| Background:Schizophrenia is a common serious mental illness that threatens people's mental health,which can cause significant damage to occupational and social function.According to the World Health Organization(WHO)statistics,the incidence of schizophrenia is 0.40 percent in 2004 and the number of people with schizophrenia is 21 million in 2016.According to the ministry of health of China,the number of people with schizophrenia is about 7.8 million in 2002,with a high degree of disability which can be the highest level of disability severity(level 7).According to statistics from the ministry of health in 2009,the burden of mental illness accounts for 20 percent of the total burden of disease,which is the top priority of the disease burden.According to the WHO,the proportion of China's mental disease burden will rise to 25% by 2020.At present,the treatment of schizophrenia is mainly based on drugs,at the same time supplemented by psychosocial treatment according to the condition.Schizophrenics can return to the family and society during the remission and recovery period,and their rehabilitation is mainly conducted outside the hospital.Because of the disease,people with schizophrenia have a very long recovery period.In addition,they face the severe challenges of daily life due to family and social dysfunction.Limited hospital day and post-discharge nursing defects can affect the recovery of patients to varying degrees,therefore,to maintain effective continuity of care for patients with schizophrenia is very important.In our country,the continuity of care research with the platform of interactive-multimedianetwork is relatively rare.In view of this,it is necessary to establish a continuity of care model with the platform of interactive-multimedia-network and apply it.Objectives:To establish a continuity of care mode base on the platform of interactivemultimedia-network,and to verify the effect of this model on the rehabilitation effect of schizophrenics.To provide a scientific and reliable reference for the research on the rehabilitation system of schizophrenia in China.Methods:The study has two stages.The first stage is to establish a continuity of care model based on the platform of interactive-multimedia-network: through the literature review,reference to the relevant literature on the research theories and models of continuity of care home and abroad,and to build a continuity of care model based on the platform of interactive-multimedianetwork.The second stage is to apply and validate the model: clinical experimental research with the method of convenient sampling,A total of 64 schizophrenia patients were selected in the first affiliated hospital of Xi'an Jiao-tong University,using the random number table method randomly divide their into intervention group and control group,each group includes 32 patiens.Use the general information questionnaire,the Brief Psychiatric Rating Scale(BPRS),Morisky self-reported adherence questionnaire(MAQ),Personal and Social Performance scale(PSP),Family APGAR Index(APGAR)to evaluate its rehabilitation effects,the lower scores of BPRS and MAQ show the better effects,and the higher scores of PSP and APGAR show the better effects.The Epidata3.1 software was applied to establish the database and input data.After sorting out the data,SPSS23.0 statistical software was used for statistical analysis.The data are described by frequency,mean and standard deviation.T test,chi-square test,Spearman correlation analysis were used to analyze the data.Results:1.In the study,4 patients were lost in 64 patients,the data of 60 patients were collected,and the intervention group and control group were 30 patients.Demographic data: there were 34 males and 26 females in the two groups.The maximum age of the patiens is 48,the minimum age of the patiens is 18,and the average age of the patients is 29.34 patients are unmarried,25 patients are married,1 patient is divorced.25 patients are below junior middle school.There are 47 patients in the job,and 13 are unemployed.The personal monthly income of 48 patients is less than 500 yuan.There are 42 patients with family monthly income of 1000~ 5000 yuan.46 patients were use the new rural and urban medical insurance.Disease related data: the average height of is 169 cm,the average weight is 61 kg,and the average hospital day is 20.4 days.During the treatment,1 patient smoked and 0 patients drank alcohol.There were 16 patients with a family history.There are 34 patients with olanzapine as the main therapeutic agents,and 13 patients with elisperidone as the main therapeutic agents.According to different data types,demographic data and disease related data have no statistically significant difference between the two groups(P>0.05).2.Before the intervention,the scores of the mental symptoms,medication adherence,family function and social function were(30.87±11.52)and(29.97±5.47),(0.60±1.52)and(0.10±0.40),(75.13±8.42)and(75.00±5.58),(7.93±2.26)and(7.73±1.70),without significant difference(P>0.05).After 1 month intervention,the scores of the mental symptoms and medication adherence were(25.47±5.26)and(28.13±4.70),(0.20±0.66)and(1.53±1.30),with significant difference(P<0.01),the scores of social function and family function were(77.13±7.19)and(76.97±5.01),(8.13±1.96)and(7.30±2.12),without significant difference(P>0.05).After 3 months intervention,the scores of the mental symptoms,medication adherence,family function and social function were(25.10±3.54)and(28.83±6.54),(0.33±1.47)and(2.16±1.51),(80.83±7.42)and(77.23±6.13),(8.93±1.41)and(8.93±1.41),with significant difference(P<0.05);After 6 months intervention,the scores of the mental symptoms,medication adherence,family function and social function were(22.87±4.69)and(29.73±7.79),(0.07±0.25)and(2.56±1.47),(84.83±6.79)and(77.73±6.13),(8.93±1.41)and(6.57±2.16),with significant difference(P<0.01).Conclusions:Continuity of care on the platform of interactive-multimedia-network can significantly improve the mental symptoms,medication compliance,social and family functions of the schizophrenics,suggested to use and promote the mode in clinical practice,in order to promote the recovery effects of patients with schizophrenia. |
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