425例住院缓解期精神分裂症患者病耻感现状及影响因素分析

doi:10.16460/j.issn1008-9969.2019.14.043

摘要/Abstract

摘要： 目的调查住院缓解期精神分裂症患者的病耻感,并分析其影响因素。方法采用便利抽样法,选取2017年12月—2018年5月在江苏省某三级甲等医院住院缓解期精神分裂症患者425例为研究对象。采用一般资料问卷、Link贬低-歧视感知量表、Herth希望量表对425例住院精神分裂症患者进行调查,采用多元线性回归分析病耻感的影响因素。结果 425例住院缓解期精神分裂症患者贬低-歧视感量表总分为（28.59±4.01分,病耻感检出率为86.4%;多元线性回归结显示,文化程度、住院次数、未婚、离异及丧偶、希望水平进入回归方程（P<0.05,共解释了住院缓解期精神分裂症患者病耻感总变异的44.2%。结论住院缓解期精神分裂症患者病耻感检出率较高,希望水平低、未婚、离异及丧偶、住院次数多、文化程度低是患者病耻感影响因素。建议护理人员通过自我肯定训练等干预措施来提高患者的希望水平,增加对精神疾病知识的教育,鼓励其坚持服药减少复发,帮助其建立起良好的人际关系,从而减轻其病耻感。

关键词: 精神分裂症, 缓解期, 病耻感, 希望水平

Abstract: Objective To investigate the stigma of inpatients with schizophrenia at remission phase and analyze its influence factors. Methods Convenience sampling method was adopted to select 425 patients with schizophrenia at remission phase in a tertiary grade A hospital in Jiangsu Province from December 2017 to May 2018 and they were investigated by using general information questionnaire, Link Disparage-discrimination Perception Scale and Herth Hope Scale, and multiple regression analysis was used to analyze the influence factors of stigma. Results The total score of Link disparage-discrimination perception scale of 425 hospitalized patients with schizophrenia at remission phase was 28.59±4.01, and the detection rate of stigma was 86.4%. Multiple linear regression showed that education background, number of hospitalization, unmarried, divorced and widowed, and hope level entered into the regression equation (P<0.05, which accounted for 44.2% of the total variation of stigma. Conclusion There is higher detection rate of stigma in patients with schizophrenia at remission phase. The lower the level of hope, the more times of hospitalization and the lower the level of education, the stronger the sense of stigma. And unmarried, divorced and widowed were the influencing factors of stigma. Improvement of patients' level of hope through self-affirmation training, more education on mental illness, adherence to medication to reduce recurrence and good interpersonal relationship are beneficial to alleviating the experience of stigma.

Key words: schizophrenia, remission, stigma, hope level

中图分类号:

R473.74

汤明文, 张燕红, 刘寿娟. 425例住院缓解期精神分裂症患者病耻感现状及影响因素分析[J]. 护理学报, 2019, 26(14): 43-46.

TANG Ming-wen, ZHANG Yan-hong, LIU Shou-juan. Stigma of Inpatients with Schizophrenia at Remission Phase and Its Influence Factors: A 425-case Study[J]. Journal of Nursing, 2019, 26(14): 43-46.

参考文献

[1]杨婧,郭洪花,张彩虹.糖尿病患者病耻感影响因素的研究进展[J].护理学报,2019,26(3):24-27.DOI:10.16460/j.issn1008-9969.2019.03.024.
[2]Wong Y I, Kong D, Tu L, et al.“My Bitterness is Deeper Than the Ocean”:Understanding Internalized Stigma from the Perspectives of Persons with Schizophrenia and Their Family Caregivers[J].Int J Ment Health Syst,2018, 12(1):14.DOI:10.1186/s13033-018-0192-4.
[3]Karidi M V, Vassilopoulou D, Savvidou E, et al.Bipolar Disorder and Self-stigma: A Comparison With Schizophrenia[J].J Affect Disord, 2015(184):209-215.DOI:10.1016/j.jad.2015.05.038.
[4]李荔,刘丽娟.基于GoPubMed对病耻感相关文献的计量学分析[J].中国心理卫生杂志,2017,31(11):857-861.DOI:10.16460/j.issn.1000-6729.2017.11.005.
[5]夏婷婷,王淑云,杨富国,等.肠造口患者造口压力及希望水平与自我管理的相关性研究[J].护理学报,2018,25(18):8-11.DOI:10.16460/j.issn.1008-9969.2018.18.008.
[6]Creamer M, Meaghan L, O'Donnell, et al.Evaluation of the Dispositional Hope Scale in Injury Survivors[J]. J Res Pers,2009,43(4):613-617.DOI:10.1016/j.jrp.2009.03.002.
[7]姚引娣,朱小平.护士长护理成本认知调查及相关因素分析[J].护理研究,2014,28(3B):927-930.DOI:10.3969/j.issn.1009-6493.2014.08.012.
[8]Bonfils K A, Luther L, Firmin R L, et al.Language and Hope in Schizophrenia-spectrum Disorders[J]. Psychiatry Res, 2016(245):8-14. DOI:10.1016/j.psychres.2016.08.013.
[9]王华阳,翁史旻,李欣,等.精神分裂症患者自我病耻感与病耻抵抗调查及影响因素分析[J].国际精神病学杂志,2018,45(6):1001-1004.DOI:10.13479/j.cnki.jip.2018.06.013.
[10]Link B G,Cullen F T,Struening E L,et al.A Modified Labeling Theory Approach to Mental Disorders:An Empirical Assessment[J].Am Soti Revi,1989,54(3):400-423.DOI:10.1016/j.socscimed.2008.11.003.
[11]徐晖. 精神分裂症患者病耻感及其服药依从性关系的研究[D].北京:中国协和医科大学,2008.
[12]董佳,周郁秋,孙玉静.精神分裂症照顾者病耻感测量工具及影响因素研究进展[J].中国健康心理学杂志,2018,26(3):476-480.DOI:10.13342/j.cnki.cjhp.2018.03.043.
[13]任莉,肖乐,张国富,等.精神分裂症患者病耻感与生活质量的关系[J].临床精神医学杂志,2013,23(5):302-304.
[14]Herth K.Abbreviated Instrument to Measure Hope: Development and Psychometric Evaluation[J]. J Adv Nurs,1992,17(10):1251-1259.DOI:10.4236/oju.2012.22014.
[15]赵海平,王健.血液透析患者的社会支持和希望[J].中华护理杂志,2000,35(5):306-308.
[16]王伟梁,周郁秋,柴囡楠,等.精神分裂症患者希望量表中文版的心理测量学评价[J].临床精神病学,2018,32(12):982-985.DOI:10.3969/j.issn.1000-6729.2018.12.002.
[17]董锋云,赵淑宜,孙红艳,等. 精神分裂症患者病耻感与自尊、社会支持的相关性分析[J].齐鲁护理杂志,2017,23(15):51-53.DOI:10.3969/j.issn.1006-7256.2017.15.021.
[18]WonPat-Borja A J,Yang L H,Link B G, et al. Eugenics,Genetics,and Mental Illness Stigma in Chinese Americans[J].Soc Psychiatry Psychiatric Epidemiol,2012, 47(1):145-156.DOI:10.1007/s00127-010-0319-7.
[19]Clara Isabel Morgades-Bamba, María José Fuster, Fernando Molero.The Impact of Internalized Stigma on the well-being of People with Schizophrenia[J].Psychiatry Res,2019, 271(1):621-627.DOI:10.1016/j.psychres.2018.12.060.
[20]Berna F, Goritz A S, Lorca P M, et al.Would I Take Antipsychotics, If I Had Psychotic Symptoms? Examining Determinants of the Decision to Take Antipsychotics[J]. Prog Neurpsychopharmacol Biol Psychiatry,2017,77(3):155-163.DOI:10.1016/j.pnpbp.2017.03.015.
[21]徐韩,王勇,粟幼嵩,等.精神分裂症患者自我病耻感及其相关因素研究[J].临床精神医学杂志,2014,24(4):244-246.DOI:10.3969/j.issn.1005-3220.2014.04.016.
[22]赵巍峰,彭敏,李新力,等.健康教育对精神分裂症患者康复的后续影响及机制[J].中国健康教育, 2017, 33(11):1016-1023.DOI:10.16168/j.cnki.issn.1002-9982.2017.11.014.
[23]余敏,江妙玲,周燕玲,等.稳定期精神分裂症患者病耻感影响因素分析[J].护理学报,2017, 24(7):58-61.DOI:10.16460/j.issn.1008-9969.2017.07.058.
[24]蔡梦燕,陈勇华,王旭东.精神分裂症患者复发再入院的影响因素与治疗策略[J].中医药管理杂志,2016,24(12):157-158.DOI:10.16690/j.cnki.1007-9203.2016.12.077.
[25]Kowalski S D,Bondanss M D.Physiological and Psychological Symptoms of Grief in Widows[J]. Res Nurs Health,2008,31(1):23-30.DOI:10.1002/nur.20228.
[26]宇虹,王丽娜,周郁秋,等.精神分裂症恢复期患者病耻感对生活质量的影响:社会支持及应对方式的中介效应[J].中国护理管理,2015,15(4):424-428.DOI:10.3969/j.issn.1672-1756.2015.01.012.
[27]刘玉莲,尹冬青.双相情感障碍患者家属病耻感与希望水平的关系研究[J].护理管理杂志,2018, 18(3):207-209.DOI:10.3969/j.issn.1671-315x.2018.03.013.
[28]Suro G, Weisman de Mamani. Burden, Interdependence, Ethnicity, and Mental Health in Caregivers of Patients with Schizophrenia[J].Family Process,2013,52(2):299-311.DOI:10.1111/famp.12002.
[29]刘雪英,何凤英,农彩云,等.希望理论在慢性精神分裂症患者康复期的应用研究[J].护士进修杂志,2016,31(2):107-110.DOI:10.16821/j.cnki.hsjx.2016.02.005.

Metrics

Viewed

Full text

Abstract

Cited

Shared