中文摘要：

目的评价医院-社区-家庭-个人四级干预模式对精神分裂症患者服药依从性、复发率、精神病性症状、社会功能、生存质量的影响,为精神分裂症患者疾病管理模式提供资料。方法选择确诊为精神分裂症患者198例,采用数字表法随机分为医院-社区-家庭-个人四级干预模式组（99例）与常规干预组（99例）,对其分别进行常规管理与医院-社区-家庭-个人四级干预模式管理,干预6个月后,对两组服药依从性、复发率、精神病性症状量表、社会功能量表、生存质量量表进行效果评价。结果干预6个月后,四级干预模式组依从性、复发率、精神病性症状严重程度前后差值、社会功能前后差值分别为96.74%、13.04%、（7.57±2.83）分、[理解与交流（6.32±3.64）分,身体运动（5.16±3.28）分,自我料理（2.87±1.38）分,与他人相处（9.05±3.51）分,生活活动（5.42±2.49）分,社会参与（7.85±3.28）分],常规干预组分别为74.74%、28.42%、（4.86±1.24）分、[理解与交流（3.89±1.86）分,身体运动（2.80±1.23）分,自我料理（2.19±1.16）分,与他人相处（5.83±3.04）分,生活活动（3.41±1.96）分,社会参与（4.27±2.17）分],两组差异均有统计学意义（χ2=9.020,P=0.003;χ2=6.932,P=0.009。t=8.527,P=0.000;t=5.775,P=0.000;t=6.554,P=0.000;t=3.652,P=0.000;t=6.712,P=0.000;t=6.144,P=0.000;t=8.829,P=0.000）。四级干预模式组较常规干预组生活质量提高,四级干预模式组干预前后差值：心理社会（16.03±6.75）分,动力和精力（15.79±6.41）分,症状和副作用（19.37±7.28）分;常规干预组干预前后差值：心理社会（12.65±5.46）分,动力和精力（11.81±4.71）分,症状和副作用（15.18±6.29）分,两组差异均有统计学意义（t=3.770,P=0.000;t=4.849,P=0.000;t=4.216,P=0.000）。结论医院-社区-家庭-个人四级干预模式,较常规疾病管理模式提高了精神分裂症患者服药依从性、降低了复发?

英文摘要：

Objective To observe the influence of hospital - community - family - individual 4 - levelintervention model on schizophrenia patients in compliance, recurrence rate, psychotic symptom, social function, quality of life and provide guidance for disease management. Methods 198 schizophrenia patients were divided into 4 -level intervention model group and conventional intervention group. After 6 moths follow - up, the effect was evaluatedby compliance rate, recurrence rate, BPRS, WHO - DASII, SQLS. Results After the intervention for 6 months, thecompliance, recurrence rate, the difference of severity of psychotic symptom, the difference of social function of the 4 -level intervention model group were 96. 74%, 13. 04%, （ 7. 57 ± 2. 83） points, [ understanding and communication（ 6. 32 ±3. 64） points, physical exercise （ 5. 16 ±3. 28） points, self care （ 2. 87 ±1. 38） points, get on well with others（ 9. 05 ±3. 51） points, life activity （ 5. 42 ±2. 49） points, social participation （ 7. 85 ±3. 28） points] , which of conventional intervention group were 74 74%, 28. 42%, （ 4. 86 ±1. 24） points, [ understanding and communication （ 3. 89 ±1.86） points, physical exercise （ 2 80 ±1.238） points, self care （ 2. 19 ±1. 16） points, get on well with others （ 5. 83 ±3 04） points, life activity （ 3. 41 ± 1. 96） points, social participation （ 4. 27 ± 2. 17） points] , the differences betweenthe two groups were significant （ χ 2 =9. 020, P =0. 003; χ2=6. 932, P =0. 009; t =8. 527, P =0. 000; t =5. 775, P =0. 000; t =6. 554, P = 0. 000; t = 3. 652, P = 0. 000; t = 6 712, P = 0. 000; t = 6. 144, P = 0. 000; t = 8. 829, P =0 000） . The differences of before intervention and after intervention in the 4 - level intervention model group werepsychological society （ 16. 03 ± 6. 75） points, power and energy （ 15. 79 ± 6. 41） points, symptoms and side effects（ 19. 37 ± 7. 28） points, which in the conventional intervention group were psyc