目的 探讨不同健康教育模式对精神分裂症患者症状及生活质量的影响及机制.方法 随机抽取精神分裂症患者104例纳入联合教育组(A组,n =35)、常规教育组(B组,n=35)和对照组(C组,n=34),对A组进行5个月的常规教育及在线教育,B组进行5个月的常规教育,C组不做干预,比较3组患者在入组时、人组5个月后、入组10个月后社会支持、病耻感、临床症状及生活质量,探讨不同健康教育模式对患者生活质量的影响机制.结果 入组10个月后,A组主观支持(13.29±1.90)、客观支持(10.97±1.04)、生活质量心理健康(MCS)分(36.40±5.80)高于B组[分别为(11.91±2.36)、(9.89±1.66)、(32.03±5.79)]和C组[分别为(10.09±2.70)、(9.91±0.90)、(31.12±8.29)](P均＜0.05),简明精神病评定量表(BPRS)得分(40.20±5.89)低于B组(47.83±6.77)和C组(50.71±7.41)(P＜0.05),病耻感量表分(34.66±10.58)低于C组(46.91±12.38) (P＜0.05),患者的主观支持和BPRS得分与患者的MCS分相关(F=5.266,P≤0.01).结论 联合教育干预效果优于常规教育,健康教育可以持续减轻临床症状并提高患者生活质量,主观支持和临床症状是影响患者MCS的重要因素.%Objective To explore the effects of different health education model on clinical symptoms and quality of life (QOL) among patients with schizophrenia.Methods 104 community schizophrenia patients were chosen randomly and divided into union education group (A group,n =35),routine education group (B group,n =35) and control group (C group,n =34).The patients in A group had both online health education and routine education service for 5 months,the patients in B group had routine health education service for 5 months,and the patients in C group had received no education.The scores insocial supports,stigma,clinical symptoms and QOL among three groups were compared before intervention,5 and 10 months after intervention,respectively.The relative factors of clinical symptoms and QOL in patients were analyzed.Results After 10 months intervention,the scores of subjective support scale (13.29 ± 1.90),objective support scale (10.97 ± 1.04),mental health summary (36.40 ± 5.80) in A group were higher than that in B group [(11.91 ±2.36),(9.89±1.66),(32.03±5.79)] andCgroup [(10.09±2.70),(9.91±0.90),(31.12±8.29)] (P＜0.05).However,the score of Brief Psychiatric Rating Scale (BPRS,40.20 ± 5.89) was lower than that in B group (47.83 ±6.77) and C group (50.71 ±7.41) (P＜0.05).The score of stigma scale (34.66 ±10.58) in A group was lower than that in C group (46.91 ± 12.38,P ＜ 0.05).The score of subjective support scale and the score of BPRS were found to predict MCS in patients (F =5.266,P≤0.01).Conclusion The effect of union education model is better than routine education model.Health education could reduce clinic symptoms of patients with schizophrenia and improve MCS of patients.The subjective support and clinical symptoms are influencing factors for MCS in patients.
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