基于微信小程序的多维度居家康复管理对精神分裂症患者的影响

林雪冰; 金含青; 马灵亚

doi:10.16766/j.cnki.issn.1674-4152.003642

基于微信小程序的多维度居家康复管理对精神分裂症患者的影响

doi: 10.16766/j.cnki.issn.1674-4152.003642

绍兴市第七人民医院精神科，浙江绍兴 312000

基金项目:

浙江省医药卫生科技计划项目 2022ZH062

详细信息

通讯作者:
金含青，E-mail：616564374@qq.com

中图分类号: R749.3 R473.74
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出版历程
- 收稿日期: 2024-01-30
- 网络出版日期: 2024-11-19

The influence of multi-dimensional home rehabilitation management based on Wechat mini program on patients with schizophrenia

Department of Psychiatry, Shaoxing Seventh People ' s Hospital, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的借助微信小程序对出院精神分裂症患者开展多维度居家康复管理，以更好地促进患者康复。方法采用随机数字表法将2021年12月—2022年12月在绍兴市第七人民医院治疗后出院的98例精神分裂症患者分为对照组(49例，常规居家康复管理)和微信组(49例，基于微信小程序的多维度居家康复管理)，比较2组服药依从性、社会功能、精神症状、病耻感、神经电生理及再入院率。结果微信组干预后服药依从性量表(MARS)评分为(7.88±1.36)分，高于对照组的(6.10±1.14)分(P < 0.05)；社会功能量表(SSPI)总分高于对照组(P < 0.05)；微信组阳性与阴性症状量表(PANSS)中阳性症状评分为(7.06±1.34)分、阴性症状评分为(13.56±2.10)分、一般症状评分为(18.34±3.25)分、总分为(38.96±5.22)分，均低于对照组的(9.45±1.47)分、(15.67±2.34)分、(19.56±2.47)分和(44.68±5.03)分(P < 0.05)；病耻感量表(SSMI-C)得分低于对照组(P < 0.05)；P300潜伏期低于对照组(P < 0.05)，波幅高于对照组(P < 0.05)；6个月后再入院率略低于对照组(P>0.05)。结论基于微信小程序的多维度居家康复管理可提高精神分裂症出院患者服药依从性，帮助控制精神症状，改善社会功能，降低病耻感和促进认知功能的改善。
- 精神分裂症 /
- 居家康复管理 /
- 微信小程序 /
- 服药依从性 /
- 再入院率
Abstract: Objective To conduct multi-dimensional home rehabilitation management for discharged schizophrenic patients using the Wechat mini program to promote patient rehabilitation. Methods A total of 98 patients with schizophrenia discharged from Shaoxing Seventh People ' s Hospital after treatment from December 2021 to December 2022 were divided into control group (49 cases, routine home rehabilitation management) and Wechat group (49 cases, multidimensional home rehabilitation management based on Wechat mini program). Medication adherence, social functioning, psychological symptoms, stigma, neuroelectrophysiology and readmission rates were compared between the two groups. Results The medication adherence rating scale (MARS) score in the Wechat group was (7.88±1.36) points, which was higher than that in the control group [(6.10±1.14) points, P < 0.05]. The scale of social function in psychosis inpatients (SSPI) was higher than in the control group (P < 0.05). On the positive and negative syndrome scale (PANSS), the positive symptom score was (7.06±1.34) points, the negative symptom score was (13.56±2.10) points, the general symptom score was (18.34±3.25) points, and the total score was (38.96±5.22) points. They were lower than (9.45±1.47) points, (15.67±2.34) points, (19.56±2.47) points and (44.68±5.03) points in the control group (P < 0.05). The SSMI-C score was lower than in the control group (P < 0.05). The latency of the P300 was lower than in the control group (P < 0.05), and its amplitude was higher than in the control group (P < 0.05). The readmission rate at 6 months was slightly lower than in the control group (P>0.05). Conclusion Multi-dimensional home rehabilitation management based on the Wechat mini program can improve medication adherence in discharged schizophrenia patients, help control mental symptoms, improve social functioning, reduce stigma and promote cognitive function improvement.
- Schizophrenia /
- Home rehabilitation management /
- Wechat mini program /
- Medication compliance /
- Readmission rate

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表 1 2组精神分裂症患者一般资料比较

Table 1. Comparison of general data between the two groups of patients with schizophrenia

项目	微信组（n=49）	对照组（n=49）	统计量	P值
性别（例）			0.163^a	0.686
男性	26	24
女性	23	25
年龄（x±s, 岁）	39.78±5.60	40.11±6.12	0.278^b	0.781
BMI（x±s）	22.13±3.45	21.78±4.35	0.441^b	0.660
婚姻状况(例)			1.142^a	0.285
在婚	30	35
未婚/离婚/丧偶	19	14
付费方式(例)			0.683^a	0.711
城镇医疗	23	27
自费	16	13
其他	10	9
住院时间（x±s, d）	23.45±3.41	22.90±5.03	0.634^b	0.528
有家族史(例)	11	9	0.251^a	0.616
注：^a为χ²值，^b为t值。

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表 2 2组精神分裂症患者MARS和SSPI比较(x ±s，分)

Table 2. Comparison of MARS and SSPI between the two groups of patients with schizophrenia (x ±s, points)

组别	例数	MARS		SSPI
组别	例数	干预前	干预6个月	干预前	干预6个月
微信组	49	5.90±1.12	7.88±1.36^b	25.78±4.09	36.67±4.14^b
对照组	49	5.67±0.77	6.10±1.14	26.71±3.10	32.41±5.17^b
统计量		1.185^a	18.916^c	1.268^a	15.709^c
P值		0.239	< 0.001	0.208	< 0.001
注：^a为t值，^c为F值；与同组干预前比较, ^bP < 0.05。

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表 3 2组精神分裂症患者PANSS比较(x ±s，分)

Table 3. Comparison of PANSS between the two groups of patients with schizophrenia (x ±s, points)

组别	例数	阳性症状		阴性症状		一般症状		总分
组别	例数	干预前	干预6个月	干预前	干预6个月	干预前	干预6个月	干预前	干预6个月
微信组	49	9.55±2.31	7.06±1.34^b	17.34±3.10	13.56±2.10^b	20.02±3.44	18.34±3.25^b	46.91±6.12	38.96±5.22^b
对照组	49	10.01±2.02	9.45±1.47	16.45±3.22	15.67±2.34	19.77±3.67	19.56±2.47	46.23±7.17	44.68±5.03
统计量		1.049^a	19.289^c	1.394^a	16.412^c	0.348^a	17.689^c	0.505^a	19.457^c
P值		0.297	< 0.001	0.167	< 0.001	0.729	< 0.001	0.615	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 4 2组精神分裂症患者SSMI-C比较(x ±s，分)

Table 4. Comparison of SSMI-C between the two groups of patients with schizophrenia (x ±s, points)

组别	例数	歧视		病情掩饰		积极效应		总分
组别	例数	干预前	干预6个月	干预前	干预6个月	干预前	干预6个月	干预前	干预6个月
微信组	49	28.23±3.10	18.21±3.45^b	15.45±2.47	12.34±3.07^b	13.41±2.01	9.47±1.44^b	57.09±5.33	40.02±4.11^b
对照组	49	27.49±2.45	21.67±3.10^b	16.09±3.41	14.22±2.16^b	13.22±3.09	11.10±2.06^b	56.80±6.24	46.99±5.03^b
统计量		1.311^a	20.317^c	1.064^a	19.302^c	0.361^a	27.411^c	0.247^a	19.301^c
P值		0.193	< 0.001	0.290	< 0.001	0.719	< 0.001	0.805	< 0.001
注：^a为t值，^c为F值；与同组干预后比较，^bP < 0.05。

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表 5 2组精神分裂症患者P300潜伏期和波幅比较(x±s)

Table 5. Comparison of latency and amplitude of P300 between the two groups of patients with schizophrenia(x±s)

组别	例数	潜伏期（ms）		波幅（μV）
组别	例数	干预前	干预6个月	干预前	干预6个月
微信组	49	325.78±10.98	290.45±15.33^b	5.90±0.79	7.84±1.17^b
对照组	49	323.61±15.32	330.14±18.76	6.11±1.44	6.35±1.27
统计量		0.806^a	35.437^c	0.895^a	18.211^c
P值		0.422	< 0.001	0.373	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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