目的 探讨社会工作在社区精神卫生三级预防中的作用。方法 选取H区在册精神障碍患者100例,随机分为干预组和对照组,每组50例。对照组采取常规精神疾病防治,干预组接受社会工作介入下的三级预防体系服务。在干预前后,对两组患者阳性与阴性症状、服药依从性及再住院率进行评估。结果 干预后干预组患者阴性与阳性症状总评分低于对照组,差异有统计学意义(t=-6.712,P<0.001),干预组服药依从性评分优于对照组,差异具有统计学意义(χ²=6.444,P=0.040),干预组患者再住院率(4.08%)低于对照组(18.75%),差异具有统计学意义(χ²=5.020,P=0.025)。结论 采用社会工作个案、小组、社区方法介入精神卫生三级预防,能有效提升患者的服药依从性,改善患者精神病性症状,降低复发率,从而提高精神卫生三级预防效果。

Objective To explore the role of social work in the three-level prevention system of community mental health. Methods A total of 100 patients with mental disorders registered in H District were selected and randomly divided into an intervention group and a control group,with 50 cases in each group.The control group received only routine mental disease prevention and treatment,the intervention group receiv the services of the three-level prevention system under the intervention of social work.The patients in the two groups were evaluated with positive and negative symptoms ,the medication compliance and patient rehospitalization rates before and after the intervention. Results After the intervention,the total score of negative and positive symptoms in the intervention group was lower than that in the control group,and the difference was statistically significant(t=--6.712,P<0.001).The medication compliance score in the intervention group was better than that in the control group,and the difference was statistically significant (χ²=6.444,P=0.040),and the rehospitalization rate in the intervention group was 4.08%,lower than 18.75% in the control group,the difference was statistically significant(χ²=5.020,P=0.025). Conclusion Using social work case,group and community methods to intervene in the three-level prevention system of mental health can effectively improve the medication compliance of patients,ameliorate patients' psychotic symptoms,and reduce the recurrence rate,thereby improving the effect of three-level prevention system of mental health.