精神分裂症照料者对精神分裂症患者病态行为应对方式及健康教育需求现状调查

Coping Styles and Health Education Needs of Caregivers for Abnormal Behaviors of Schizophrenia Patients

目的探讨住院精神分裂症患者的照料者对患者主要病态行为出现时的应对方式、对常见精神卫生知识的了解程度及对健康教育知识的需求情况。方法对300名精神分裂症患者的照料者,采用自制的一般情况调查表(婚姻、与患者关系、与患者的感情及与患者的交流情况等)、照料者对患者病态行为应对方式调查表(病态应对方式、教育开导、继续服药、督促活动、强制就医、打骂惩罚及放任顺从等)、照料者健康知识知晓情况调查表(是否知道患者疾病的诊断与性质、精神分裂症复发的可能性、精神分裂症的不良影响、药物的常见不良反应、维持用药的时间、如何与患者进行沟通交流、疾病对后代的影响抢救等)及照料者健康教育需求情况调查表(教育途径及内容、出院后教育指导及教育形式、婚育指导内容等)进行现状调查。结果照料者在精神分裂症患者出现意志减退、幻觉妄想、消极行为、攻击行为、违拗拒药及反复外跑时,选择"强制就医"的比例分别为18.7%、34.0%、50.0%、42.0%、18.7%及25.3%。在出现锥体外系反应、消化道反应、镇静过度、心血管反应、体质量增加及睡眠障碍时,选择"及时就医"的比例分别为25.3%、28.7%、20.0%、34.0%、9.3%、16.7%。照料者在药物保管、婚育注意事项、疾病遗传影响及帮助患者回归社会方面缺乏了解,仅42.0%的照料者全部知道疾病诊断。70.0%的照料者希望通过医生、护士获取健康教育知识,25.7%的照料者希望通过网络获取。婚育指导内容中,48.0%及46.0%的照料者分别选择"后代遗传概率"及"患者可否结婚";出院后教育形式中,54.7%的照料者选择了"电话咨询医生"。结论精神分裂症患者照料者对患者病态行为常不能及时准确辨认,多选择不良应对方式,且对常见精神卫生知识缺乏了解,因此极有必要向他们提供有效而全面的健康教育指导,尤其是加强网络宣传普及的力度。

Objective To investigate the coping strategies for abnormal behaviors of schizophrenia patients, the understanding of common mental health knowledge and the needs for health education knowledge in caregivers of inpatients with schizophrenia. Methods A total of 300 caregivers of schizophrenia patients were investigated using self -made general questionnaire （marital status, relationship with patients, feelings toward patients and communication with patients, etc. ）,illness behavior coping strategy questionnaire （coping styles, education, enlightenment, continued medication, supervising activities, compulsory medical treatment, abuse, punishment, indulgency and obedience, etc.）, health knowledge questionnaire （diagnosis and nature of disease, possibility of schizophrenia recurrence, adverse effects of schizophrenia, adverse reactions to drugs, duration of medication,communication modes, influence on descendants, emergency treatment, etc.）, and health education need questionnaire （educational channels, educational contents, education guidance and forms after hospital discharge, marriage guidance contents, etc.）. Results When patients had hypobulia, hallucination, suicidal behavior, attack behavior, disobey behavior and repeated running away, compulsory medical treatment was chosen by 18.7%, 34.0%, 50.0%, 42.0%, 18.7% and 25.3% of caregivers, respectively. When patients had extrapyramidal symptoms, gastrointestinal reactions, excessive sedation, cardiovascular responses, overweight and sleep disorders, timely medical treatment was chosen by 25.3%, 28.7%, 20.0%, 34.0%, 9.3% and16.7% of caregivers, respectively. The caregivers lacked the knowledge about drug storage, marriage matters, genetic influence and helping patients return to society. Only 42.0% of caregivers knew the whole diagnosis. Seventy percent of caregivers hoped to get healthy knowledge from doctors and nurses, and 25.7% hoped to get healthy knowledge on the Internet. For the marriage guidance, 48.0%and 46.0%of caregivers chose “genetic probability of offspring”and“whether patients can get married”, respectively. For the education forms after hospital discharge, 54.7% of caregivers chose “doctor telephone consultation”. Conclusion Caregivers of schizophrenia can not identify the illness behavior timely and correctly. Most of them choose the negative coping strategies and lack the knowledge about mental health. Therefore, it is necessary to supply effective and comprehensive healthy guidance to caregivers of schizophrenia, especially network popularization.