汪云芳 李日照 王美 谭凤玲 欧阳小芬 许曲

[摘要]目的 研究正念認知疗法运用于肇事肇祸精神分裂症患者康复治疗中的价值。方法 选取2017年8月～2019年3月广州市民政局精神病院强制医疗所收治的104例肇事肇祸精神分裂症患者作为研究对象，遵照随机双盲法将其分成对照组与研究组，每组各52例。对照组患者采取常规护理，研究组患者在对照组的基础上采用正念认知疗法。比较两组患者干预前后的阳性与阴性症状量表（PANSS）、五因素正念问卷（FFMQ）、护士用住院病人观察量表（NOSIE）评分。结果 两组患者干预前的PANSS各项评分比较，差异无统计学意义（P>0.05）;两组患者干预后的PANSS各项评分均低于干预前，且研究组患者干预后的PANSS各项评分均低于对照组，差异有统计学意义（P<0.05）。两组患者干预前的FFMQ评分比较，差异无统计学意义（P>0.05）;两组患者干预后的FFMQ评分均高于干预前，且研究组患者干预后的FFMQ评分高于对照组，差异有统计学意义（P<0.05）。两组患者干预前的总积极因素、总消极因素、病情总估计评分比较，差异无统计学意义（P>0.05）;两组患者干预后的NOSIE评分均低于干预前，且研究组患者干预后的NOSIE评分低于对照组，差异有统计学意义（P<0.05）。结论 应用循证方法制定科学、规范的正念认知行为干预方案，运用于肇事肇祸精神分裂症患者康复治疗中可以改善患者抑郁情绪，减轻患者痛苦，值得在临床推广应用。

[关键词]精神分裂症;肇事肇祸;正念认知疗法;康复效果

[中图分类号] R743          [文献标识码] A          [文章编号] 1674-4721（2020）8（a）-0076-05

Influence of mindfulness-based cognitive therapy on the rehabilitation effect of trouble-making schizophrenia patients

WANG Yun-fang1   LI Ri-zhao2   WANG Mei1   TAN Feng-ling1   OUYANG Xiao-fen1   XU Qu1

1. Compulsory Medical Institute， Guangzhou Civil Affairs Bureau Mental Hospital， Guangzhou Kangning Hospital， Guangdong Province， Guangzhou   510000， China; 2. Department of Rehabilitation， Guangzhou Huiai Hospital， Guangzhou Brain Hospital， Guangdong Province， Guangzhou   510000， China

[Abstract] Objective To study the value of mindfulness-based cognitive therapy in the rehabilitation of trouble-making schizophrenia patients. Methods A total of 104 trouble-making schizophrenia patients admitted to Compulsory Medical Institute of Guangzhou Civil Affairs Bureau Mental Hospital from August 2017 to March 2019 were selected as the research objects， and they were divided into the control group and the study group according to the random double-blind method， 52 cases in each group. Patients in the control group received the routine nursing， and patients in the study group received the mindfulness-based cognitive therapy on the basis of the control group. The positive and negative symptom scale （PANSS）， five-facet mindfulness questionnaire （FFMQ）， and nurses′ observation scale inpatient evaluation （NOSIE） scores before and after intervention between the two groups were compared. Results There were no statistically significant differences in the scores of PANSS before intervention between the two groups （P>0.05）. The PANSS scores of patients of the two groups after intervention were lower than those before intervention， and the PANSS scores of the study group after intervention were lower than those of the control group， the differences were statistically significant （P<0.05）. There was no significant difference in the FFMQ score of patients between the two groups before intervention （P>0.05）. The FFMQ scores of patients of the two groups after intervention were higher than those before intervention， and the FFMQ score of patients of the study group after intervention was higher than that of the control group， the differences were statistically significant （P<0.05）. There were no statistically significant differences in the total positive factors， total negative factors， and the total estimated scores of patients between the two groups before intervention （P>0.05）. The NOSIE scores of patients of the two groups after intervention were lower than those before intervention， and the NOSIE scores of patients of the study group after intervention were lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion The scientific and standardized mindfulness-based cognitive therapy by evidence-based methods in the rehabilitation of trouble-making schizophrenia patients can improve depression and relieve pain. It is worthy of clinical promotion and application.

[Key words] Schizophrenia; Trouble-making; Mindfulness-based cognitive therapy; Rehabilitation effect

精神分裂症是慢性病，具有较高的患病率、复发率及致残率。患者在疾病症状、社会等因素的影响下，失去辨认及控制能力，产生暴力冲动行为，造成肇事肇祸事件，这类事件可发生在病程的各个时期[1-2]。严重者还可能出现伤人毁物、杀人放火行为，直接扰乱社会公共秩序及社会和谐[3-4]。有关精神分裂症患者肇事的报导逐渐受到公众重视，肇事肇祸事件具有一定突发性，且对社会影响较差[5]，加大了社会对精神病患者的畏惧感。相关……