-90 (SCL-90) and family burden scale of diseases (FBS) before and after the treatment. Results: ①The total scores and factor scores ( obsessive symptoms, interpersonal relationship, depression, anxiety) of SCL-90 of the first three groups after the treatment were lower than those before the treatment (P<0. 05); however, the scores of somatization and interpersonal relationship of control group after the treatment were higher than those before the treatment (P<0. 01). ②The total scores and factor scores (economic bur-den, family daily life, family entertainment activities, family relationship) of FBS of the first three groups after the treatment were low-er than those before the treatment (P<0. 01). Conclusions:It is significantly related to the family burden of the patients with chronic schizophrenia and their main caregivers' psychological health. Cognitive behavioral therapy, family therapy and vocational rehabilitation intervention can significantly alleviate the main caregivers' psychological health of the patients chronic schizophrenia and improve their family burden.