【摘要】 目的:研究居澳华人对各类精神科服务的看法及使用效果,探讨社区精神卫生服务在中国的应用前景。方法:用半定式问卷调查正在单一使用各类服务的123位华裔精神病患者,深层面谈或电话会谈法作为补充,并根据其接受的服务类型分为社区、门诊和住院组,以生活技能量表(LSP)、简明精神病评定量表(BPRS)评定各组治疗前后的功能状态。结果:大部分患者对澳洲社区精神卫生服务评价较高,认为效果较好。接受社区服务者LSP各因子分及总分显著提高(入组时中位数md=76.5、6个月后md=113.5,SgnRank=-27.5,P<0.01)、BPRS各因子分及总分降低(入组时总分md=48、6个月后md=33,SgnRank=18,P<0.05)。接受多元化门诊服务者LSP各因子分及总分提高(入组时md=78.5,6个月后md=108,SgnRank=-18,P<0.01)、BPRS中“思维障碍”因子分明显降低(入组时md=3.63、六个月后md=3.23,SgnRank=14.5,P<0.05)。单纯住院组各评分无明显改变。结论:居澳华人对澳洲社区精神卫生服务评价较高,客观评价效果亦较好,中国可借鉴澳洲的经验,开展有本土特色的、有效的社区精神卫生服务。更多还原

【Abstract】 AIM:To investigate the opinion and outcome when Chinese Australian psychiatric patients used community mental health services,and to explore the application foreground of these services in China. METHODS:A random sample of 123 Chinese patients with schizophrenia from two major community mental health services,two psychiatric hospitals and several private clinics of Chinese psychiatrists in Sydney were identified.All of them were employing only one type of services during this research.All participants completed a self administered semi structured questionnaire to explore their view to the services and the perceived outcome when they employed the services.However,it was subsequently decided to supplement the data collection strategy with in depth face to face interviews or individual telephone interviews to increase the validity of findings. Client function and their symptom severity were measured by using the life skills profile(LSP) and the brief psychiatric rating scale(BPRS) respectively on initial referral and at six monthly intervals thereafter. RESULTS:The majority of the subjects had high approval of Australian psychiatric services,especially community mental health services.They thought that their mental health conditions were improved when they employed the services.The clients who used community mental health services had the general and sub scale scores of LSP improved and the general and sub scale scores of BPRS decreased significantly(initial LSP general score median(md) of LSP and BPRS were 76.5 and 48 respectively, after six months md=113.5 and 33 respectively,Sgn Rank=-27.5 and 18,P< 0.01 and< 0.05).The clients who used diversiform outpatient department services had the general and sub scale scores of LSP improved(initial md=78.5,after six months md=108,Sgn Rank=-18,P< 0.01) and psychotic index score of BPRS decreased (initial md=3.63,after six months md=3.23,Sgn Rank=14.5,P< 0.05).The clients who used inpatient department services only had no significant changes in the two scales. CONCLUSION:The majority of Chinese migrants highly appraised the Australian community mental health services.The objective evaluation of the service showed that it had good effects to the clients as well. There is much in Australian community mental health services that we can make use of.Comprehensive,integrated and high quality community mental health services should be developed in China, in Chinese way.更多还原