社区精神分裂症患者、家属和精神病防治人员对疾病认知、治疗依从性及社区服务评价的质性研究

来源 :中华行为医学与脑科学杂志 | 被引量 : 0次 | 上传用户:edison_young
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:调查汕头市社区精神分裂症患者、家属、精神病防治人员对疾病的感知、治疗依从性、社区随访服务的评价,为提高管理治疗质量提供参考依据。方法:采用分层抽样质性研究方法,于2019年2~8月对汕头市7个区县在册在管的社区精神分裂症患者17 198人进行抽样调查,每个区县分别抽取2个镇(街道),对所抽取的镇(街道)再分别抽取10名患者、10位家属和3名精神病防治人员,对疾病的感知、治疗依从性、社区随访服务的评价进行调查分析。受访者最终纳入137例患者、138名家属和41名精神病防治人员,采用访谈调查法对受访者进行半结构式访谈,按传统方法收集数据资料,采用SPSS 12.0统计学软件包进行描述性统计分析。结果:(1)34.3%患者和32.6%家属对疾病认知不全,22.6%患者和23.2%家属存在病耻感。(2)26.3%患者对治疗不依从、29.9%患者无自知力,53.3%患者和24.6%家属对药物副作用和成瘾性认识不当,35.0%患者和13.0%家属存在病好不用药的误区。(3)29.2%患者和31.2%家属厌烦长程服药,24.8%患者和21.0%家属感到被社会隔离,17.5%患者感到得不到支持和18.8%家属承认对患者关心不够。(4)31.4%患者不主动接受随访服务,37.2%患者和20.3%家属不配合随访医生,21.2%患者和10.1%家属对随访服务不满意。(5)精神病防治人员基本能掌握辖区患者的病情和定期开展随访服务(90.2%)、掌握应急处置方法(92.7%)、有开展培训(97.6%)。但精神病防治人员的精神科执业比低(58.5%)而且多为兼职(78.0%),平均工作年限为(5.7±1.4)年,对社区随访服务的满意度较高(95.1%),但认为精神病防治工作困难较大(36.6%)、对身兼多职承担多项公共卫生服务工作感到不满(31.7%)。结论:汕头市严重精神障碍管理治疗项目初显成效,对社区随访服务较满意,但患者和家属对疾病认知水平仍偏低、服药依从性差、负性情绪较明显、对药物治疗存在顾虑。有必要加强人员专业化专职化,对患者和家属开展早期心理健康教育和合理情绪行为训练。“,”Objective:To investigate the evaluation of disease perception, treatment compliance and community follow-up services of community schizophrenia patients, family members and personnel in Shantou City, and to provide a reference basis for improving the quality of management treatment.Methods:With the method of stratified sampling qualitative research, a community sample of 17 198 patients with schizophrenia in seven districts or county in Shantou City were sampled from February to August 2019, with 2 towns being drawn from each district or county, and 10 patients, 10 family members and 3 personnel were selected in each town. The evaluation of disease perception, treatment compliance and community follow-up services were investigated and analyzed. Respondents were eventually included in 137 patients, 138 family members and 41 personnel.The interviewees were conducted with semi-structured interviews, the data were collected according to traditional methods, and the descriptive statistical analysis was carried out with SPSS 12.0.Results:(1)34.3% of patients and 32.6% of the family members were not fully aware of the disease.22.6% of the patients and 23.2% of the family members had a sense of ill shame. (2)26.3% of patients did not comply with treatment, 29.9% of patients had not insight, 53.3% of patients and 24.6% of family members on the side effects of drugs and addiction understood improperly, and, 35.0% of patients and 13.0% of the family had a misunderstanding of illness and using drugs. (3)29.2% of patients and 31.2% of their families were tired of taking long-term medication, 24.8% of patients and 21.0% of their families felt socially isolated, and, 17.5% felt unsupported and 18.8% of their families admitted that they did not care enough about patients. (4)31.4% of patients did not actively receive follow-up services, 37.2% of patients and 20.3% of family members did not cooperate with follow-up doctors, and, 21.2% of patients and 10.1% of family members were not satisfied with follow-up services. (5)The personnel of psychiatric care could basically grasp the conditions of patients in the jurisdiction and carried out follow-up services on a regular basis (90.2%), master emergency disposal methods (92.7%), and have carried out training (97.6%). However, the psychiatric practice of the personnel were lower than (58.5%) and most lying part-time (78.0%), the average length of service was 5.7±1.4 years. The personnel satisfaction with the community follow-up service was higher (95.1%), but most of them thought that the psychiatric care was more difficult (36.6%), and were dissatisfied with the multi-functional staff to undertake a number of public services (31.7%).Conclusion:The management treatment project of mental disorders services in Shantou City show initial results.The patients were satisfied with the community follow-up service, but the patients and their families still have low level of cognition, poor compliance, obvious negative emotions, and have concerns about drug treatment.It is necessary to strengthen the professionalization of personnel, to carry out early mental health education and rational emotional behavior training for patients and their families.
其他文献
制革产业是我国轻工业体系的重要组成部分。制革过程产生的废水中含有部分染料,对环境造成污染的同时,也危及着人体的健康。纤维素是一种天然高分子类生物质资源,具有可生物降解
实现最大功率追踪(MPPT)和变速恒频(VSCF)是风力发电的两个根本问题。本文以混合驱动型永磁风力发电机为研究对象,研究了该类型的风力机实现上述两个关键技术的非线性动力学与控制问题,完成了如下的工作:首先,建立了混合驱动永磁伺服电机永磁气隙-气动双耦合的非线性模型,分析了参数变化时,系统出现混沌现象的发生机理与发生条件,设计了无源控制器,以实现消除混沌运动的目的。其次,建立了以混合驱动系统为核心
轮系在现代传动系统中应用十分广泛,而传动效率是其性能评估的重要指标。对传动效率的获取主要是通过计算与试验两大途径,由于试验的成本较高,且其结果通用性较差,目前多通过计算得到效率,但对传动效率理论及计算的进一步研究仍然需要试验结果来支持和验证。所以研究轮系传动效率及其试验有着重要的理论及现实意义。本文围绕轮系传动效率试验展开研究,在设计过程中始终贯穿拆装方便、结构紧凑的理念,在满足强度要求的条件下,
功能性油脂是一类具有特殊生理功能的油脂,它具有减少心血管疾病发生、促进机体细胞生长、调节免疫机制及脂代谢、抗癌、抗过敏和抗皮肤衰老等功能,在医学医药、功能性食品及日常方面得到广泛应用,具有广阔的应用前景。微生物功能性油脂的开发研究可以解决功能性油脂产量短缺、生产来源有限、人们日常需求量不足的问题。深黄被孢霉是目前研究较为广泛,最有可能实现功能性油脂工业化生产的产油微生物。为提高功能性油脂的产量,本
螺旋藻作为一种营养成分十分丰富的微生物,目前已应用于食品、化妆品、医药、饲料等领域。而且作为空间受控生态生命保障系统的生产者生物,其应用前景仍十分广阔。本文针对螺旋
一、香菇覆土栽培采用自然转色、开放出菇、拉大干湿差、实行干湿交替的水分管理等技术,能使香菇菇体大、肉质厚、花菇量多。二、产量与常规法相比,可提高30%~40%。三、菌棒脱
道德与法治教学和文化课教学同等重要.教育一直都是我国发展的头等大事,教育教学不仅是让学生学会知识,尤其是道德与法治教学,其更希望达到以文育人的效果.道德与法治教学作
近年来,随着时代的进步以及经济高速发展,财务会计在企业经济管理工作中的重要作用日渐凸现,地位越来越重要,不仅提高了管理效率,还能提高运营效率.同时,各种规章制度制定以
在高等教育中,培养大学生创新创业能力是实现人才培养目标的关键点,也是拓展高职院校毕业生就业路径的必然选择.本文分析了社会实践活动对大学生创新创业能力培养的重要意义,
本论文系统地研究了宇佐美曲霉(Aspergillus usamii)木聚糖酶(Xylanase)的分离纯化、理化性质和酶学性质、以及木聚糖酶基因克隆和序列分析。采用硫酸铵盐析,Phenyl-Sepharose CL-4B疏水层析,Sephadex G-50凝胶层析和DEAE-Sepharose fast flow阴离子交换层析等分离技术,从宇佐美曲霉E001固态培养物浸出液中分离出一种SDS-PA