某军队医院内科门诊神经症性症状患者医院满意度的影响因素

Study on the internal medicine department outpatients'satisfaction with hospitals in military hospitals and its correlative factors

目的:研究某军队医院内科门诊患者神经症性症状的流行规律和具有此类症状患者的医院满意度及影响因素。方法:从某三家军队医院内科门诊随机抽取502名患者。用Zung焦虑自评表,W akefield抑郁自评表,A lbert惊恐障碍和躯体化障碍评估手册,一般情况调查表评估研究对象。心理科医生、内科医生依据DSM-Ⅳ对502名患者进行鉴别诊断。结果:502名患者中,2/3为躯体疾病不伴有神经症性症状,1/3为有神经症性症状。其中有神经症性症状患者中,已确诊为各种神经症的占34.5%,确诊为躯化障碍的占8.33%,确诊为躯体疾病伴神经症性症状的占57.14%。神经症性症状组自认医院满意度显著低于躯体疾病不伴有神经症性症状组。结论:军队医院内科门诊患者的心理问题严重,神经症性症状患者自认医院满意度低。神经症性症状严重程度,自认疾病程度、特殊检查次数、累积就诊次数、累积医疗费用、药物治疗情况对此类患者的医院满意度影响较大。可以通过采用加强精神卫生服务意识和观念、重视对精神卫生知识的学习和运用等对策干预目前军队医院内科门诊的这一现状。

Objective： To investigate the prevalence of neurotic symptoms in internal medicine department of some military hospitals and for the outpatients with neurotic symptoms how to satisfy with hospitals and its correlative factors. Methods： Firstly, 502 subjects were taken out from all outpatients in internal medicine department of three military hospitals, Secondly, all subjects were tested by SAS,SDS.Albert manual for the panic and summarization scales and the general questionnaire. Thirdly, they were firmly diagnosed by physicians and psychiatrists according to DSM-IV. Results： Among all 502 outpatients, 2/3 have physical diseases without neurotic symptoms. 1/3 have neurotic symptoms. Among internal department outpatients with neurotic symptoms. the prevalence rate of neurosis is 34.5%, summarization disorder is 8.33%, physical diseases with neurotic symptoms is 57.14%. The outpatients with neurotic symptoms were much less satisfied with hospitals than the outpatients of physical diseases without neurotic symptoms. Conclusions ：The mental problem is serious and widespread in internal medicine department of military hospitals, The outpatients with neurotic symptoms in internal medicine were much less satisfied. The outpatients＇satisfaction with hospitals were directly influenced by the score of neurotic symptoms, their attitude to the disease, the total numbers of special check-up, consuming fee, drug treatment. We can interfere in the present situation through several strategies such as having concept and idea to give psychological service so on.