精神病患者病耻感状况及影响因素分析

Current situation and influencing factors of stigma of the patients with mental disorders

目的：调查精神病患者社会支持、应对方式、一般自我效能感、病耻感状况，并分析社会支持、应对方式、一般自我效能感对精神病患者病耻感的影响。方法采用Link病耻感系列量表、社会支持评定量表、一般自我效能感量表、简易应对方式问卷对406例住院康复期精神病患者进行问卷调查及分析。结果406例精神病患者病耻感总分为（2．33±0．19），低于量表中点2．5分，差异有统计学意义（t＝-17．857，P＜0．01）；患者社会支持总分、一般自我效能感总分、消积应对得分分别为（32．13±7．03），（25．75±7．31），（1．59±0．66）分，与全国常模比较差异均有统计学意义（t值分别为42．505，0．000，-4．866；P＜0．01）；相关分析显示，病耻感与社会支持总分、社会支持利用度、一般自我效能感评分之间存在负相关关系（P＜0．05），与消极应对存在正相关关系（P＜0．01）；逐步回归分析发现消极应对为病耻感的影响因素（P＜0．01），采用消极应对方式越多的患者，病耻感越强。结论提高精神病患者社会支持和一般自我效能感，减少消极应对均有助于减轻其病耻感。

Objective To investigate the influence of social support , coping style and self efficacy on stigma of patients with mental disorders .Methods Using the Link stigma series scale , the social support rating scale, the General self-efficacy scale and the Simplified coping style questionnaire ,we assessed and analyzed 406 psychiatric patients’ social support, general self-efficacy, coping style and its influence on the stigma . Results The total score of stigma of the 406 patients was （2.33 ±0.19） which was significantly lower than the rating scale point （t=-17.857,P〈0.01）.The total scores of social support , utilization of social support and general self-efficacy were （32.13 ±7.03）, （25.75 ±7.31） and （1.59 ±0.66）, which were also significantly different than the national norm （t=42.505, 0.000, -4.866, respectively;P〈0.01）.Correlation analysis results showed that stigma had significant negative correlation with total score of social support , utilization of social support and general self-efficacy （P〈0.05）;stigma had positive correlation with negative coping style （P〈0.01）.Multiple linear stepwise regression showed that negative coping style was the significant influence factor to the stigma （P 〈0.01）.The more negative coping style adopted by the patients , the more serious stigma the patient would perceive .Conclusions It will be helpful to reduce psychiatric patients ’ stigma by improving social support , general self-efficacy and adapting less negative coping style .