摘要目的 探讨支持性就业(SE)服务对精神分裂症患者职业康复的疗效.方法 将108例符合入组标准的精神分裂症患者,采用区组随机数字表法分为研究组与对照组.研究组54例,在药物维持治疗基础上接受SE服务；对照组54例,在药物维持治疗基础上只接受一般的门诊和随访服务.采用工作社交技巧评估量表(Wsss)评定患者找寻工作与职业保持相关的社交能力；用阳性与阴性症状量表(PANSS)评定精神症状的严重性,同时在入组后第6个月末时统计2组找到竞争性就业岗位的患者数和平均工作天数.结果 (1)在入组后第6个月末评估时研究组WSSS总分高于对照组,阴性症状因子分低于对照组,均差异有统计学意义(均P＜0.00).同组比较:第6个月末研究组WSSS总分高于基线评估时,PANSS总分与阴性症状因子低于基线评估时,均差异有统计学意义(P＜0.01 ～0.05);第6个月末对照组阴性症状因子也低于基线评估时,差异有统计学意义(P＜0.01).(2)入组后第6个月末时2组就业情况比较:研究组先后有20例(37.03％)找到了竞争性的工作岗位,平均工作天数为(35.11±12.71)d,对照组有6例(11.11％)找到了竞争性的工作岗位,平均工作天数为(20.15 ±8.04)d,两组差异有统计学意义(x2=9.93,P＜0.01；t=2.70,P＜ 0.05).结论 SE服务可以改善精神分裂症患者获得与保持竞争性就业岗位的能力,提高就业率,同时对阴性症状的改善也有一定的疗效.

abstractsObjective To investigate the effects of supported employment(SE) on the vocational rehabilitation for schizophrenic rehabilitants.Methods 108 schizophrenic rehabilitants with stable conditions were recruited and randomly allocated into the control group and experimental group.Fifty-four cases in the control group received the general outpatient service and follow-up service with drug maintenance therapy and 54 cases in the experimental group received SE with drug maintenance therapy.At the baseline and the end of the sixth month,all of the 108 cases were assessed by the Positive and Negative Syndrome Scale (PANSS) and Work-related Social Skills Scale (WSSS) respectively.The competitive employment rate and average working days of the two groups were evaluated at the end of the sixth month.Results There was no significant difference in the total score of WSSS,and the total score of PANSS and its sub-scores on the Positive Scale,Negative Scale and General Psychopathological Scale betweeu the two groups at the baseline(P＞ 0.05).At the cnd of the sixth months,significant differences (P＜0.01 ～ 0.05) were found in the total score of WSSS,the sub-score of the Negative Scale,the competitive employment rate and the average working days((35.11 ± 12.71) d vs(20.15 ± 8.04) d) between the experimental and control groups.Conclusion SE can increase the employment rate of schizophrenic rehabilitants,improve their abilities to acquire and maintain competitive employment,and meanwhile relieve their negative symptoms.