社区严重精神障碍患者规律面访情况及其影响因素研究  

Prevalence and Influencing Factors of Receiving Regular Interviews for Patients with Severe Mental Disorders in Communities

作　　者：冯为[1] 李世明 杨雀屏[1] 吴越[1] 崔凤伟 FENG Wei;LI Shiming;YANG Queping;WU Yue;CUI Fengwei(Department of Social Prevention,the Affiliated Wuxi Mental Health Center of Nanjing Medical University,Wuxi 214000,China)

机构地区：[1]南京医科大学附属无锡市精神卫生中心社会防治办公室,江苏无锡214000

出　　处：《中国全科医学》2022年第4期475-479,共5页Chinese General Practice

基　　金：南京医科大学科技发展基金项目(NMUB2019305);无锡市重点软科学课题(KX-21-C230)。

摘　　要：背景严重精神障碍患者因自知力欠缺及高复发性、高致残性等特点,对社会稳定造成严重威胁。做好社区面访管理工作意义重大,通过定期面访患者本人,可以更好地综合评估患者病情,以便及时采取措施,提高管理服务质量。目的了解社区严重精神障碍患者规律面访情况及其影响因素,为提高社区患者的面访服务管理质量提供参考依据。方法2020年10—12月,利用2019年底江苏省严重精神障碍管理系统中建档管理的无锡市严重精神障碍患者基础档案及随访管理信息,分析当年度无锡市社区严重精神障碍患者规律面访情况,采用Logistic回归分析规律面访的影响因素。结果共纳入27778例研究对象,其规律面访率为81.08%(22523/27778)。Logistic回归分析结果显示,非本地户籍〔OR(95%CI)=0.704(0.640,0.775)〕、年龄≤44岁〔OR(95%CI)=0.522(0.472,0.578)〕、学历为高中及以上〔高中/中专OR(95%CI)=0.493(0.446,0.545),大专及以上OR(95%CI)=0.470(0.415,0.532)〕、目前有正式工作〔OR(95%CI)=0.715(0.668,0.766)〕、未婚〔OR(95%CI)=0.746(0.665,0.838)〕、经济状况为非贫困〔OR(95%CI)=0.587(0.517,0.666)〕、没有进行抗精神病药物治疗〔OR(95%CI)=0.491(0.440,0.548)〕、服药时长0~10年〔OR(95%CI)=0.881(0.778,0.998)〕、不是“以奖代补”监护补助对象〔OR(95%CI)=0.807(0.704,0.926)〕、不参加社区康复服务〔OR(95%CI)=0.844(0.716,0.996)〕是患者规律面访的消极影响因素(P<0.05)。结论无锡市社区严重精神障碍患者规律面访率尚需进一步提高,应重点关注非本地户籍、年龄≤44岁、高中及以上学历、目前有正式工作、未婚、经济非贫困、没有进行抗精神病药物治疗、服药时长0~10年、不是监护补助对象和不参加社区康复服务的社区严重精神障碍患者。可通过制定倾斜性政策、开展宣传教育、降低患者病耻感、改善患者疾病认知、加强患者社会支持等措施提�Background Patients with severe mental disorders pose a serious threat to social stability due to lack of insight and high recurrence and disability rates.Therefore,it is essential to conduct regular interviews with these patients to better evaluate their conditions comprehensively,so as to timely deliver appropriate interventions,thereby improving the level of severe mental disorder management.Objective To explore the prevalence of receiving regular interviews and associated factors in patients with severe mental disorders in the community,providing information for improving the quality of severe mental disorder management via interviews.Methods Basic and follow-up management data of Wuxi severe mental disorder patients with files created as of 2019 were collected from Jiangsu Severe Mental Disorder Patients Management System during October to December 2020.The prevalence of these patients receiving regular interviews was analyzed,and associated factors were examined by Logistic regression analysis.Results A total of 27778 samples were included,with a prevalence of receiving regular interviews of 81.08%(22523/27778).Logistic regression analysis showed that non-local hukou〔OR(95%CI)=0.704(0.640,0.775)〕,≤44 years old〔OR(95%CI)=0.522(0.472,0.578)〕,education level〔high school/secondary vocational school:OR(95%CI)=0.493(0.446,0.545)and junior college:OR(95%CI)=0.470(0.415,0.532)〕,full-time employment〔OR(95%CI)=0.715(0.668,0.766)〕,unmarried〔OR(95%CI)=0.746(0.665,0.838)〕,non-poor〔OR(95%CI)=0.587(0.517,0.666)〕,no antipsychotic treatment〔OR(95%CI)=0.491(0.440,0.548)〕,0-10-year medication treatment〔OR(95%CI)=0.881(0.778,0.998)〕,receiving no management subsidy〔OR(95%CI)=0.807(0.704,0.926)〕,not participating in community rehabilitation services〔OR(95%CI)=0.844(0.716,0.996)〕were barriers to receive regular interviews(P<0.05).Conclusion The prevalence of receiving regular interviews in Wuxi severe mental disorder patients needs to be improved.And recommended interventions include deve

关 键 词：精神障碍 严重 社区卫生服务 面访 影响因素分析 

分 类 号：R74[医药卫生—神经病学与精神病学] R197[医药卫生—临床医学]