| Objectives:In order to find a more effective rehabilitation management model for the patients with severe mental disorders,the intervention of different management modes for 12 months was conducted for the patients with severe mental disorders in the community,and the social function,medication compliance,stigma and disability of the patients were evaluated.The intervention effects of different management modes on the patients with mental disorders were observed.Methods:In this study,72 patients with mental disorders who met the inclusion criteria and volunteered to participate in a community in Baoding City,Hebei Province,were randomly divided into intervention group and control group.The control group received routine community management,while the intervention group received strengths model of case management intervention on the basis of routine drug treatment,One patient relapsed and fell off in the intervention group at 2 months after the intervention.At 5 months,two patients could not insist on participating in the activity when they found a job,and three patients were lost in the later period of the intervention.In the control group,there were 2 cases of relapse and abscission at 4 months,2 cases of late-stage loss of follow-up,and 32 patients finally participated in the control group activities.The World Health Organization Disability Assessment Schedule 2.0(WHO-DAS II),Global Assessment of Functioning Scale(GAF),Social Disability Screening Schedule(SDSS),Medicine Adherence Rating Scale(MARS)and Psychiatric Disgrace Scale were used at baseline,3 months,6 months and 12 months for mental disorder patients were used to monitor the effects of different management modes on disability,general function,social function,medication compliance and disgrace.Hypothesis tests were conducted using repeated measurement variance analysis in SPSS 22.0 statistical software.Results:1.The scores of WHO Disability Assessment Scale were analyzed by repeated measures of variance.The results showed that there was interaction between time and intervention(P<0.05).The inter-group effect reached a significant level(P<0.05).The time effect was significant in both groups(P<0.05).In the control group,there was significant difference in the dimension of understanding and communication in March and June compared with the previous measurement score(P<0.05),in June,the self-care dimension had statistical significance compared with the previous measurement score(P<0.05),and the total score had statistical significance compared with the previous measurement in June(P<0.05);in the intervention group,the scores of six dimensions in March and June had statistical significance compared with the previous measurement(P<0.05),and there was no significant difference between the scores in December and in June(P>0.05).2.The results of repeated measurement variance analysis showed that time and intervention mode had interaction(P<0.05)in the general function,and the inter-group effect reached significant level(P<0.05).The time effect was significant in both groups(P<0.05).in the intervention group and control group,the scores in March and June were significantly higher than those in the previous measurement(P<0.05),but there was no significant difference between December and June(P>0.05).3.After repeated analysis of variance,the results of the social functional defect screening scale showed that time had an interaction with the intervention mode(P<0.05).The intergroup effect reached a significant level(P<0.05),and the time effect was significant in the intervention group(P<0.05),but not in the control group(P>0.05).There was no statistical significance in the scores of the 4 time points in the control group(P>0.05),and the scores of the intervention group at 3 months were statistically significant(P<0.05),while the scores at 6 months and 12 months were not statistically significant(P>0.05).4.Repeated anova was used in the drug compliance scale,and the results showed that there was an interaction between time and intervention mode(P<0.05).The intergroup effect was significant(P<0.05),and the time effect reached a significant level in the intervention group(P<0.05),but was not significant in the control group(P>0.05).There was no significant difference in the scores of four time points in the control group(P>0.05).The scores of 3 months in the intervention group were significantly different from those of the previous measurement(P<0.05).There was no significant difference in the scores of June and December compared with the previous measurement(P>0.05).5.The scores of the stigma scale were analyzed by repeated variance analysis,and the results showed that time and intervention methods also had an interactive effect(P<0.05).The intergroup effect reached a significant level(P<0.05),and the time effect was significant in the intervention group(P<0.05),but not in the control group(P>0.05).No statistical significance was found in the scores at 4 time points in the control group(P>0.05),and the scores at 3 months and 6 months in the intervention group were statistically significant(P<0.05),while the scores at 12 months were not statistically significant(P>0.05).Conclusion:After 12 months of different management mode after the intervention,the strengths model of case management than traditional community management can improve the patient's social function,decrease the degree of disability and reduce the disease in patients with shame,increase medication compliance,instructions in the perspective of advantage,the advantage of recovery oriented case management model of mental disorder patients in community rehabilitation is more effective,and can maintain continuous. |
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