Medical Social Work Interventional Research On Community Rehabilitation Of Schizophrenics From The Perspective Of Evidence-based Practice

Schizophrenia is one of the serious problems affecting public health security,which has brought great burden to patients,families and society.Driven by the third revolution in psychiatry,at the beginning of the 20 th century,China established a national mental health work plans,which emphasized on the schizophrenia’s prevention,treatment and rehabilitation.Mental health service system and the network gradually shifted to community and grass-roots.Community rehabilitation mode began to be applied and popularized in China as a kind of both have economic benefit and rehabilitation effect new pattern.In this case,social work can embedded itself into the the mental health service system.Social work plays an important role in the spirit of disease prevention and control system.At the same time,is also faced some problems,such as professional development difficulties and professional quality defects.There are also some needs of improving mental disorders community rehabilitation service development of specialization.Evidence-based practice is the way to help this work to get rid of professional dilemma and make it more scientific.This study is divided into five chapters,including introduction,evidence search and evaluation,research design,evidence implementation and application,and the research conclusions.The first chapter is the introduction.Schizophrenia community rehabilitation is concerned by different subjects,such as psychiatry,psychology and social work.Each subject not only has its own view on schizophrenia rehabilitation,but also has the professional treatment methods.The specific treatment plan is diverse.Which one is the best? Which treatment should be used in each individual patient? Social workers must distinguish them in a "scientific" way.Schizophrenia is a medical problem from the source,evidence-based practice also originated from evidence-based medicine,the application of certified effective evidence in rehabilitation services for schizophrenia’s evidence-based thinking should be consistent.In this chapter,the author arranged the concept,elements and their relations,operation steps and methods of evidence-based practice in detail,so as to make a better guidance of this research.The second chapter is evidence search and evaluation.according to the methods and steps of evidence-based practice,starting from the four elements of service object characteristics,service evidence,service practitioner skills and service environment of evidence-based practice,the author systematically evaluates the community rehabilitation service effect of schizophrenia patients,and selects randomized controlled experiments（N=4445）that meet the established inclusion criteria from 4562 original studies),the literature was managed by the Review Manager 5.4 tool,the bias risk assessment of the included literature was conducted based on the cochrane risk bias tool,and the efficacy of the intervention was evaluated using inductive methods.According to the judgment criteria of mental rehabilitation,the evaluation indicators include two dimensions: clinical symptom relief and functional rehabilitation.The second chapter is the evidence search and evaluation.In this part,according to the methods and steps of evidence-based practice,the author carried out a systematic evaluation of community rehabilitation services for schizophrenics and evaluates the effects of community rehabilitation services for schizophrenics from the four elements of service object characteristics,service evidence,service practitioner skills and service environment of evidence-based practice.Randomized controlled trials（N=4445）that met the inclusion criteria were selected from 4562 original studies,the literature was managed by the Review Manager5.4 tool,the cochrane risk bias tool was used to assess the risk of bias in the included literature,and the efficacy of the intervention was evaluated using the induction description method.According to the criteria of mental rehabilitation,the evaluation indexes include clinical symptom relief and functional rehabilitation.The third chapter is the research design.This part defined the research objectives,research content,research methods,research tools,research process and other contents.This study took home patients with schizophrenia as the research object.First of all,using the systematic evaluation method to get the risk bias evaluation of the existing research evidence of community rehabilitation of schizophrenia patients,then we obtained the best evidence of community rehabilitation of schizophrenia patients in theory;Secondly,the research evidence was applied to 24 subjects,and the effect of service was observed and analyzed by randomized control method.Finally,the best service evidence of medical social workers’ intervention in community rehabilitation of schizophrenia patients was obtained.This study,on one hand,can improve the rehabilitation level of schizophrenia patients;on the other hand,it contributes to enrich the theoretical research achievements of medical social work and promote the professionalization and localization of medical social work.The fourth chapter is the implementation and application of evidence.In this chapter the author studied the effect of psychomotor rehabilitation service and social skill rehabilitation service carried out by medical social workers in group work on the rehabilitation level of schizophrenia patients at home.This chapter took the health promotion studio of L Street,Yuzhong District,Chongqing as the research place.After analyzing the basic situation and needs of schizophrenic patients in L Street,Yuzhong District,Chongqing through interviews,24 schizophrenic patients in home state are carried out the intervention for 3 months.The results were evaluated in terms of positive and negative symptoms（PANSS）and social dysfunction（SDSS）.The fifth chapter is the research conclusion.This study was summarized,reflected and prospected.Firstly,from biological psychiatry and sociology,the theoretical logic of medical social work service to improve the level of community rehabilitation of schizophrenia patients has been analyzed.Secondly,starting from the specific practice of community rehabilitation services for mental disorders in L Street,Yuzhong District,Chongqing,the impact of medical social work services on the community rehabilitation service system for mental disorders was summarized.Finally,some suggestions were put forward from the perspectives of mental illness prevention,scientific decision-making and talent training.