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目的通过家庭签约服务对社区严重精神障碍患者的管理效果进行探讨,以期为社区精神卫生服务实践提供合理依据。方法应用整群随机抽样方法,选取潍坊安丘市1个乡镇卫生院和1个社区卫生服务中心辖区各100例患者为调查对象,用问卷调查法、回顾性分析法及量表评定方法,评估签约服务前后阳性和阴性症状量表(PANSS)评分、Morning Side康复状态量表(MRSS)评分、危险性分级及家属精神卫生知识知晓率4方面的差异性,应用SPSS 19.0统计学软件进行数据分析。结果家庭签约服务2年末、1年末与签约服务前PANSS量表总分明显下降。家庭签约服务2年末、1年末与签约服务前MRSS总分、症状、行为表现因子分及依赖性因子分明显下降。家庭签约服务后1年末、2年末与签约服务前比较,危险性分级差异具有统计学意义(H=240.33,P<0.005)。签约服务后1年末、2年末与签约服务前比较,家属精神卫生知识知晓情况差异具有统计学意义(H=201.021,P<0.005)结论家庭签约服务管理模式有利于稳定患者病情和社会康复,减少患者危险性行为,提高家属精神卫生知识知晓率,是适合我国国情的社区精神卫生服务模式,值得不断完善与全面推广应用。
Objective To discuss the management effect of community severe mental disorder patients through family contract service so as to provide a reasonable basis for community mental health service practice. Methods A cluster random sampling method was used to select 100 township hospitals and 1 community health service center in Weqiu Anqiu City as the research object. The questionnaires, retrospective analysis and scale assessment methods were used to evaluate (PANSS) score, Morning Side Rehabilitation Status Scale (MRSS) score, risk grade and family member’s mental health knowledge awareness rate before and after the signing of the service, using SPSS 19.0 statistical software for data analysis . As a result, the total score of PANSS before the end of 1 year, the end of 1 year and the contract service of family contract service decreased significantly. The MRSS score, symptom, behavior performance factor and dependency factor of family contract service at the end of two years, the end of one year and the contracted service decreased obviously. Family contract service at the end of 1 year, 2 years before signing service compared with the risk of grading difference was statistically significant (H = 240.33, P <0.005). There was significant difference in family members’ knowledge about mental health (H = 201.021, P <0.005) compared with that before signing service at the end of 1 year and 2 years after signing contract service. Conclusion The family contract service management mode is conducive to stabilizing patient’s condition and social rehabilitation, reducing Patients risk behavior, improve mental health awareness of family members, is suitable for China’s national community mental health service model, it is worth constantly improving and comprehensive promotion and application.