Article(id=1311350481578980064, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202603459, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1774886400000, receivedDateStr=2026-03-31, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579918522, onlineDateStr=2026-09-28, pubDate=1787587200000, pubDateStr=2026-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579918522, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579918522, creator=13701087609, updateTime=1790579918522, updator=13701087609, issue=Issue{id=1311350363295417204, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='16', pageStart='2881', pageEnd='3072', issueExtLink='null', onlineDate='null', pubDate='1787587200000', pubDateStr='2026-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1790579890321, creator='13701087609', updateTime=1790584112451, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311368072267653663, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311368072267653664, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350363295417204, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2956, endPage=2961, ext={EN=ArticleExt(id=1311350481780306657, articleId=1311350481578980064, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Development of a comprehensive evaluation index system for community-based rehabilitation interventions for patients with severe mental disorders, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To develop a comprehensive evaluation index system for community-based rehabilitation interventions tailored to China, addressing various adverse outcomes among patients with severe mental disorders, and to provide an assessment tool for improving the community-based rehabilitation management system at the grassroots level.

Methods

The indicator system was developed based on the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework, in conjunction with China’s guidelines for the management and treatment of severe mental disorders. Using the Delphi expert consultation method, we conducted two rounds of expert consultations with 15 experts to select the evaluation indicators, and then applied the Analytic Hierarchy Process (AHP) to calculate the weights of each indicator, thereby establishing an indicator system.

Results

The questionnaire response rate was 100% in both rounds of expert consultation, with an expert authority coefficient of 0.85. The final indicator system comprises 4 first-level indicators, 13 second-level indicators, and 22 third-level indicators. The first-level indicators, ranked by weight from highest to lowest, are: risk behaviors (0.389 0), disease status (0.273 4), social functions (0.224 6), and mental functions (0.113 0).

Conclusion

The indicator system developed in this study focuses on the comprehensive rehabilitation levels of patients with severe mental disorders across multiple dimensions of adverse outcomes. It demonstrates good scientific validity and reliability and can serve as an assessment tool for evaluating community-based rehabilitation outcomes and improving services.

, authors=Lan WU1, Lei LEI2, Xiao-rong QIN3, Xiao-fan PENG1, Xiao-jing ZHANG1, Yuan-yuan LIU1, Xiang LIU4, Xian-mei YANG2, authorsList=Lan WU, Lei LEI, Xiao-rong QIN, Xiao-fan PENG, Xiao-jing ZHANG, Yuan-yuan LIU, Xiang LIU, Xian-mei YANG, authorCompany=null, correspAuthors=Xian-mei YANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350482568835814, articleId=1311350481578980064, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=严重精神障碍患者社区康复干预效果综合评价指标体系构建研究, columnId=1228016573533847611, journalTitle=现代预防医学, columnName=基层卫生服务, runingTitle=null, highlight=null, articleAbstract=
目的

针对严重精神障碍患者的各类不良结局,构建适用于我国的社区康复干预效果综合评价指标体系,为完善基层社区康复管理体系提供测评工具。

方法

基于WHO的国际功能、残疾和健康分类(International Classification of Functioning, Disability and Health , ICF)框架,结合我国严重精神障碍管理治疗工作规范,进行指标体系构建。采用德尔菲专家咨询法,对15名专家进行2轮专家咨询完成评价指标的筛选,并运用层次分析法计算各指标权重,从而构建指标体系。

结果

两轮专家咨询问卷回收率均为100%,专家权威系数为0.85。最终构建的指标体系包括4个一级指标、13个二级指标、22个三级指标。一级指标权重从大到小分别为:危险行为(0.389 0)、疾病情况(0.273 4)、社会功能(0.224 6)、心理功能(0.113 0)。

结论

本研究构建的指标体系聚焦严重精神障碍患者多维度不良结局的综合康复水平,具有较好的科学性和可靠性,可为社区康复效果评价和服务改进提供测评工具。

, authors=巫岚1, 雷蕾2, 秦小荣3, 彭小凡1, 张晓婧1, 刘元元1, 刘祥4, 杨先梅2, authorsList=巫岚, 雷蕾, 秦小荣, 彭小凡, 张晓婧, 刘元元, 刘祥, 杨先梅, authorCompany=null, correspAuthors=杨先梅, authorNote=

巫岚(2001—),女,硕士在读,研究方向:流行病与卫生统计学

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杨先梅,E-mail:
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Basis for expert judgment

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判断依据影响程度大影响程度中影响程度小
分值人数分值人数分值人数
工作经验0.5100.450.30
理论依据0.360.290.10
从国内外同行处了解0.160.180.11
直觉判断0.100.160.19
), ArticleFig(id=1311350487501337381, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350481578980064, language=CN, label=表1, caption=

专家判断依据表

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判断依据影响程度大影响程度中影响程度小
分值人数分值人数分值人数
工作经验0.5100.450.30
理论依据0.360.290.10
从国内外同行处了解0.160.180.11
直觉判断0.100.160.19
), ArticleFig(id=1311350487581029158, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350481578980064, language=EN, label=Table 2, caption=

Expert self-assessment of familiarity

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熟悉程度很熟悉熟悉一般熟悉不熟悉很不熟悉
分值人数分值人数分值人数分值人数分值人数
专家自评0.970.780.500.300.10
), ArticleFig(id=1311350487639749415, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350481578980064, language=CN, label=表2, caption=

专家熟悉程度自评表

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熟悉程度很熟悉熟悉一般熟悉不熟悉很不熟悉
分值人数分值人数分值人数分值人数分值人数
专家自评0.970.780.500.300.10
), ArticleFig(id=1311350487719441192, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350481578980064, language=EN, label=Table 3, caption=

Comprehensive evaluation index system and weights for community rehabilitation interventions for patients with severe mental disorders

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一级指标权重二级指标权重三级指标权重
疾病情况(Disease status)0.273 4精神病症状0.477 5精神病症状1.000 0
复发0.419 3因精神障碍住院次数1.000 0
共病0.103 2新增共病情况1.000 0
心理功能(Mental functions)0.113 0认知功能0.531 6注意力0.760 1
记忆力0.134 3
自知力0.105 6
情感功能0.295 4焦虑0.329 5
抑郁0.670 5
睡眠功能0.173 0失眠0.704 5
嗜睡0.295 5
社会功能(Social functions)0.224 6自我照顾0.420 0个人生活料理0.151 8
服药依从性0.848 2
家务劳动0.172 5家务劳动1.000 0
工作与学习0.186 6工作/学习类型0.486 0
工作/学习难易程度0.514 0
社会人际交往0.220 9社会人际交往1.000 0
危险行为(Risk behaviors)0.389 0对自我危险行为0.318 2自伤0.310 2
自杀未遂0.689 8
对他人危险行为0.509 0轻度滋事0.084 7
肇事0.378 8
肇祸0.536 5
其他危险行为0.172 8其他危险行为1.000 0
), ArticleFig(id=1311350487790744361, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350481578980064, language=CN, label=表3, caption=

严重精神障碍患者社区康复干预效果综合评价指标体系及权重

, figureFileSmall=null, figureFileBig=null, tableContent=
一级指标权重二级指标权重三级指标权重
疾病情况(Disease status)0.273 4精神病症状0.477 5精神病症状1.000 0
复发0.419 3因精神障碍住院次数1.000 0
共病0.103 2新增共病情况1.000 0
心理功能(Mental functions)0.113 0认知功能0.531 6注意力0.760 1
记忆力0.134 3
自知力0.105 6
情感功能0.295 4焦虑0.329 5
抑郁0.670 5
睡眠功能0.173 0失眠0.704 5
嗜睡0.295 5
社会功能(Social functions)0.224 6自我照顾0.420 0个人生活料理0.151 8
服药依从性0.848 2
家务劳动0.172 5家务劳动1.000 0
工作与学习0.186 6工作/学习类型0.486 0
工作/学习难易程度0.514 0
社会人际交往0.220 9社会人际交往1.000 0
危险行为(Risk behaviors)0.389 0对自我危险行为0.318 2自伤0.310 2
自杀未遂0.689 8
对他人危险行为0.509 0轻度滋事0.084 7
肇事0.378 8
肇祸0.536 5
其他危险行为0.172 8其他危险行为1.000 0
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严重精神障碍患者社区康复干预效果综合评价指标体系构建研究
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巫岚 1 , 雷蕾 2 , 秦小荣 3 , 彭小凡 1 , 张晓婧 1 , 刘元元 1 , 刘祥 4 , 杨先梅 2
现代预防医学 | 基层卫生服务 2026,53(16): 2956-2961
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现代预防医学 |基层卫生服务 2026 , 53 (16) : 2956 -2961
严重精神障碍患者社区康复干预效果综合评价指标体系构建研究
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巫岚1, 雷蕾2, 秦小荣3, 彭小凡1, 张晓婧1, 刘元元1, 刘祥4, 杨先梅2
作者信息
  • 1.四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系,四川 成都 610041
  • 2.绵阳市第三人民医院·四川省精神卫生中心
  • 3.成都市第四人民医院.成都市精神卫生中心
  • 4.四川大学华西公共卫生学院/四川大学华西第四医院健康行为与社会医学系
通讯作者:
杨先梅,E-mail:
作者简介:

巫岚(2001—),女,硕士在读,研究方向:流行病与卫生统计学

Development of a comprehensive evaluation index system for community-based rehabilitation interventions for patients with severe mental disorders
Lan WU1, Lei LEI2, Xiao-rong QIN3, Xiao-fan PENG1, Xiao-jing ZHANG1, Yuan-yuan LIU1, Xiang LIU4, Xian-mei YANG2
Affiliations
  • Department of Epidemiology and Health Statistics, West China School of Public Health, West China Fourth Hospital,Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-08-25 doi: 10.20043/j.cnki.MPM.202603459
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目的

针对严重精神障碍患者的各类不良结局,构建适用于我国的社区康复干预效果综合评价指标体系,为完善基层社区康复管理体系提供测评工具。

方法

基于WHO的国际功能、残疾和健康分类(International Classification of Functioning, Disability and Health , ICF)框架,结合我国严重精神障碍管理治疗工作规范,进行指标体系构建。采用德尔菲专家咨询法,对15名专家进行2轮专家咨询完成评价指标的筛选,并运用层次分析法计算各指标权重,从而构建指标体系。

结果

两轮专家咨询问卷回收率均为100%,专家权威系数为0.85。最终构建的指标体系包括4个一级指标、13个二级指标、22个三级指标。一级指标权重从大到小分别为:危险行为(0.389 0)、疾病情况(0.273 4)、社会功能(0.224 6)、心理功能(0.113 0)。

结论

本研究构建的指标体系聚焦严重精神障碍患者多维度不良结局的综合康复水平,具有较好的科学性和可靠性,可为社区康复效果评价和服务改进提供测评工具。

严重精神障碍  /  社区康复  /  指标体系  /  德尔菲法  /  层次分析法
Objective

To develop a comprehensive evaluation index system for community-based rehabilitation interventions tailored to China, addressing various adverse outcomes among patients with severe mental disorders, and to provide an assessment tool for improving the community-based rehabilitation management system at the grassroots level.

Methods

The indicator system was developed based on the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) framework, in conjunction with China’s guidelines for the management and treatment of severe mental disorders. Using the Delphi expert consultation method, we conducted two rounds of expert consultations with 15 experts to select the evaluation indicators, and then applied the Analytic Hierarchy Process (AHP) to calculate the weights of each indicator, thereby establishing an indicator system.

Results

The questionnaire response rate was 100% in both rounds of expert consultation, with an expert authority coefficient of 0.85. The final indicator system comprises 4 first-level indicators, 13 second-level indicators, and 22 third-level indicators. The first-level indicators, ranked by weight from highest to lowest, are: risk behaviors (0.389 0), disease status (0.273 4), social functions (0.224 6), and mental functions (0.113 0).

Conclusion

The indicator system developed in this study focuses on the comprehensive rehabilitation levels of patients with severe mental disorders across multiple dimensions of adverse outcomes. It demonstrates good scientific validity and reliability and can serve as an assessment tool for evaluating community-based rehabilitation outcomes and improving services.

Severe mental disorders  /  Community-based rehabilitation  /  Indicator system  /  Delphi method  /  Analytic Hierarchy Process
巫岚, 雷蕾, 秦小荣, 彭小凡, 张晓婧, 刘元元, 刘祥, 杨先梅. 严重精神障碍患者社区康复干预效果综合评价指标体系构建研究. 现代预防医学, 2026 , 53 (16) : 2956 -2961 . DOI: 10.20043/j.cnki.MPM.202603459
Lan WU, Lei LEI, Xiao-rong QIN, Xiao-fan PENG, Xiao-jing ZHANG, Yuan-yuan LIU, Xiang LIU, Xian-mei YANG. Development of a comprehensive evaluation index system for community-based rehabilitation interventions for patients with severe mental disorders[J]. Modern Preventive Medicine, 2026 , 53 (16) : 2956 -2961 . DOI: 10.20043/j.cnki.MPM.202603459
罹患严重精神障碍不仅影响患者的个体健康与社会功能,也给家庭和社会带来沉重负担,如何减少和预防严重精神障碍所引起的各类不良结局危害是一个不容忽视的全球公共卫生问题[1]。社区康复是解决严重精神障碍患者康复需求的基本策略和回归融入社会的主要途径[2]。《“健康中国”2030规划纲要》也明确指出“加强严重精神障碍患者救治救助管理,全面推进精神障碍社区康复”[3]。
科学系统的评价体系是提升严重精神障碍社区康复干预效果与服务质量的重要前提,其不仅能为量化评估社区康复工作成效提供客观依据,更能为优化康复服务内容与模式以及制定针对性的干预策略提供方向。近年来,我国严重精神障碍社区康复工作在各地逐步推进并取得一定成效[4],但与之配套的康复评价体系建设仍存在局限。一方面,绝大多数地区的社区康复工作侧重于对患者进行常规随访,并统计区域内的宏观管理指标,如报告患病率、规范管理率及规律服药率等[5],以及精神卫生服务的可及性或服务效率等的评价[6]。这类指标主要用于整体层面的评估,难以反映患者个体的康复干预效果。另一方面,针对严重精神障碍患者的社区康复研究,其结局评价多局限于精神病性症状、自知力、社会支持、社会功能、或生活质量等单一维度指标[7~9],缺乏能够综合反映患者康复水平的评价体系。因此本研究以国际功能、残疾和健康分类(International Classification of Functioning, Disability and Health , ICF)[10]为基础框架,结合我国严重精神障碍管理治疗工作规范[11],通过文献回顾、德尔菲法和层次分析法,构建了一套供基层精神卫生工作人员使用的综合评价指标体系。该指标体系兼顾科学性与可行性,旨在为严重精神障碍患者社区康复干预效果的全面、科学评价,以及社区康复管理服务体系的完善提供参考依据。
以严重精神障碍、社区康复、Severe Mental Disorders、Community-Based Rehabilitation等为主题,通过中国知网、万方数据、PubMed、Web of Science等数据库检索国内外相关文献并分析整理,最后基于ICF的理论框架对患者各类不良结局进行归纳,结合我国严重精神障碍管理治疗工作规范,同时参考世界卫生组织残疾评定量表(Disability Assessment Schedule 2.0, DAS2.0)[12],经过课题组进行多轮讨论和总结后,充分考虑指标的重要性和可及性,梳理出了严重精神障碍患者社区康复干预效果综合评价指标体系及德尔菲专家咨询问卷初稿。
采用德尔菲专家咨询法,通过电子邮件邀请国内外相关领域专家,对评价指标的重要性进行评分并提出修改意见,以完成指标体系的构建。专家入选标准为:①从事精神医学、康复医学、公共卫生管理、流行病学等相关领域工作10年以上,具有丰富的临床或科研实践经验;②具有中级及以上专业技术职称;③对本研究主题感兴趣且自愿参与。在专家初选后,对每位专家进行讲解本研究的方法、意义以及相关信息,确认专家自愿参与本研究后,进一步征询其相关意见。整个咨询过程中专家独立判断,在每一轮咨询完成回收问卷后,及时整理汇总并统计分析专家的反馈意见。
根据初步确定的指标体系,编制结构式问卷《严重精神障碍患者社区康复干预效果综合评价指标专家咨询表》,通过电子邮件形式向专家开展2轮咨询。问卷包括3个部分:①专家一般情况调查表,填写个人基本信息。②采用Likert-5级对指标的重要性进行评分,同时设置需要添加或删除的指标与修改建议栏。③对研究熟悉程度(Cs)及判别依据(Ca)进行评分[13],具体赋值见表1、表2。
(1)专家积极程度:通过函询问卷的回收率反映,当回收率大于70%时[14],表示专家参与的积极程度较高。
(2)专家权威程度(Cr):通过指标判断依据(Ca)和熟悉程度(Cs)进行计算,,当Cr大于0.7时,表明专家的权威程度较好,结果可接受[15]。
(3)专家意见协调程度:通过变异系数和肯德尔协调系数(Kendall W)来衡量,变异系数越小,Kendall W越大,表明专家意见一致性越好[16]。对Kendall W值进行χ2检验,当P<0.05,表示评价结果具有可信性。
(4)专家意见集中程度:通过指标的算数均数和满分比来反映,均值和满分比越大,该指标重要性越高。
(5)指标筛选:对均值>3.5,满分率>20%且变异系数<0.25的指标予以保留,并结合专家意见和临床实际进行修订,经小组讨论后确定最终指标体系。
在德尔菲专家咨询所确定的指标体系基础上,建立评价指标体系层次结构模型并对专家进行层次分析问卷调查。利用Saaty1-9标度法[17]构建一系列判断矩阵,对各层级内的指标进行两两比较,计算各判断矩阵的特征向量和指标的权重系数,并对判断矩阵进行一致性检验。当一致性比率(Consistency Ratio, CR)值<0.1时,表示各层指标判断矩阵构建合理,有较好的一致性[18]。
采用Excel 2019对德尔菲专家咨询结果整理汇总,使用SPSS 26.0软件计算各指标的算数均数、标准差、满分比、积极程度、权威程度、意见协调程度、意见集中程度和指标权重。采用χ2检验对Kendall W进行假设检验,检验水准α=0.05。
(1)专家基本情况:本研究共邀请15名专家参与咨询,平均年龄为(51.0±12.8)岁;平均工作年限为(25.8±13.2)年,其中20年以上10人(66.67%);硕士及以上学历10人(66.67%);副高及以上职称13人(86.67%)。专业领域涵盖精神病与精神卫生学、法医精神病学、临床心理学、卫生管理学、护理学、公共卫生等。
(2)专家积极程度和权威程度:两轮专家函询的问卷回收率均为100%,且第1轮中多名专家提出了建设性修改意见,表明专家对本研究的重视程度和参与积极性较高。专家权威系数为0.85,结果具有较高的可信度。
(3)专家意见协调程度和集中程度:两轮函询后,各指标重要性评分的变异系数均小于0.25,肯德尔协调系数由第1轮的0.209上升至第2轮的0.332(P均小于0.001),表明专家意见逐步趋于一致,协调性良好。第1轮和第2轮咨询中,所有指标重要性的算术平均值分别均大于3.5和3.6,满分比均高于20%,表明专家意见较为集中。
(4)指标增删和修改:
第1轮咨询结束后,一级指标“心理功能”和三级指标“注意力”的变异系数略大于0.25。心理功能是反映患者康复的重要指标,相关研究表明其改善与症状缓解、负性情绪降低及复发率下降密切相关[19~20];而注意力作为认知功能的一个关键维度,其改善同样有助于提升整体认知功能和社会功能[21~23]。由于这2项指标在精神障碍患者康复效果评估中具有不可替代的重要性,经专家和课题小组讨论后,决定予以保留。此外,根据专家意见对指标体系还进行了如下调整:①删除2项指标,分别是二级指标“活动性”和三级指标“自杀”。②新增9项指标,包含3项二级指标和6项三级指标。3项二级指标分别是“共病”,“其他危险行为”和“家务劳动”。6项三级指标分别是“记忆力”、“嗜睡”、“工作/学习类型”、“新增共病情况”,“其他危险行为”和“家务劳动”。③合并2项三级指标“与陌生人相处”和“与关系密切的人相处”为1项三级指标“社会人际交往”。④修改了7项具体评分说明。
第2轮咨询结束后所有指标均保留,无新增和删除条目,修改了2项三级指标的具体评分说明。
以“严重精神障碍患者社区康复干预效果综合评价指标体系”作目标层,准则层为一级指标,子准则层为二级指标,指标层为三级指标,具体见图1。
各层级指标判断矩阵的一致性比率CR均小于0.1,表明指标权重设置逻辑合理,一致性程度高,最终评价指标体系包括4个一级指标、13个二级指标、22个三级指标,具体结果见表3。
当前社区康复工作多侧重于宏观管理层面的统计报告[5],且既往研究关注的结局多局限于单一维度的少数指标,难以全面把握患者的整体康复状态。本研究依据ICF[10]理论框架进行维度划分,同时遵循《严重精神障碍管理治疗工作规范》[11],在指标设置上与国家严重精神障碍管理信息系统有效衔接,确保指标体系的科学性与可及性。本研究构建的指标体系包含疾病情况、心理功能、社会功能、危险行为4个一级指标,13个二级指标以及22个三级指标,体现了生物-心理-社会模式的整合视角,使康复效果的评价回归到患者本身,为个体化康复干预提供依据。
本研究结果显示,一级指标权重从大到小分别为危险行为、疾病情况、社会功能、心理功能。危险行为权重最高,这凸显了其在评估体系中的重要性。尽管在规范的康复干预下,患者中危险行为的发生率较低,但将其纳入评估并持续监测康复过程中的安全隐患,对保障患者及社区安全具有重要的底线意义。疾病情况位居第二,提示严重精神障碍患者的关键康复目标仍是症状控制与病情稳定[24]。精神症状的缓解是患者回归社会的基础,也是社区康复干预的重点内容。社会功能在评价体系中占有重要位置,反映出专家共同认为康复的最终目标是帮助患者恢复社会角色、参与日常活动,与我国精神障碍康复“促进患者回归社会”的政策导向[4]以及世界卫生组织“功能恢复”的理念相契合[25]。心理功能同样是体系的重要维度,说明情绪调节、自知力等内在心理状态对康复质量具有不可忽视的影响,体现了“全人康复”理念[26]。综上,权重分布体现了康复评价的优先级,以危险行为监测为安全底线,症状控制为基础,同时促进社会功能与心理状态的改善,为社区康复服务的资源配置和干预重点提供了量化依据。
本指标体系的实践应用价值主要体现在以下几方面:第一,为基层精防人员提供了标准化的测评工具,通过对患者开展的定期随访,可实现社区康复干预效果的动态比较,进而掌握患者康复进展并及时调整康复方案。第二,本指标与国家现有的严重精神障碍患者管理工作衔接紧密,如精神病性症状、危险行为等指标的评价可直接调用严重精神障碍管理信息系统,既避免了重复评估带来的工作负担,又确保了数据来源的可及性和稳定性。第三,通过本指标体系的推广应用,可积累不同地区、不同类型患者的相关数据,为卫生行政部门评估社区康复服务成效,识别服务短板和优化资源配置提供参考依据。
本研究同时存在一定局限性。目前仅完成了指标体系的构建,尚未进行大范围的实证应用。后续研究将在此基础上,开展多中心、大样本的前瞻性队列研究,对指标体系的信效度、区分度及适用性进行系统验证,并根据实证结果,优化指标设置与权重分配,以进一步提升指标体系的科学性与可操作性,为其在社区康复实践中的推广应用提供更可靠的依据。本研究聚焦于患者个体水平的康复评价,未纳入家庭支持、社区资源、服务可及性等环境变量,这些因素虽不直接构成康复结局,却对康复进程具有重要影响。鉴于本研究的指标体系定位,接下来的实证研究将把上述变量作为背景指标,纳入与指标体系配套的问卷调查中,从而保证指标体系聚焦个体水平的同时,为后续有关环境因素的分析提供数据支撑。
  • 四川省自然科学基金面上项目(2025ZNSFSC0782)
  • 国家自然科学基金项目(81903414)
  • 绵阳市卫健委项目(2024082)
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2026年第53卷第16期
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doi: 10.20043/j.cnki.MPM.202603459
  • 接收时间:2026-03-31
  • 首发时间:2026-09-28
  • 出版时间:2026-08-25
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  • 收稿日期:2026-03-31
基金
四川省自然科学基金面上项目(2025ZNSFSC0782)
国家自然科学基金项目(81903414)
绵阳市卫健委项目(2024082)
作者信息
    1.四川大学华西公共卫生学院/华西第四医院流行病与卫生统计学系,四川 成都 610041
    2.绵阳市第三人民医院·四川省精神卫生中心
    3.成都市第四人民医院.成都市精神卫生中心
    4.四川大学华西公共卫生学院/四川大学华西第四医院健康行为与社会医学系

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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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