人类职能模式康复训练对精神分裂症患者自我效能及病耻感的干预效果

doi:10.3761/j.issn.0254-1769.2022.02.005

摘要/Abstract

摘要：

目的探讨人类职能模式康复训练对康复期精神分裂症患者自我效能及病耻感的干预效果。方法采用方便抽样法,选取2020年8月—2021年3月在江西省赣州市某三级甲等精神专科医院住院的103例康复期精神分裂症患者作为研究对象,随机分为试验组（53例）和对照组（50例）。两组均接受抗精神病药物治疗及常规护理,在此基础上,试验组进行人类职能模式康复训练,每周5次,共8周,对照组进行常规康复训练。两组干预前后采用一般自我效能感量表和精神疾病患者病耻感量表中文版评价干预效果。结果试验组一般自我效能感量表干预前得分为（15.46±2.74）分,干预后得分为（17.92±2.42）分,高于干预前;干预前精神疾病患者病耻感量表中文版总分为（52.12±7.53）分、歧视分量表得分为（21.36±6.83）分、病情掩饰分量表得分为（17.28±4.45）分、积极效应分量表得分为（13.48±3.81）分,干预后精神疾病患者病耻感量表中文版总分为（41.66±4.95）分、歧视分量表得分为（16.84±4.02）分、病情掩饰分量表得分为（14.18±2.75）分、积极效应分量表得分为（10.64±2.38）分,均低于干预前,差异均有统计学意义（P<0.001）。对照组一般自我效能感量表得分、病耻感总分、歧视分量表、病情掩饰分量表、积极效应分量表得分干预前后比较,差异均无统计学意义（P>0.05）。干预后试验组一般自我效能感量表得分高于对照组,精神疾病患者病耻感量表中文版总分及各维度得分低于对照组,差异有统计学意义（P<0.001）。结论人类职能模式的康复训练能够有效降低患者的病耻感水平,提高自我效能感。

关键词: 人类职能模式, 精神分裂症, 自我效能, 病耻感, 康复护理, 精神病护理学

Abstract:

Objective To explore the intervention effects of rehabilitation training of mode of human occupation （MOHO） on self-efficacy and stigma of convalescent schizophrenic patients. Methods 103 inpatients with schizophrenia were randomly divided into a research group（53 cases） and a control group（50 cases）. The study group received a rehabilitation training of MOHO on the basis of anti-psychotic treatment and routine nursing, 5 times a week for 8 weeks. The control group received a routine rehabilitation training on the basis of anti-psychotic treatment and routine nursing. Before and after the intervention,the general self-efficacy scale（GSES） and the stigma scale for patients with mental illness（SSMI-C） were used to evaluate the effect of the intervention. Results The results of intra group comparison showed that GSES was（15.46±2.74） before intervention and（17.92 ±2.42） after intervention. Before the intervention,the total score of stigma was（52.12±7.53）,discrimination was （21.36±6.83）,disease concealment was （17.28±4.45）,positive effect was（13.48±3.81）;after the intervention,the total score of stigma was （41.66±4.95）,discrimination was（16.84±4.02）,disease concealment was （14.18±2.75）,and positive effect was（10.64±2.38）. The difference was statistically significant（P<0.001）. The comparison results within the control group showed that the post test score of self-efficacy was higher than the pretest score,and there was no significant difference in GSES score,total score of stigma,discrimination,disease concealment and positive effect factor score（P>0.05）. After the intervention,the GSES score of the research group was higher than that of the control group,and the total score and each dimension score of stigma were lower than those of the control group（P<0.001）. Conclusion The rehabilitation training of MOHO can effectively reduce the level of stigma and improve the sense of self-efficacy.

Key words: Mode of Human Occupation, Schizophrenia, Self-Efficacy, Stigma, Rehabilitation Nursing, Psychiatric Nursing

袁水莲, 伍振红, 张倩, 李扬, 李江婵, 郭隆润, 苏建宁. 人类职能模式康复训练对精神分裂症患者自我效能及病耻感的干预效果[J]. 中华护理杂志, 2022, 57(2): 158-164.

YUAN Shuilian, WU Zhenhong, ZHANG Qian, LI Yang, LI Jiangchan, GUO Longrun, SU Jianning. Intervention effects of rehabilitation training of mode of human occupation on self-efficacy and stigma of schizophrenia patients[J]. Chinese Journal of Nursing, 2022, 57(2): 158-164.

图/表 4

表1 康复训练内容

Table 1 Content of rehabilitation training

表2 两组一般资料比较

Table 2 Comparison of general information between the two groups

表3 干预前后两组一般自我效能感量表得分比较（分,$\bar{x}\pm s$）

Table 3 Comparison of GSES scores between the two groups before and after intervention（score,$\bar{x}\pm s$）

表4 干预前后两组精神疾病患者病耻感量表中文版总分及各分量表得分比较（分,$\bar{x}\pm s$）

Table 4 Comparison of total SSMI-C scores and factor scores before and after intervention between the two groups（score,$\bar{x}\pm s$）

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