周红 周青 钱斌 龚兴波 沈丹

摘 要 目的：探討家属培训对精神分裂症患者服药依从性的影响。方法：本研究采用前瞻性研究设计和随机对照方法。选取社区42例精神分裂症患者及其家属将患者随机分成研究组和对照组，家属分法同患者。研究组患者中男性9例，女性12例，平均年龄（40.6±8.86）岁，家属平均年龄（57.5±9.6）岁。对照组患者中男性11例，女性10例，平均年龄（41.7±8.24）岁，家属平均年龄（57.3±9.0）岁。对照组家属不给予任何措施，研究组给予系统的家属培训。干预一年后，比较两组患者的服药依从性、入院率和家属的疾病认知水平。结果：干预一年后，研究组的家属疾病认知水平明显高于对照组；研究组与对照组患者服药依从性的差异有统计学意义（P<0.05）；研究组的复发住院率低于对照组，但差异无统计学意义（P>0.05）。结论：家属培训提升了家属对疾病的认知水平，提高患者的服药依从性，但对降低住院率无明显效果。

关键词 精神分裂症；家属培训；服药依从性

中图分类号：R749.3 文献标志码：A 文章编号：1006-1533（2018）06-0050-04

Influence of family member training on the medication compliance of schizophrenic patients

ZHOU Hong， ZHOU Qing， QIAN Bin， GONG Xingbo， SHEN Dan

（Psychosis Prevention Department of Mental Health Center of Fengxian District， Shanghai 201418， China）

ABSTRACT Objective： To explore the influence of family member training on the medication compliance of schizophrenic patients. Methods： This study used the prospective study design and randomized controlled methods. 42 schizophrenic patients and their family members were selected in the community and were randomly divided into a study group and a control group and the division of the family members was the same as the patients. In the study group， there were 9 males and 12 females， the average age was （40.6±8.86） years， and the average age of the family members was （57.5±9.6） years. In the control group， there were 11 males and 10 females， the average age was （41.7±8.24） years， and the average age of the family members was （57.3±9.0） years. The family members of the control group were not given any measures， and those of the study group were given the family member training. After one year of intervention， the compliance and the admission rate of the two groups and the cognitive level of the family members were compared. Results： After one year intervention， the cognitive level of the family members in the intervention group was significantly higher than that in the control group； there was a significant difference in the compliance of the patients in the study group and in the control group（P<0.05）. The rate of recurrent hospitalization in the intervention group was lower than that in the control group， but there was no significant difference between the two groups（P>0.05）. Conclusion： The family member training improves the cognitive level of the family members to the disease and the compliance of the patients， but has no obvious effect on reducing the hospitalization rate.

KEY WORDS schizophrenia； family member training； medication compliance

精神分裂症是一种发病机制未明的严重精神障碍，多起病于青年或成年早期，具思维、情感、行为及社会功能等多方面的障碍或精神活动不协调[1]。终身患病率为1%左右[2]。世界卫生组织在《全球疾病负担》中明确精神分裂症位居世界十大致残原因之列[3]。目前，抗精神病药物是治疗精神分裂症的最有效方法，但药物依从性问题不容乐观。有文献报道，不依从服药率平均为50%[4]。同时研究发现，服药依从性差不但是治疗过程中的不利因素，更是导致疾病复发再住院的主要因素[5]。……