重性精神疾病关锁患者解锁救治前后家庭照料者的负担

Burden change of caregivers of locked patients with psychoses after unlocking and treatment

目的:了解曾被关锁的重性精神疾病患者的家庭照料者负担在解锁救治前后的变化。方法:使用自编调查问卷,对中央补助地方重性精神疾病管理治疗项目(简称"686"项目)解锁救治的266例重性精神疾病患者及其家庭照料者进行调查,分析比较解锁救治前后照料者看护患者投入时间占劳动时间的比例、受累家庭照料患者的机会成本、照料者对自身承受的心理压力和经济负担的主观评价,以及解锁前后的家庭经济状况。结果:解锁救治后,家庭照料者看护患者投入时间占劳动时间的比例之和由解锁前的(62.2±35.1)%降至(30.2±28.0)%(P<0.001),受累家庭照料患者的机会成本减少[城镇地区(8771.4±4079.3)元vs.(5103.4±3899.6)元,P<0.001;农村地区(2827.1±1688.5)元vs.(1342.5±1346.7)元,P<0.001],照料者心理压力[(8.9±1.4)vs.(4.5±1.7)]和经济负担的主观评分[(9.2±1.2)vs.(4.9±2.1)]显著降低(P均<0.001)。结论:重性精神疾病患者的家庭照料者负担在患者获得解锁救治后明显减轻,各地开展的解锁救治专项工作具有现实的社会经济意义。

Objective：To compare the burden of the caregivers of locked patients with psychoses before and after enrolling in the unlocking and treatment program. Methods： Totally 266 patients with psychoses and their caregivers were investigated with the self-made questionnaire.All the patients were unlocked and provided with anti-psychotic treatment under the National Continuing Management and Intervention Program for Psychoses （686 Program）.Pre-post tests were conducted in terms of caregivers＇ time spent in taking care of the patients other than in working,the opportunity cost of the affected families for taking care of the patients,caregivers＇ subjective estimate of the psychological stress and economic burden,as well as the economic status of the affected families. Results： After enrolling in the unlocking and treatment program,caregivers spent smaller amount of time in taking care of each patient [（62.2±35.1）% vs.（30.2±28.0）%,P〈0.001],the opportunity cost of the affected families for taking care of the patients reduced significantly [urban area （8771.4±4079.3） yuan vs.（5103.4±3899.6） yuan,P〈0.001;rural area （2827.1±1688.5） yuan vs.（1342.5±1346.7） yuan,P〈0.001],the caregivers experienced less psychological stress [（8.9±1.4） vs.（4.5±1.7）,P〈0.001] and economic burden [（9.2±1.7） vs.（4.9±2.1）,P〈0.001]. Conclusion： The burden of caregivers of patients with psychoses may be alleviated much after enrolling in the unlocking and treatment program,and the program shows its social and economic significance.