Impact of Hospital-Community-Family Linkage Model Intervention on Patients with Schizophrenia during the Post-Discharge Rehabilitation Period

Shu TAN; Jing ZENG; Runjuan MA; Wensa YIN

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Shu TAN, Jing ZENG, Runjuan MA, Wensa YIN. Impact of Hospital-Community-Family Linkage Model Intervention on Patients with Schizophrenia during the Post-Discharge Rehabilitation Period[J]. Journal of Kunming Medical University.

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Impact of Hospital-Community-Family Linkage Model Intervention on Patients with Schizophrenia during the Post-Discharge Rehabilitation Period

Nursing Department，Affiliated Mental Health Center of Kunming Medical University，Kunming Yunnan 650032，China

Received Date: 2025-07-22

Abstract

Abstract

Objective To explore the effects of a hospital-community-family linkage nursing model on the unplanned readmission rate, Activity of Daily Living Scale （ADL）, Brief Psychiatric Rating Scale （BPRS）, and Social Disability Screening Schedule （SDSS） scores of patients with convalescent schizophrenia within 6 months after discharge. Methods A randomized controlled trial was conducted using a random number table. Ninety-eight eligible patients with convalescent schizophrenia discharged from a tertiary-grade A psychiatric hospital between January 2022 and January 2023 were enrolled and randomly assigned to an intervention group （n = 49） and a control group （n = 49）. The control group received routine continuous care, including telephone follow-ups and reminders for re-examinations. The intervention group received hospital-community-family linkage interventions, including dynamic health management, community rehabilitation activities, and family supervision. Repeated measures analysis of variance （ANOVA） was used to compare rehabilitation outcomes at different time points between the two groups. Results At 6 months post-discharge, the unplanned readmission rate was 6.12% in the intervention group, significantly lower than that in the control group （42.86%）（χ² = 18.732, P < 0.001）.Repeated measures ANOVA revealed significant time and group interaction effects, time main effects, and group main effects for: ADL（F = 13.753/40.338/24.172, P < 0.001）, SDSS（F = 15.117/25.338/10.612, P < 0.001）, BPRS（F = 27.289/74.970/70.157, P < 0.001）.At 6 months, the intervention group showed significantly better outcomes than controls in: ADL（14.32±1.14, 21.77±4.68; P < 0.05）, SDSS（2.98±2.05, 7.26±2.88; P < 0.05）, BPRS（19.30±2.24, 33.82±5.59; P <0.05）. Conclusion The hospital-community-family linkage nursing model can effectively reduce the unplanned readmission rate and improve the daily living ability of patients with convalescent schizophrenia.
- Schizophrenia,
- Integrated hospital-community-family care,
- Unplanned readmission rate

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References(23)

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