生命树叙事法联合感觉运动训练在慢性稳定期精神分裂症患者中的应用

茅丽利; 沈银萍; 潘小芳

doi:10.16766/j.cnki.issn.1674-4152.003599

生命树叙事法联合感觉运动训练在慢性稳定期精神分裂症患者中的应用

doi: 10.16766/j.cnki.issn.1674-4152.003599

湖州市第三人民医院精神科，浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目 2023KY1182

详细信息

通讯作者:
茅丽利, E-mail: 15957245045@163.com

中图分类号: R749.3 R493
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出版历程
- 收稿日期: 2024-01-09
- 网络出版日期: 2024-09-05

Application of tree of life narrative combined sensorimotor training in chronic stable schizophrenia

Psychiatric Department, Huzhou Third Municipal Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的探究生命树叙事法联合感觉运动训练对慢性稳定期精神分裂症患者心理状况、临床症状、认知功能以及社会功能的影响。方法采用随机数字表法将2022年3月—2023年3月在湖州市第三人民医院就诊的97例慢性稳定期精神分裂症患者分为对照组(49例，常规护理)和试验组(48例，生命树叙事法联合感觉运动训练+常规护理)，比较2组干预效果。结果试验组干预后自我效能感量表(GSES)评分高于对照组(P＜0.05)；病耻感量表(SSMI-C)评分低于对照组(P＜0.05)；阳性和阴性症状量表(PANSS)总分[(36.37±5.35)分]低于对照组[(46.83±7.44)分, P＜0.05]；威斯康星卡片分类测验(WCST)中持续错误次数[(7.94±2.11)次]低于对照组[(9.78±2.56)次, P＜0.05]，正确反应次数[(51.92±6.34)次]、概念化水平百分数[(65.77±7.23)%]高于对照组[(46.71±7.26)次、(60.33±4.99)%, 均P＜0.05]；社会功能评定量表(SSPI)总分高于对照组(P＜0.05)。结论生命树叙事法联合感觉运动训练可提高慢性稳定期精神分裂症患者自我效能感，降低病耻感，改善临床症状和认知功能，提高社会功能。
- 精神分裂症 /
- 生命树叙事法 /
- 感觉运动训练 /
- 病耻感 /
- 认知功能
Abstract: Objective To explore the effects of the tree of life narration combined with sensorimotor training on psychological status, clinical symptoms, cognitive function, and social function of patients with chronic stable schizophrenia. Methods A total of 97 patients with chronic stable schizophrenia treated in Huzhou Third Municipal Hospital from March 2022 to March 2023 were divided into a control group (49 cases, conventional care) and an experimental group (48 cases, tree of life narrative method combined with sensory-motor training+routine care) by random number table method. Results The score of general self-efficacy scale (GSES) in the experimental group was higher than that in the control group (P < 0.05). The score of Chinese version of stigma scale for mental illness (SSMI-C) in the experimental group was lower than that of the control group (P < 0.05). The total score of PANSS (36.37±5.35) in the experimental group was lower than that of the control group (46.83±7.44, P < 0.05). The number of persistent errors (7.94±2.11) in the Wisconsin card sorting test (WCST) in the experimental group was lower than that in the control group (9.78±2.56, P < 0.05), the number of correct reactions (51.92±6.34), and percentage of conceptualization (65.77±7.23)% in the WCST in the experimental group were higher than those in the control group [46.71±7.26, (60.33±4.99)%, P < 0.05]. The total score of scale of social function in psychosis inpatients (SSPI) in the experimental group was higher than that in the control group (P < 0.05). Conclusion The tree of life narrative combined with sensorimotor training can improve self-efficacy, reduce stigma, improve clinical symptoms and cognitive function, and improve social function in chronic stable schizophrenia patients.
- Schizophrenia /
- Narrative of tree of life /
- Sensorimotor training /
- Stigma /
- Cognitive function

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表 1 2组精神分裂症患者一般资料比较

Table 1. Comparison of general data between two groups in schizophrenia patient

组别	例数	性别(例)		年龄(x±s，岁)	受教育年限(x±s，年)	婚姻状况(例)		病程(x±s，年)
组别	例数	男性	女性	年龄(x±s，岁)	受教育年限(x±s，年)	已婚	未婚/离异	病程(x±s，年)
对照组	49	24	25	39.89±5.67	11.57±2.45	35	14	3.23±0.66
试验组	48	21	27	38.23±8.01	12.53±3.27	40	8	3.11±0.74
统计量		0.267^a		1.180^b	1.639^b	1.960^a		0.843^b
P值		0.606		0.240	0.104	0.162		0.401
注：^a为χ²值，^b为t值。

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表 2 生命树叙事法干预方案

Table 2. Intervention program using the tree of life narrative method

阶段	活动主题	活动内容
初期	话期待	开始热身：找朋友
		主要活动：团体介绍、团体期望
		结束时刻：患者表达感受，组织者总结
	画支持	开始热身：手牵手
		主要活动：画生命树、分享生命树
		结束时刻：患者表达感受，组织者总结
中期	享故事	开始热身：松鼠与大树
		主要活动：我的故事、新的生命树
		结束时刻：患者表达感受，组织者总结
	聊经验	开始热身：抓虫子
		主要活动：经验分享、成功体验、困扰讨论
		结束时刻：患者表达感受，组织者总结
后期	悟收获	开始热身：心有千千结
		主要活动：总结成长、分享期待、送上祝福
		结束时刻：患者表达感受，组织者总结

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表 3 2组精神分裂症患者干预前后SSMI-C评分比较(x±s，分)

Table 3. Comparison of SSMI-C scores before and after intervention between two groups in schizophrenia patients (x±s, points)

组别	例数	歧视		病情掩饰		积极效应		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
试验组	48	21.34±4.21	16.70±3.11^b	17.33±3.10	14.56±3.92^b	13.45±2.03	10.44±2.17^b	52.12±6.73	41.77±5.24^b
对照组	49	21.66±3.70	20.51±4.11	17.52±3.29	16.83±3.24	13.20±3.24	13.02±3.11	52.38±7.24	50.36±6.11
统计量		0.398^a	18.901^c	0.293^a	15.671^c	0.454^a	16.781^c	0.183^a	17.904^c
P值		0.692	< 0.001	0.771	0.003	0.651	< 0.001	0.855	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 4 2组精神分裂症患者干预前后PANSS评分比较(x±s，分)

Table 4. Comparison of PANSS scores before and after intervention between two groups in schizophrenia patients (x±s, points)

组别	例数	阳性症状		阴性症状		一般症状		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
试验组	48	18.34±4.56	10.35±3.22^b	14.89±2.47	9.46±2.49^b	26.67±6.33	16.56±6.09^b	59.90±5.51	36.37±5.35^b
对照组	49	17.67±3.75	14.04±3.40^b	14.22±3.58	11.56±3.07^b	26.24±7.04	21.23±5.33^b	58.13±7.21	46.83±7.44^b
统计量		0.792^a	17.893^c	1.071^a	16.324^c	0.316^a	17.098^c	1.356^a	19.031^c
P值		0.431	< 0.001	0.287	< 0.001	0.753	< 0.001	0.178	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 5 2组精神分裂症患者干预前后认知功能比较(x±s)

Table 5. Comparison of cognitive function before and after intervention between two groups in schizophrenia patients (x±s)

组别	例数	持续错误次数(次)		正确反应次数(次)		概念化水平百分数(%)
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后
试验组	48	13.45±2.17	7.94±2.11^b	35.67±5.23	51.92±6.34^b	54.67±7.56	65.77±7.23^b
对照组	49	13.88±3.09	9.78±2.56^b	35.89±5.44	46.71±7.26^b	55.01±7.28	60.33±4.99^b
统计量		0.792^a	20.091^c	0.203^a	18.951^c	0.226^a	21.034^c
P值		0.431	< 0.001	0.840	< 0.001	0.822	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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表 6 2组精神分裂症患者干预前后SSPI评分比较(x±s，分)

Table 6. Comparison of SSPI scores before and after intervention between two groups in patients with schizophrenia (x±s, points)

组别	例数	日常生活能力		社会性活动技能		运动和交往		总分
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
试验组	48	8.78±1.90	13.45±2.36^b	8.25±1.23	14.57±3.64^b	11.40±2.37	15.79±3.29^b	28.39±4.60	43.81±5.77^b
对照组	49	9.11±2.10	11.23±2.17^b	8.03±1.77	10.98±2.12^b	11.72±2.44	13.24±3.10^b	28.86±5.60	35.45±6.24^b
统计量		0.811^a	20.098^c	0.709^a	15.671^c	0.655^a	18.453^c	0.451^a	16.567^c
P值		0.419	< 0.001	0.480	< 0.001	0.514	< 0.001	0.653	< 0.001
注：^a为t值，^c为F值；与同组干预前比较，^bP < 0.05。

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