精神分裂症患者的家庭负担及其与服药依从性的关系

Family burden and its relationship with medication compliance in patients with schizophrenia

关键词:  精神分裂症  家庭负担  依从性

Key words:  schizophrenia  family burden  compliance

摘要:

目的　分析精神分裂症患者家庭负担的影响因素，以及家庭负担与患者服药依从性的关系。方法　选取2012年7月2日至9日河北省39家精神疾病专科医院或综合医院精神科门诊与住院的精神分裂症患者418例作为研究对象。对患者的一般情况、疾病的症状及严重程度进行评估，采用药物依从性评定量表（medication adherence rating scale，MARS）评估患者的依从性情况，家庭负担量表（family burden scale，FBS）评估患者因病给家庭带来的负担。根据评估结果将患者分成依从组（MARS总分≥6分）和非依从组（MARS总分<6分），对两组的家庭负担进行比较，探讨服药依从性与家庭负担的关系，并分析患者家庭负担的相关影响因素。结果　（1）依从组FBS总分（14±12）与非依从组（20±12）相比，差异无显著性意义(P>0.05)。但其中家庭日常活动、家庭休闲娱乐活动、家庭成员躯体健康、家庭成员心理健康4项因子分数比较显示，依从组均低于非依从组，差异有显著性意义(P<0.05）；（2）CGI-S总分、服药依从性、就业情况、性别和病程与精神分裂症患者家庭负担相关(P<0.05）。结论　精神分裂症患者家庭负担普遍较重，家庭负担与服药依从性、性别、疾病总体严重度、就业情况和病程相关；服药依从性越差，家庭负担越重。应提高对精神分裂症患者服药依从性的重视程度。

Abstract:

Objective To investigate the influential factors of family burden in patients with schizophrenia and the relationship between family burden and medication adherence.Methods A total of18 patients with schizophrenia，who were treated in the outpatient department and inpatient department of9 mental health institutions in Hebei Province from July to July 9 in012，were selected as study subjects.The general condition of patients，symptoms and severity of the disease were evaluated.The medication adherence rating scale (MARS) was used to assess the compliance; the family burden scale (FBS) to assess the burden that the patients brought to their family because of the disease.According to the evaluation results of MARS，the patients were divided into compliance group (MARS total score≥6) and noncompliance group (MARS total score<6).The family burden of the two groups were compared to investigate the relationship between the medication compliance and family burden.At the same time，the influence factors of the family burden were analyzed.Results (1) There was no significant difference in the total score of FBS between the compliance group (14±12) and the noncompliance group (20±12).Compared to the noncompliance group，the compliance group had lower rating scores in family daily activities，family entertainment，physical health of family members，and mental health of family members (P<0.05).(2) The total score of CGI-S，medication compliance，employment situation，gender，and course of disease were negatively correlated with family burden of the patients (P<0.05).Conclusion The family burden of Schizophrenia patients are generally heavy and is associated with medication compliance，gender，overall severity of disease，employment situation and course of disease.Poorer medication compliance，the heavier family burden.We should take medication compliance in the patients with schizophrenia seriously，try to improve it.