宁夏银川市居民重性精神疾病现状调查分析

发布时间：2018-06-12 00:20

本文选题：重性精神疾病 + 现状调查　；参考：《宁夏医科大学》2012年硕士论文

【摘要】：目的掌握宁夏银川市居民重性精神疾病的流行特征；了解宁夏银川市居民首次患精神疾病后的求医行为及影响因素；了解宁夏银川市居民对精神卫生知识认知情况，为政府制定银川市乃至整个宁夏重性精神疾病的早期防治政策提供科学参考依据，提高居民对重性精神疾病的正确求医行为和精神卫生知识认知能力。方法论文分三部分。第一部分宁夏银川市居民重性精神疾病现状调查分析 2010年1月1日至2011年12月31日期间，对宁夏银川市15岁及以上居民，由经过统一培训的医务人员组成的调查队，采用线索调查和整群调查相结合的方法按照村/居委会、小区逐个摸底和排查，所有摸底调查出的疑似重性精神疾病患者皆经宁夏精神卫生中心专家确诊，确诊后的患者填写问卷调查表。第二部分宁夏银川市重性精神疾病患者首次求医行为及影响因素调查分析参考1:1匹配的病例对照研究方法，已确诊的银川市重性精神疾病患者信息在Excel办公工具中是随机顺序排列，赋予随机数字表，进行单纯随机抽样，抽取有求医行为组206份，按照性别、年龄范围在±2岁之间的原则进行匹配确定对照组。第三部分宁夏银川市普通居民精神卫生知识认知情况调查分析采用分层随机抽样，，首先按全市三个行政区分层，使用随机数字表,在每一层各抽1个街道。再在抽中的街道各抽取2个社区居民委员会，最终确定6个社区居民委员会。然后从社区所有有人居住的户中按系统抽样方式随机抽取目标户,从抽中的每户中用随机数字表抽取60人作为调查对象并填写问卷调查表。结果第一部分2010年1月1日至2011年12月31日在宁夏银川市15岁及以上居民进行了重性精神疾病患者彻底的摸底和排查，共排查重性精神疾病患者3104例，患病率1.56‰，其中以精神分裂症为主，有2362例，患病率为1.19‰，宁夏银川市居民不同年龄阶段重性精神疾病患病率差异有统计学意义（χ~2=522.581P=0.0000.05），经标化，重性精神疾病患者以40～年龄段多见，患病率0.56‰，其次以30～年龄段，患病率0.47‰，不同民族重性精神疾病患病率差异有统计学意义（χ~2=32.232P=0.000＜0.05），经标化，精神分裂症患者汉族患病率高于回族，不同地区居民重性精神疾病患病率差异有统计学意义（χ~2=49.337P=0.000＜0.05），经标化，兴庆区患病率高于其他地区患病率，重性精神疾病城市患病率与农村患病率差异有统计学意义（χ~2=241.501P=0.000＜0.05），第二部分宁夏银川市重性精神疾病患者患病以后，首次选择求医行为以非专科医院为主，占76%，精神专科占15.5%，迷信、巫医占8.5%。经卡方检验，影响患者首次选择不同求医行为与民族（χ~2=14.068P=0.001＜0.05）、婚姻状况（χ~2=18.901P=0.006＜0.05）、监护人对精神卫生知识的了解（χ~2=15.304P=0.005＜0.05）及对精神科就诊的忌讳（χ~2=18.308P=0.00＜0.05）差异有统计学意义。经卡方检验，影响患者首次得病后有无求医行为因素与民族（χ~2=38.474P=0.00＜0.05）、文化程度（χ~2=10.176P=0.038＜0.05）、职业（χ~2=133.711P=0.00＜0.05）、经济状况（χ~2=77.079P=0.00＜0.05）、发病形式（χ~2=14.234P=0.001＜0.05）、医疗机构离家距离（χ~2=161.956P=0.00＜0.05）、监护人的文化程度（χ~2=15.355P=0.004＜0.05）、对患者疾病的判断（χ~2=19.834P=0.00＜0.05）、对精神疾病知识的了解（χ~2=12.601P=0.002＜0.05）、求医习惯（χ~2=9.030P=0.011＜0.05）差异有统计学意义。经条件Logistic回归进一步分析证明民族、经济情况、发病形式、监护人对精神疾病知识的了解及医疗机构离家的距离对患者是否有求医行为有影响。第三部分宁夏银川市普通居民的精神卫生知识知晓率为52.5%，普通居民性别（χ~2=42.164P=0.000＜0.05）、年龄（χ~2=42.935P=0.000＜0.05）、文化程度（χ~2=37.194P=0.000＜0.05）、职业（χ~2=41.268P=0.000＜0.05）及在银川居住时间（χ~2=19.221P=0.000＜0.05）对精神卫生知识认知情况在统计学上有显著性差异，通过问卷应答正确分布，提示普通市民是否知道每年的“世界精神卫生日”是正确应答率最低，为10%。其次对“精神病”和“神经病”是一样的疾病吗，正确应答率为15%。对正确应答率低于50%的精神卫生知识，是今后宣传精神卫生知识的重点。结论1精神分裂症是今后疾病防治的重点病种，汉族及40～年龄段的精神疾病患者是宣传和预防的重点特征人群，兴庆区是宁夏银川市防治精神疾病的重点区域。 2我们要对影响患者选择求医行为及其有无求医行为的因素通过不同的途径进行干预，以提高宁夏银川市重性精神疾病患者及监护人早期就医、纠正其求医行为，减轻患者及其家庭、社会的疾病负担。 3在今后的精神卫生知识宣传工作中,宣要注重60～年龄段、非正式上过学及无业的重点特征人群,要以普通群众为阵营,深入社区、深入贫困家庭,拓宽宣传途径,使市民更直接获取知识,提高防范意识，为市民及早求医和选择合理求医行为提供科学指导。
[Abstract]:Objective to understand the epidemiological characteristics of heavy mental illness in Yinchuan, Ningxia, and to understand the behavior and influencing factors of the first mental illness in Yinchuan, Ningxia, and to understand the knowledge of mental health knowledge in Yinchuan, Ningxia, and to formulate the early prevention and control policy for the government of Yinchuan city and even the whole of Ningxia. It provides scientific reference basis for improving residents' correct medical treatment behavior and mental health knowledge and cognition ability for severe mental illness.
Methods the paper is divided into three parts.
Part one survey and analysis of severe mental illness among residents in Yinchuan, Ningxia
During the period from January 1, 2010 to December 31, 2011, a survey team of 15 years old and above in Yinchuan, Ningxia, which was composed of medical personnel trained by unified training, used the method of clue investigation and cluster investigation in accordance with the village / neighborhood committee. Experts from the mental health center of the Xia Dynasty confirmed that the patients were filled in the questionnaire after diagnosis.
The second part is the investigation and analysis of the first medical seeking behavior and its influencing factors of patients with severe mental illness in Yinchuan, Ningxia.
Referring to the case-control study method matched with 1:1, the information of patients with severe mental illness in Yinchuan was arranged in random order in Excel office tools. Random numbers were given, random sampling was carried out, 206 medical treatment groups were selected, and the control group was matched according to the principle of gender and age range of 2 years.
The third part is the survey and analysis of mental health knowledge of ordinary residents in Yinchuan, Ningxia.
By stratified random sampling, we first stratified the three administrative districts in the city, used random digital tables, pumped 1 streets at each floor, and then selected 2 community residents' committees in the streets in which they were drawn. Finally, 6 community residents' committees were determined. In each household, a random number table was used to extract 60 people as the subjects and fill out the questionnaire.
Results in the first part of the first part from January 1, 2010 to December 31, 2011, people aged 15 and above in Yinchuan, Ningxia, carried out a thorough investigation and investigation of the patients with severe mental illness. 3104 cases of severe mental illness were investigated, the prevalence rate was 1.56 per thousand. Among them, schizophrenia was dominated by 2362 cases, the prevalence rate was 1.19 per thousand, and the residents in Yinchuan of Ningxia were in different years. The prevalence rate of severe mental illness in the age stage was statistically significant (x ~2=522.581P=0.0000.05). The prevalence rate of severe mental disease was 40 to age, the prevalence rate was 0.56 per thousand, followed by 30 ~ age, and the prevalence rate was 0.47 per thousand. The difference of the prevalence rate of different ethnic heavy mental diseases was statistically significant (x ~2=32.232P=0.000 < 0.05). The prevalence rate of Han nationality in schizophrenic patients was higher than that of Hui nationality, and the prevalence rate of heavy mental illness in different areas was statistically significant (x ~2=49.337P=0.000 < 0.05). The prevalence rate of Xingqing region was higher than that of other regions, and the difference between the urban prevalence rate and the rural prevalence rate was statistically significant (~2=241.501P=0.0 00 < 0.05),
The second part of the patients with severe mental illness in Yinchuan, Ningxia, was the first choice to seek medical treatment for the first time in non specialist hospitals, accounting for 76%, psychiatric specialist accounted for 15.5%, superstition, and witch doctors accounted for 8.5%. by chi square test, affecting the first choice of different medical seeking behavior and nationality (chi ~2= 14.068P=0.001 < 0.05) and marital status (x ~2=18.901P=0.006 < 0.05). The guardian's knowledge of mental health (chi ~2=15.304P=0.005 < 0.05) and the taboo of the psychiatric consultation (x ~2=18.308P=0.00 < 0.05) were statistically significant. After the chi square test, there were no medical behavior factors and ethnic groups (chi ~2=38.474P=0.00 < 0.05), cultural degree (x ~2=10.176P=0.038 < 0.05), occupation (chi Square), occupation (chi square). ~2=133.711P=0.00 < 0.05), the economic condition (x ~2=77.079P=0.00 < 0.05), the form of the disease (x ~2=14.234P=0.001 < 0.05), the distance from the medical institution (x ~2=161.956P=0.00 < 0.05), the educational level of the guardian (x ~2=15.355P=0.004 < 0.05), the judgement of the patient's disease (x ~2=19.834P=0.00 < 0.05), and the knowledge of mental illness (x ~2=12.6) 01P=0.002 < 0.05), the difference in the habit of seeking medical treatment (x ~2=9.030P=0.011 < 0.05) was statistically significant. Further analysis of the conditional Logistic regression showed that the nation, the economic situation, the form of the disease, the knowledge of the mental illness and the distance from the medical institution left home had an influence on the patient's behavior of seeking medical treatment.
In the third part, the awareness rate of mental health knowledge for ordinary residents in Yinchuan, Ningxia, was 52.5%, gender (chi ~2=42.164P=0.000 < 0.05), age (x ~2=42.935P=0.000 < 0.05), educational level (x ~2=37.194P=0.000 < 0.05), occupation (x ~2=41.268P=0.000 < 0.05) and Yinchuan residence time (x ~2=19.221P=0.000 < 0.05) on mental health There is a significant difference in knowledge cognition. Through the correct distribution of questionnaire response, it is suggested that ordinary citizens know that the annual "World Mental Health Day" is the lowest correct response rate. Is 10%. the same disease as "psychosis" and "neuropathy", and the correct response rate is lower than 50% of the correct response rate of 15%.. Mental health knowledge is the focus of mental health knowledge in the future.
Conclusion 1 schizophrenia is the focus of disease prevention and treatment in the future. The Han and 40 age group of mental diseases are the key characteristics of propaganda and prevention, and Xingqing is the key area for the prevention and treatment of mental diseases in Yinchuan, Ningxia.
2 we should interfere with the factors affecting patients' choice of seeking medical treatment and the behavior of seeking medical treatment through different ways to improve the early medical treatment of the patients and the guardians in Yinchuan, Ningxia, to correct their medical seeking behavior, and to reduce the burden of the patients and their families and the social disease.
3 in the propaganda work of mental health knowledge in the future, we should pay attention to 60 years of age, informal learning and the key characteristics of non industry. We should take the common people as the camp, go deep into the community, go deep into the poor families, broaden the way of publicity, make the public get more direct knowledge, improve the awareness of prevention, and seek medical advice and seek medical advice for the public early. To provide scientific guidance.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749

【参考文献】