精神疾病患者诊疗行为调查研究

发布时间：2018-07-03 14:40

本文选题：精神疾病 + 诊疗行为　；参考：《兰州大学》2012年硕士论文

【摘要】：目的：1、了解精神疾病患者获得专科就诊的途径、首诊机构分布；2、探讨精神疾病患者初主动就诊影响因素；3、抑郁症、精神分裂症、焦虑症及躯体形式障碍就诊延误时间、治疗延误时间；4、非专科医务工作人员对精神疾病的识别率、确诊率及转诊率：5、疾病缓解影响因素；6为精神疾病防治提供科学依据。方法：采用自编《精神疾病患者诊疗行为调查表》进行现场调查,用随机数字表确定20例／天,已录入过的复诊者跳过不计。结果：1、患者获得专科就诊最常见途径是通过他人介绍,占41.8%,其次是非专科医疗机构转诊,占30.3%；首诊选择非精神专科机构占51.9%,精神专科医院(包括综合医院精神专科)48.1%。2、婚姻状况不稳定及精神卫生知识缺乏是初诊主动就诊的危险因素；抑郁症、精神分裂症、焦虑症及躯体形式障碍就诊延误时间中位数分别是113.5天(4天～21年)、34.0天(2天～15年)、86.5天(4天-10年)、309.0天(53天～8年),治疗延误时间中位数分别是6.0月(1月～21年)、3.0月(3天～15年)、3.0月(4天～8年)、5.5月(10天～8年),各类精神疾病首诊机构比较差异有统计学意义(P0.05)。3、非专科识别率17.8%,确诊并给于合理用药率10.5%,89.5%的患者未得到合理用药而转诊精神科。5、就诊延误时间、有无擅自停药均是患者疾病缓解情况的危险因素,首诊选择专业机构为保护因素。结论：精神疾病患者存在严重的就诊延误及治疗延误,患者／家属精神卫生知识知晓率低、非专科医生识别率低、精神卫生资源的不可及性是影响患者就诊延误的重要因素。首诊不同机构、就诊延误时间、有无擅自停药均对患者疾病缓解情况有影响。因此应普及精神卫生知识的宣传和加强培训非专科医务人员,改善患者诊疗行为,提高精神疾病就诊率、识别率、治疗率。
[Abstract]:Objective: to understand the ways for patients with mental illness to obtain special treatment, and to explore the factors influencing the first visit, depression, schizophrenia, anxiety disorder and somatoform disorder, and to explore the delay time of visiting patients with mental illness, such as depression, schizophrenia, anxiety disorder and somatoform disorder. The delayed time of treatment was 4, the recognition rate, diagnosis rate and referral rate of mental illness among non-specialized medical staff were 5, and the influencing factors of disease mitigation were provided scientific basis for the prevention and treatment of mental illness. Methods: the questionnaire of diagnosis and treatment of mental illness was used to conduct field investigation, and 20 cases were determined by random digital table. Results: one, the most common way for patients to get special treatment is through the introduction of others, accounting for 41.8%, followed by non-specialist medical institutions referral, accounting for 30.3%; For the first visit, 51.9% were non-psychiatric institutions, 48.1% of psychiatric hospitals (including general hospital psychiatric specialties), unstable marital status and lack of mental health knowledge were the risk factors of first visit, depression, schizophrenia, The median delay time for anxiety disorder and somatoform disorder were 113.5 days (4 days ~ 21 years), 34.0 days (2 days ~ 15 years) and 309.0 days (53 days ~ 8 years), respectively. Months (3 days to 15 years), 3.0 months (4 days to 8 years), 5.5 months (10 days to 8 years), there were significant differences in the first diagnosis institutions of all kinds of mental diseases (P0.05). 3. The non-specialist recognition rate was 17.88.The rate of diagnosis and rational use of drugs was 10.5% and 89.5% of the patients did not get reasonable use of drugs. And referral psychiatry. 5, delay time, Withdrawal of drugs without authorization is a risk factor for the remission of disease, and professional institutions are selected as protective factors for the first visit. Conclusion: patients with mental illness have serious delay in visiting and treatment, low awareness rate of mental health knowledge of patients / family members, low recognition rate of non-specialist doctors, and inaccessibility of mental health resources are the important factors affecting delay in visiting patients. The first visit to different institutions, the delay time, with or without withdrawal of drugs have an impact on the patient's disease relief. Therefore, we should popularize the knowledge of mental health and strengthen the training of non-specialist medical personnel, improve the diagnosis and treatment behavior of patients, increase the rate of psychiatric visit, recognition rate, treatment rate.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4

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