个案管理培训对乡村精神卫生服务能力的影响

发布时间：2018-03-17 05:01

本文选题：病例管理　切入点：精神分裂症　出处：《中国全科医学》2014年22期 　论文类型：期刊论文

【摘要】：目的探讨个案管理培训对乡村精神卫生服务能力的影响。方法于2011年4月—2012年4月,采用简单随机抽样法选取新乡县合河乡、大召营乡经过省级全科医师培训并取得全科医师资格的41名乡村医生,选取由乡卫生院随访管理的精神分裂症患者82例及其相应的患者家属116名。采用随机数字表法将乡村医生、精神分裂症患者分为研究组和对照组,其中乡村医生研究组21名,对照组20名;精神分裂症患者研究组42例,对照组40例。患者家属根据患者分组情况相应的分为研究组56名和对照组60名。两组乡村医生均进行基本培训,研究组在此基础上进行个案管理培训;两组患者均进行精神疾病健康教育,研究组在此基础上进行综合干预;两组患者家属均进行家属护理教育,研究组在此基础上参与针对患者制定的个案管理计划。采取病例测验问卷评定两组医生对精神疾病的识别能力;于干预前后对两组患者进行社会功能缺陷筛选量表(SDSS)评分;采用精神卫生与心理保健知识问卷对两组患者家属进行精神卫生与心理保健知识知晓率调查。结果研究组精神分裂症复发率为2.4%(1/42),低于对照组的7.5%(3/40)(χ2=4.046,P0.05)。研究组医生诊断阳性症状为主的精神分裂症、躁狂症及阴性症状为主的精神分裂症正确率高于对照组(P0.05);对阳性症状为主的精神分裂症、躁狂症及阴性症状为主的精神分裂症的症状识别率高于对照组(P0.05);提出的阳性症状为主的精神分裂症、躁狂症及阴性症状为主的精神分裂症治疗建议正确率高于对照组(P0.05)。干预后,研究组患者职业工作、家庭内活动、自理能力、兴趣和关心评分均低于对照组(P0.05)。不同文化程度和不同年龄患者SDSS评分比较,差异有统计学意义(P0.05)。研究组患者家属精神卫生基本知识和精神卫生纪念日回答正确率分别为76.8%(43/56)、17.8%(10/56),分别高于对照组的38.3%(23/60)、8.3%(5/60)(χ2=4.328、4.124,P0.05)。结论个案管理培训对乡村精神卫生综合服务能力的提高、精神分裂症患者社会功能的恢复具有促进作用。
[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.
【作者单位】：新乡医学院第二附属医院防治科;
【基金】：“686”项目:中央支付地方重性精神疾病管理治疗项目
【分类号】：R749

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