精神分裂症患者复发风险感知的定性研究  

A qualitative study of perception of risk of relapse in patients with schizophrenia

作　　者：宇虹 周郁秋[1] 孙玉静 李国华 侯冬玉[4] 秦孟男 任嘉欣 张维妙 YU Hong;ZHOU Yuqiu;SUN Yujing;LI Guohua;HOU Dongyu;QIN Mengnan;REN Jiaxin;ZHANG Weimiao(School of Nursing,Harbin Medical University,Harbin 150081,China;The Third People's Hospital of Daqing,Daqing 163319,Heilangjiang Province,China;Chifeng Anding Hospital,Chifeng 024000,Inner Mongolia Autonomous Region,China;The Second Affliated Hospital,Harbin Medical University,Harbin 150081,China;Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]哈尔滨医科大学护理学院,哈尔滨150081 [2]大庆市第三医院,黑龙江大庆163319 [3]赤峰市安定医院,内蒙古赤峰024000 [4]哈尔滨医科大学附属第二医院,哈尔滨150081 [5]山西医科大学,太原030001

出　　处：《中国心理卫生杂志》2024年第5期388-393,共6页Chinese Mental Health Journal

基　　金：国家自然科学基金面上项目(72074063);教育部人文社会科学项目(21YJCZH145);黑龙江省教育科学规划重点课题(GJB1422788);大庆市科技局项目(zdy-2021-85);哈尔滨医科大学创新基金(2018-KYYWF-0555)。

摘　　要：目的:明确精神分裂症患者复发风险感知的主要内容,探讨其风险感知的特征与变化。方法:采用现象学研究方法,对首次发病、首次复发和多次复发的精神分裂症患者进行半结构式深入访谈,共计纳入23例符合美国精神障碍诊断与统计手册第5版(DSM-5)精神分裂症诊断标准的门诊和住院患者,所有患者PANSS得分均低于60分。所有资料按照定性研究中的Colaizzi分析法进行整理与分析。结果:精神分裂症患者复发风险感知包括4个主题和11个亚主题:易感性(整体认识片面模糊、从乐观到客观的转变),预警症状(动态提升、家属帮助患者识别),危险因素(缺乏了解、心理社会因素与复发的关系、服药与复发关系的动态认识)和后果风险感知(照护负担和经济负担、社会功能受损及适应不良、影响公共安全、自身健康风险)。结论:精神分裂症患者复发风险的感知内容较为丰富,且整体复发风险感知水平较低。Objective:To elucidate the primary elements pertaining to the perception of relapse risk and to in-vestigate the characteristics and alterations of perception of the risk of recurrence in patients with schizophrenia.Methods:By using the method of phenomenological study,semi-structured in-depth interviews were conducted among schizophrenic patients with first onset,first recurrence and multiple recurrences.Twenty-three 23 outpatient and inpatient cases that met the criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were included,and all patients had PANSS scores below 60.The interview data were collated and analyzed according to Colaizzi analysis.Results:The perception of recurrence risk in patients with schizophrenia en-compassed 4 major themes and 11 sub-themes,namely susceptibility(limited overall understanding,transition from optimism to objectivity),detection of early warning symptoms(dynamic escalation,assistance from family mem-bers in identification),understanding risk factors(lack of understanding,the relationship between psychosocial fac-tors and relapse,dynamic understanding of medication-relapse relationship),and apprehension of the consequences of recurrence(care burden and financial constraints,impaired social functioning and maladjustment,impact on pub-lic safety,personal health risks).Conclusion:The content of risk perception of recurrence in patients with schizo-phrenia is relatively substantial.The overall level of risk perception of recurrence in patients with schizophrenia is low.

关 键 词：精神分裂症 复发 风险感知 定性研究 

分 类 号：R749.3[医药卫生—神经病学与精神病学]