2021年新冠肺炎疫情下居家严重精神障碍患者服药情况分析  

The impact of COVID-19 pandemic on the medication adherence of at-home patients with severe mental disorder

作　　者：刘红英 陈思宇 叶泽文 王欣 徐江华 李思琪 苟澜华 杨单 李玲 田小兵 刘新 LIU Hong-ying;CHEN Si-yu;YE Ze-wen;WANG Xin;XU Jiang-hua;LI Si-qi;GOU Lan-hua;YANG Dan;LI Ling;TIAN Xiao-bing;LIU Xin(Psychiatric Rehabilitation Department of Nanchong Psychosomatics Hospital,Nanchong 637700,Sichuan Province,China;Preventive Medicine Department of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China;Psychiatric Department of the Affiliated Hospital of Chengdu University,Chengdu 610081,Sichuan Province,China)

机构地区：[1]南充市身心医院精神康复科,四川南充637000 [2]川北医学院预防医学系,四川南充637000 [3]成都大学附属医院精神科,成都610081

出　　处：《预防医学情报杂志》2022年第6期745-751,共7页Journal of Preventive Medicine Information

基　　金：南充市应用技术研究与开发专项项目(项目编号:20YFZJZC0010);南充市多中心健康管理队列设计与数据平台建设项目(项目编号:18SXHZ0164)。

摘　　要：目的 了解新冠疫情期间居家严重精神障碍患者社会支持水平及规律服药情况。方法 于2021-02/04期间,在四川省营山县,以县严重精神障碍管理办公室划分的管理片区为抽样单位,采取随机整群抽样方法,选取患者及主要照护者,收集其人口学信息、疫情期间社会支持水平、规律服药情况。采用SAS 9.4软件进行t检验和χ^(2)检验,影响因素筛选采用二分类Logistic回归分析。结果 共获得有效问卷1 006份。调查对象规律服药率为39.86%;患者客观支持、主观支持和支持利用度得分分别为4.61±1.50、16.29±5.39和5.39±2.84分,社会支持总分为26.29±6.89分;农村(OR=2.45,95%CI:1.29~4.69)、年龄大的患者(OR=1.99,95%CI:1.25~3.18),规律用药率低;文化程度高(小学 VS 文盲:OR=0.43,95%CI:0.31~0.61;初中及以上 VS 文盲:OR=0.28,95%CI:0.19~0.42)、参加社区康复活动(OR=0.41,95%CI:0.29~0.57)、免费用药(OR=0.57,95%CI:0.34~0.95)和客观支持度高(OR=0.77,95%CI:0.69~0.86)的患者,规律用药率越高。结论 新冠疫情期间,居家严重精神障碍患者规律服药率低,社会支持水平也明显下降,这在农村、年龄大、文化程度低的患者中更为严重。Objective To investigate the impact of COVID-19 on recovery of at- home patients with severe mental disorder in terms of regular medication taking rate and social support level.Methods During February to April,2021,patients with severe mental disorders were selected through cluster random sampling method in Yingshan county,Sichuan province,with management section of psychiatric disease prevention as sampling unit.Data regarding patients’ and their primary caregivers’ demographic characteristic,medication taking rate and social support level during COVID- 19 pandemic were collected,t- test and chi- squre test was performed by SAS9.4,and Logistic regression model was employed to identify influencing factors.Results A total of 1006eligible patients were recruited into this study.The rate of regular medication taking was 39.86%.The score at Social Support Scale was 26.29 ± 6.89,and scores at three sub- scale of objective,subjective and utilization of support were 4.61 ± 1.50,16.29 ± 5.39 and 5.39 ± 2.84,respectively.The rates of regular medication taking was lower in patients from rural area (OR=2.45,95%CI:1.29-4.69) and with advanced age (OR=1.99,95%CI:1.25-3.18),while higher in patients with higher educational level (primary school Vs illiteracy:OR=0.43,95%CI:0.31-0.61;junior or above Vs illiteracy:OR=0.28,95%CI:0.19-0.42),participate in community rehabilitation activities (OR=0.41,95% CI:0.29- 0.57),with free medication (OR=0.57,95% CI:0.34- 0.95).In addition,patients acquired higher level of objective support were observed to be with higher rate of regular medication taking (OR=0.77,95%CI:0.69-0.86).Conclusions The pandemic of COVID-19 poses a substantial impact on recovery of patients with severe mental disorders in terms of deteriorated rates of medication taking.This is particularly the true in those from rural area,with advanced age and with low level of education.

关 键 词：新冠疫情 严重精神障碍患者 社区 规律服药 社会支持 

分 类 号：R181[医药卫生—流行病学]