某综合医院住院患者精神障碍流行情况调查

发布时间：2018-02-06 04:35

本文关键词： 精神障碍现况调查危险因素综合医院简明国际神经精神访谈检查心理护理　出处：《河北北方学院》2016年硕士论文　论文类型：学位论文

【摘要】：目的:调查某综合医院非精神科住院患者精神障碍的患病情况、科室分布特征及其人口学特征;调查非精神科医生对精神障碍的识别率;调查非精神科住院患者精神障碍的共病情况以及精神卫生服务利用现状。方法:2014年6月-8月期间,采用整群抽样的方法,以简明国际神经精神访谈检查(Mini international neuropsychiatry interview,MINI)为调查工具,收集某综合医院非精神病科室住院患者的数据资料。资料分析采用SPSS统计软件进行单因素和多因素分析。有效病例共597例,脱落率为5.3%。结果:1.本次调查精神障碍的患病率为17.6%;识别率为51.4%。不同精神障碍患病率依次为:抑郁障碍9.4%、广泛性焦虑障碍3.7%、心境恶劣1.7%、自杀1.2%、轻躁狂发作1.2%、惊恐障碍为0.3%、场所恐惧症为0.5%、社交恐惧症为0.2%、强迫症为1.0%、创伤后应激障碍为2.0%、酒滥用或酒依赖为2.0%、非酒精类精神活性物质使用障碍为0.5%、精神性疾患为0.7%、神经性厌食为0.7%、神经性贪食为0.2%、反社会人格障碍为0;住院患者患病率最高的四个科室依次为:消化内科44.9%,康复科25.0%,老年病房24.1%,神经内科19.0%。2.将自编问卷中的各个变量进行多因素logistic回归分析,结果表明,科室、居住方式、心理疾病史、就诊意愿为独立影响因素。3.住院患者的精神障碍往往存在共病现象,以抑郁障碍与其他障碍共病最为多见。4.在精神卫生服务利用方面,住院患者对精神疾患认识不足,对可提供的精神卫生服务利用率普遍较低。根据调查,得出以下结论:1.在综合医院中,住院患者精神障碍患病率高、识别率低,应引起足够的重视。2.在综合医院中,内科、独居、有过心理疾病史、对精神障碍有负性看法的住院患者为精神障碍的高发人群,需要重点关注;对外伤术后的住院患者应排除是否存在创伤后应激障碍。3.在综合医院中,建立精神/心理专科,将有效提高非精神科室医师的识别率,降低住院患者精神障碍的患病率。4.在综合医院中,住院患者抑郁障碍患病率最高,且与其他精神障碍共病最多见。5.加强对非精神科医师进行精神病学症状学的培训,积极开展心理护理及健康教育,可提高医师对精神障碍的识别率,降低住院患者精神障碍的患病率。6.综合医院住院患者对于精神卫生服务利用的情况较差,应加强患者对精神疾患认识,普及相关精神卫生知识,引起患者自身重视,将有利于降低精神障碍患病率。
[Abstract]:Objective: to investigate the prevalence, distribution and demographic characteristics of mental disorders in non-psychiatric inpatients in a general hospital. To investigate the recognition rate of mental disorders by non-psychiatrists; Methods: from June 2014 to August, cluster sampling was used to investigate the prevalence of mental disorders and the utilization of mental health services in non-psychiatric inpatients. Mini international neuropsychiatry interview mini was used as an investigation tool. The data of inpatients in non-psychiatric department of a general hospital were collected. The data were analyzed by SPSS software for univariate and multivariate analysis. There were 597 effective cases. Results: 1. The prevalence of mental disorders in this survey was 17.6; The recognition rate was 51.4. The prevalence rate of different mental disorders was 9.4depression, 3.7generalized anxiety disorder, 1.7m bad mood, 1.2suicide, 1.2% hypomania. Panic disorder was 0.3g, place phobia was 0.5, social phobia was 0.2, obsessive-compulsive disorder was 1.0, post-traumatic stress disorder was 2.0, alcohol abuse or alcohol dependence was 2.0%. The use of non-alcoholic psychoactive substances was 0.5g, psychiatric disorder 0.7cm, anorexia nervosa 0.7m, neurotic gluttony 0.2g, antisocial personality disorder 0. The highest prevalence rate of inpatients was 44.9 in the Department of Gastroenterology, 25.0 in the Rehabilitation Department and 24.1% in the Geriatric ward. The multivariate logistic regression analysis of all the variables in the questionnaire showed that the department, the way of living, and the history of mental illness. The mental disorders of inpatients often have syndromes, and depression and other disorders are the most common. 4. In the use of mental health services. The inpatients have insufficient understanding of mental disorders, and the utilization rate of available mental health services is generally low. According to the investigation, the following conclusions can be drawn: 1. In general hospitals, the prevalence of mental disorders among inpatients is high. The recognition rate is low, should cause enough attention .2.In general hospital, internal medicine, living alone, having a history of mental illness, the inpatients who have negative views on mental disorders are the high risk groups of mental disorders, which need to be paid more attention to. Posttraumatic stress disorder (PTSD) should be ruled out for the inpatients after trauma. In general hospital, the establishment of mental / psychological specialty will effectively improve the recognition rate of non-psychiatric department physicians. Reduce the prevalence of mental disorders in inpatients. 4. In general hospitals, inpatients with depression prevalence rate is the highest. And the most common diseases with other mental disorders .5.Strengthening the training of psychiatric symptoms for non-psychiatrists, actively developing psychological care and health education, can improve the recognition rate of psychiatric disorders. To reduce the prevalence rate of mental disorders of inpatients. 6. The utilization of mental health services of inpatients in general hospitals is poor. It is necessary to strengthen patients' understanding of mental disorders and popularize related mental health knowledge. It will help to reduce the prevalence rate of mental disorders by paying attention to the patients themselves.
【学位授予单位】：河北北方学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749

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