住院精神分裂症患者病耻感的相关因素研究

发布时间：2018-06-13 19:05

本文选题：精神分裂症 + 病耻感　；参考：《山东大学》2014年硕士论文

【摘要】：目的：分析社会功能、社会支持、面子观、自知力等因素对住院精神分裂症患者病耻感的影响,为今后的科研及临床治疗提供指导及依据。方法：选取2012年2月～2013年5月在山东省精神卫生中心住院符合ICD-10的368例精神分裂症患者为受试者,在患者入院后完成一般人口学资料及疾病资料的收集,并采用阳性与阴性症状量表(Positive and Negative Symptoms Scale, PANSS)、个人和社会功能量表(Personal and Social Performance, PSP)评定其病情严重程度及社会功能；在治疗第8周末采用阳性与阴性症状量表(Positive and Negative Symptoms Scale, PANSS)、个人和社会功能量表(Personal and Social Performance, PSP)、精神疾病患者病耻感评估量表(Scale of Stigma in People with Mental Illness,SSPMI)、社会支持评定量表(Social Science Research Solutions, SSRS)、面子观量表(Consciousness of Social Face, CSF)、自知力与治疗态度问卷(Insight and Treatment Attitudes Questionnairs,ITAQ)评定患者的病情严重程度、社会功能、病耻感、社会支持情况、面子观、自知力。不合格资料剔除后,采用SPSS18.0统计软件对所得数据进行统计学分析,P0.05为差异有统计学意义。结果：1.住院精神分裂症患者病耻感得分34.63+17.23,病耻感三个因子(社交因子、个人能力因子、治疗因子)平均得分水平无统计学差异(P0.05)。不同婚姻状况的患者,其病耻感得分的比较差异具有统计学意义(P0.05),其中已婚同居组病耻感得分低于其他两组,差异均有统计学意义(均P0.05)。 2.住院精神分裂症患者的病耻感总分与客观社会支持(P0.05)、主观社会支持(P0.01)、对支持的利用度(P0.05)以及社会支持总分(P0.01)均呈负相关。 3.住院精神分裂症患者的病耻感总分与怕掉面子(P0.01)、面子观量表总分(P0.01)呈显著正相关,与想要面子无统计学意义的相关(P0.05)。其中怕掉面子得分与病耻感的三个因子得分均呈显著正相关(均P0.01)。 4.住院精神分裂症患者的病耻感总分与治疗前、后PANSS量表总分均呈正相关(均P0.05),与治疗前、后PSP量表总分均呈负相关(均P0.05),与自知力量表得分呈正相关(P0.05)。 5.多元逐步回归分析显示：性别、面子观量表总分、社会支持总分、治疗后PANSS量表总分、治疗前后PSP量表差值为住院精神分裂症患者病耻感主要的影响因素。结论：1.住院精神分裂症患者具有病耻感,其病耻感在社交、个人能力、治疗等方面表现程度突出且相近。 2.婚姻状况影响患者的病耻感,婚姻状况不良者病耻感较为严重。 3.社会支持越多的患者,其病耻感程度越低；爱面子、怕丢脸的患者,病耻感程度较为严重。 4.治疗后的残留症状越严重,可导致患者感受到的病耻感越多,其中阴性症状与病耻感的关系最密切；治疗后患者的社会功能越好,其病耻感越少。 5.患者的自知力越高,越容易产生病耻感。
[Abstract]:Objective: to analyze the influence of social function, social support, face view and insight on the stigma of inpatients with schizophrenia, and to provide guidance and basis for future scientific research and clinical treatment. Methods: 368 schizophrenic patients who were hospitalized in Shandong Mental Health Center from February 2012 to May 2013 were selected as subjects. The general demographic data and disease data were collected after admission. Positive and negative symptoms scale, PANSS scale, personal and Social performance scale (PSPs) were used to evaluate the severity of illness and social function. At the end of the 8th week of treatment, positive and negative and scale, PANSS scale, personal and Social performance, PSPN, scale of sick people in people with Mental illness, Social support scale and Social support Research scale were used. Solutions, SSRSU, face perception scale, consciousness of Social facilitiousness, CSF, Insight and treatment Attitudes questionnaire, CSFI were used to assess the severity of the patients' condition. Social function, ill sense of shame, social support, face view, insight. After disqualified data were eliminated, SPSS 18.0 statistical software was used for statistical analysis of the data. The result is 1: 1. The score of inpatients with schizophrenia was 34.63 17.23, and the average score of three factors (social factor, individual ability factor, treatment factor) had no statistical difference (P 0.05). Patients with different marital status had significant difference in score of stigma (P 0.05), and the score of stigma in married cohabitation group was lower than that in other two groups (P 0.05). The total score of stigma of inpatients with schizophrenia was negatively correlated with objective social support (P0.05), subjective social support (P0.01), utilization of support (P0.05) and total score of social support (P0.01). There was a significant positive correlation between the total score of shame and fear of face and the total score of face view scale (P0.01), and there was no significant correlation between the total score of the inpatients and those who wanted face without statistical significance (P0.05). Among them, the score of fear of face was positively correlated with the score of the three factors of stigma (P 0.01). The total score of the inpatients with schizophrenia was positively correlated with the total scores of PANSS scale before and after treatment (all P 0.05), and negatively correlated with the total scores of PSP scale before and after treatment (all P 0.05, P 0.05 and P 0.05). Multiple stepwise regression analysis showed that gender, total score of face scale, total score of social support, total score of PANSS scale after treatment, difference of PSP scale before and after treatment were the main influencing factors of stigma in inpatients with schizophrenia. Conclusion 1. Inpatients with schizophrenia have a sense of shame, the sense of shame in the social, personal ability, treatment and other aspects of the performance of prominent and similar. 2. Marital status affects the patient's ill sense of shame, poor marital status of the more serious sense of disease. 3. The more social support, the lower the degree of stigma; the more face, afraid of losing face, the more serious the degree of stigma. 4. The more serious the residual symptoms after treatment, the more the patients feel the stigma, among which the negative symptoms are most closely related to the stigma, and the better the social function of the patients after treatment, the less the stigma. The higher the patient's insight, the more likely they are to develop a sense of shame.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R749.3

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