精神分裂症患者幻听自我管理记录单的设计及应用

doi:10.3761/j.issn.0254-1769.2020.07.014

摘要/Abstract

摘要：

目的探讨精神分裂症患者幻听自我管理记录单的设计及应用效果。方法设计出的精神分裂症患者幻听自我管理记录单由表首、项目及备注3个部分组成。便利选取江苏省某三级甲等精神病医院成年精神科男女病房各2个,按性别采取抛硬币法随机抽出试验组和对照组各2个病房,从每个病房便利抽取2017年1月—2018年12月住院的20例患者,共抽取80例精神分裂症住院患者及其主要照顾者作为研究对象。试验组在对照组干预方法的基础上采用自行设计的精神分裂症幻听患者自我管理记录单,指导患者进行自我管理;对照组接受常规的药物治疗、幻听护理和管理。在干预前、干预后1个月、3个月、6个月时,比较两组的干预效果。结果试验组34例、对照组30例完成研究。干预前阳性和阴性症状量表（Positive and Negative Syndrome,PANSS）（焦虑、紧张、先占观念3个条目）、冲动行为风险评估量表和服药依从性得分比较,差异无统计学意义（P>0.05）,干预后试验组的PANSS（焦虑、紧张、先占观念3个条目）、冲动行为风险评估量表得分低于对照组,服药依从性得分高于对照组,差异有统计学意义（P<0.05）,且随着干预时间的延长,效果逐渐明显（P<0.05）。结论采用幻听自我管理记录单对精神分裂症患者进行管理,有助于患者有效地识别、应对、管理幻听症状,改善幻听对其情绪及行为的影响。

关键词: 精神分裂症, 幻听, 自我管理记录单, 精神病护理

Abstract:

Objective To explore the effect of the design and application of auditory hallucination self-management records for patients with schizophrenia. Methods The auditory hallucination self-management records for schizophrenia patients is composed of three parts: table head, items and remarks. A convenient sampling method was adopted to select two male wards and two female ones from adult psychiatric department in a tertiary psychiatric hospital in Jiangsu Province. The two wards in the experimental group and the control group were taken randomly by flipping a coin based on the gender differences. 20 cases admitted in hospital from January 2017 to December 2018 from each ward were conveniently selected. A total of 80 cases of hospitalized patients with schizophrenia and their main caregivers were selected. The control group received conventional drug therapy,nursing and management of auditory hallucination. On the basis of the intervention in the control group,patients in the experimental group were given the extra of auditory hallucination self-management record sheets to guide patients for self-management. The results and effects of two groups were compared before intervention,at one month,three months,and six months after the intervention. Results 34 patients in the experimental group and 30 patients in the control group completed the study. There were no significant differences in the scales of Positive and Negative Syndrome（PANSS）（anxiety,tension,preemption）,impulsive behavior risk assessment scale and medication adherence rating scale between the two groups before intervention（P>0.05）. The scales of PANSS（anxiety,tension,preemption）,impulsive behavior risk assessment scale and medication adherence scores of the two groups were statistically significant after intervention（P<0.05）. With the extension of the intervention time,the scales of PANSS（anxiety,tension,preemption）and impulsive behavior risk assessment scales of the experimental group were significantly lower than those in the control group,and the medication adherence rating scale was significantly higher than those in the control group. These differences were statistically significant（P<0.05）. Conclusion Management of patients with schizophrenia by auditory hallucination self-management record sheet can effectively identify,cope with and manage auditory hallucinations and alleviate the impact of auditory hallucinations on their mood and behavior.

Key words: Schizophrenia, Auditory Hallucination, Self-Management Record Sheet, Psychiatric Nursing

金全香, 张燕红, 陈兆红, 刘寿娟, 祖凤英, 季金杰, 曹香, 刘富英. 精神分裂症患者幻听自我管理记录单的设计及应用[J]. 中华护理杂志, 2020, 55(7): 1033-1039.

JIN Quanxiang, ZHANG Yanhong, CHEN Zhaohong, LIU Shoujuan, ZU Fengying, JI Jinjie, CAO Xiang, LIU Fuying. Design and application of auditory hallucination self-management records for schizophrenia patients[J]. Chinese Journal of Nursing, 2020, 55(7): 1033-1039.

图/表 4

图1 精神分裂症患者幻听自我管理记录单

表1 两组干预前后阳性和阴性症状量表焦虑、紧张、先占观念3个条目评分比较（分,$\bar{x}$±s）

表2 两组冲动风险评分比较（分,$\bar{x}$±s）

表3 两组服药依从性评分比较（分,$\bar{x}$±s）

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