精神分裂症患者病耻感与其就医行为的相关性研究

发布时间：2018-12-10 09:29

【摘要】：目的描述精神分裂症患者的病耻感水平,探讨精神分裂症患者就医行为及分析精神分裂症患者病耻感与就医行为的关系。方法选取2015年7月至2015年12月在唐山市第五医院、开滦精神卫生中心接受住院治疗的精神分裂症患者239例,以团体施测的方法,使用精神病患者病耻感评估表和就医情况问卷进行病耻感及其就医行为的研究与分析。结果研究对象精神疾病的病耻感的平均分为(42.91±14.73),多数研究对象认为自己受到了社会的歧视、偏见及社会隔离,说明精神分裂症患者存在病耻感。不同婚姻状况之间研究对象的社交因子呈显著性差异(P0.05),未婚患者比已婚患者有较强烈的病耻感。不同文化程度之间研究对象的能力因子得分、病耻感总分显著性差异(P0.05),初中及以下比高中/中专和大专以上得分明显高。不同研究对象经济收入之间能力因子得分、病耻感总分显著性差(P0.05),每月经济收入1000比3000元得分明显高,不同病程之间调查者的能力因子得分、治疗因子与病耻感总分显著性差异(P0.05),患者病程11~20年相比5年病耻感得分明显高(p0.05),但患病时长21年与5年则无明显差异。多元逐步回归发现,文化程度进入病耻感的回归方程,可能是病耻感的影响因素。研究对象发病到首次精神科专科就医延误时间中位数是6个月,最大值为204个月,就医延误时间与社交因子、能力因子、治疗因子和病耻感呈显著正相关(P0.05),二元logistic回归发现,社交因子(or值:1.054,95%CI:1.002~1.109)可能是就医延误的影响因素。结论精神分裂症患者普遍存在病耻感与就医行为障碍。精神分裂症患者病耻感越强其就医行为越可能延误。
[Abstract]:Objective to describe the level of stigma in schizophrenic patients, and to investigate the behavior of seeking medical treatment in schizophrenic patients and to analyze the relationship between the stigma of schizophrenia and the behavior of seeking medical treatment. Methods 239 schizophrenic patients admitted to Kailuan Mental Health Center from July 2015 to December 2015 in the Fifth Hospital of Tangshan City were selected. The stigma and behavior of psychiatric patients were studied and analyzed by using the scale of evaluation of stigma and the questionnaire of patients seeking medical treatment. Results the average score of stigma of mental disorders was (42.91 卤14.73). Most of the subjects thought they had been discriminated against by society, prejudice and social isolation, which indicated that schizophrenia patients had a sense of shame. The social factors of different marital status were significantly different (P0.05), unmarried patients than married patients have a stronger sense of shame. The scores of ability factors and the total score of stigma were significantly different among the subjects with different education levels (P0.05). The scores of junior middle school and below were significantly higher than those of high school / technical secondary school and junior high school. The score of ability factor and the total score of stigma were significantly lower among different subjects (P0.05). The score of income of 1000 yuan per month was significantly higher than that of 3000 yuan, and the score of ability factor of investigators between different course of disease was significantly higher than that of 3000 yuan. There was significant difference between the total score of treatment factor and the total score of stigma (P0.05). The score of disease stigma in patients with disease duration from 11 to 20 years was significantly higher than that in 5 years (p0.05), but there was no significant difference between 21 years and 5 years of disease duration. The multiple stepwise regression found that the regression equation of the degree of education into the disease stigma may be the influencing factor of the disease stigma. The median delay time from onset to first psychiatric specialty was 6 months and the maximum value was 204 months. There was a significant positive correlation between delay time and social factors, ability factors, treatment factors and stigma (P0.05). Binary logistic regression showed that social factors (or value: 1.054 / 95 CI: 1.002 / 1.109) may be the influencing factors of medical delay. Conclusion the symptoms of stigma and behavior disorder are common in schizophrenic patients. The stronger the stigma of schizophrenia, the more likely to be delayed.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R749.3

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