胡天兰 何芳

【摘要】 目的：将个案管理应用于出院双相情感障碍患者的护理干预中，探究其对患者病耻感、应对方式及生活质量的影响。方法：选取本院2014年1月-2017年1月收治的120例双相情感障碍患者为研究对象，按照随机数字表法将其分为对照组和观察组，各60例。对照组给予常规出院护理，观察组则在采用常规出院护理措施的同时联合个案护理进行干预。评估并比较干预前与干预2个月后两组患者的病耻感、CSQ及生活质量评分。结果：干预前，两组病耻感评分、CSQ评分比较，差异均无统计学意义（P>0.05）；干预2个月后观察组社交、能力、治疗方面的病耻感评分均低于对照组，CSQ评分、生活质量评分均优于对照组，差异均有统计学意义（P<0.05）。结论：个案管理能使双相情感障碍患者的病耻感降低，有效改善其应对方式，提高生活质量。

【关键词】 个案管理； 双相情感障碍； 病耻感； 应对方式； 生活质量

【Abstract】 Objective：To apply case management to nursing intervention of patients with bipolar affective disorder，and to explore the effect of case management on the stigma，coping style and quality of life of patients with bipolar disorder.Method：A total of 120 patients with bipolar affective disorder admitted in our hospital from January 2014 to January 2017 were selected as study objects.According to the random number table method，they were divided into control group and observation group，60 cases in each group.The control group was given routine discharge nursing，the observation group was treated with routine discharge nursing measures in conjunction with individual nursing intervention.The stigma，CSQ and quality of life scores were evaluated and compared before and after intervention 2 months.Result：Before intervention，there were no significant differences in scores of the stigma and CSQ between the two groups（P>0.05）.After intervention 2 months，the scores social，ability and treatment of stigma in the observation group were significant lower than those in control group，the scores of the CSQ and quality of life were better than those in control group，the differences were statistically significant（P<0.05）.Conclusion：Case management can reduce the stigma of bipolar affective disorder patients and effectively improve their coping style and quality of life.

【Key words】 Case management； Bipolar affective disorder； Stigma； Coping style； Quality of life

First-authors address：Tianyou Hospital Affiliated to Wuhan University of Science and Technology，Wuhan 430000，China

doi：10.3969/j.issn.1674-4985.2018.20.036

临床情感障碍的病例中有超过50%为双相情感障碍，双相情感障碍在任何年龄均可发生，已成为目前精神卫生面临的主要问题[1-2]。双相情感障碍的患者常出现活动水平紊乱、心境紊乱等症状，主要表现为心境低落、冲动、焦虑、精力减退、物质滥用等[3]。病耻感是因个体或群体存在的身体或行为特性产生不正确的社会态度，其为精神障碍患者正常回归生活的一种重要阻碍因素[4-6]；此外，有研究报道，在情感障碍病情的进展中应对方式发挥重要作用。个案管理是一种在多学科成员团队协作的条件下提供科学、合理的医疗护理行为照护模式，它具有长期、延续、无缝隙管理性的特点[7]。本……