综合医院精神科青少年来诊者首诊后按时复诊情况调查  

Investigation into the timely return visit rates after first interview in adolescent clients to the psychiatric outpatient clinic of a general hospital

作　　者：陈敏华[1] 曲峰蕾 周丽娜 叶莉 王相兰[1] Chen Minhua;Qu Fenglei;Zhou Lina;Ye Li;Wang Xianglan(Department of Psychiatry,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院精神科,广州510630

出　　处：《中华医学杂志》2020年第21期1658-1661,共4页National Medical Journal of China

摘　　要：目的调查精神科门诊青少年来诊者首诊后的按时复诊情况及其相关因素。方法对2018年5至10月中山大学附属第三医院精神科所有首次来诊青少年进行调查,以首诊后1个月内到门诊复诊为按时复诊,通过χ^2检验、Logistic回归等分析按时复诊率(RVR)及其相关因素,并通过电话随访调查未复诊的原因。结果共纳入1121例来诊者,年龄(16.0±1.6)岁,85.8%为学生,总体RVR为62.7%(703/1121),希望药物治疗者RVR(69.8%)最高,不接受药物治疗者(55.8%)最低(χ^2=9.028,P=0.029)。住院治疗者RVR最高(97.6%),门诊药物治疗者(61.2%)次之,观察和自我调整者(45.3%)最低(χ^2=82.269,P<0.001)。处方了心境稳定剂者按时复诊率显著高于未使用者(χ^2=9.498,P=0.002)。Logistic回归分析显示处理方式和是否使用稳定剂是影响按时复诊的主要因素。电话随访显示未复诊的主要原因是症状好转(68.4%)和条件限制(14.3%)。结论对药物治疗态度越积极者按时复诊率越高,住院治疗和使用心境稳定剂者按时复诊率较高。来诊者对系统治疗的认识不足是其未复诊的主要原因。Objective To investigate the timely return visit rates after first visits of adolescent clients to the psychiatric outpatient clinic in a general hospital and analyze the relevant factors.Methods All adolescent clients firstly visited psychiatric outpatient clinic of the Third Affiliated Hospital of Sun Yat-sen University from May to October 2018 were surveyed.The timely return visit was defined as the return visit within one month after the first visit and the timely return visit rate(RVR)was calculated.Chi-square test and binary Logistic regression were used to compare the RVR subgroup differences and relevant factors.Reasons for non-attendance at the return visit were acquired by the telephone follow-up.Results A total of 1121 cases were enrolled,with an age of(16.0±1.6)years,85.8%of them were students,and the overall RVR was 62.7%(703/1121).The highest RVR was found in those who hoped for drug treatment(69.8%)and the lowest in those who did not accept drug treatment(55.8%)(χ^2=9.028,P=0.029).The highest RVR was found in hospitalized patients(97.6%),followed by outpatient pharmacotherapy group(61.2%)and keeping observation and self-adjustment group(45.3%)(χ^2=82.269,P<0.001).The RVR of patients prescribed mood stabilizers was significantly higher than that of non-users(χ^2=9.498,P=0.002).Logistic regression analysis showed the main factors that affect the timely return visit included treatment regimens and prescribing of mood stabilizers.Results of telephone follow-up of clients with non-attendance showed that the main reasons were symptoms alleviation(68.4%)and various visiting barriers(14.3%).Conclusions Clients with active attitude towards pharmacotherapy,hospitalization and using mood stabilizers in outpatient have higher RVR rates.Insufficient understanding of systemic therapy remains the main reason why the clients fail to attend the return visit in time.

关 键 词：青少年 精神科 门诊 复诊率 随访 

分 类 号：R74[医药卫生—神经病学与精神病学]