长期住院慢性精神分裂症患者生活质量及影响因素分析

Study about quality of life of inpatients with chronic schizophrenia and influencing factors

目的 探讨长期住院的慢性精神分裂症患者的生活质量及影响因素。方法 采用阳性症状和阴性症状量表（PANSS）、治疗不良反应量表（TESS）、健康状况调查问卷（sF一36）以及自编患者一般情况调查表（人口学资料、病期、住院时间、临床用药、目前状态、躯体疾病），对2012年8月～2013年8月的163例慢性精神分裂症住院患者进行评定，并与82名健康志愿者进行对照分析。结果 精神分裂症患者SF-36生活质量各维度评分均低于对照组，两组间差异有统计学显著意义（P〈0．01）；患者的生理机能与药物不良反应呈负相关（r=-0.290，P〈0．01）；躯体疼痛与患者的阳性症状（r=-0．144，P〈0．05）及阴性症状（r=-0．199，P〈0．05）呈负相关；一般健康状况与患者的阴性症状（r=-0．193，P〈0．05）及一般精神病理症状（r=-0．219，P〈0．01）呈负相关；精力与患者的阴性症状（r=-0．342，P〈0．01）及一般精神病理症状（r=-0．186，P〈0．05）呈负相关；社会功能与药物不良反应（r=-0．173，P〈0．05）呈负相关；情感职能与患者的阳性症状（r=-0．201，P〈0．05）呈负相关；精神健康与阴性症状（r=-0．214，P〈0．01）及一般精神病理症状（r=-0．168，P〈0．05）、药物不良反应（r=-0．194，P〈0．05）呈负相关。结论 长期住院的慢性精神分裂症患者的生活质量低下，影响因素是多方面的，包括患者的精神状态、药物疗效、不良反应等。

Objective To explore the quality of life and its influencing factors of inpatients with chronic schizophrenia. Methods Totals of 163 inpatients with chronic schizophrenia hospitalized in Rongjun Hospital of Laizhou,Shandong Province, during the period from August 2012 to August 2013 were selected. The Short- Form-36 Health Survey（SF- 36） , Positive and Negative Syndrome Scale （PANSS）, Treatment Emergent Symptoms Scale （TESS） and self- designed questionnaire （ demographic characteristics, duration of disease, length of stay, clinical medication, psychiatric state, physical illness）were used to assess patients＇ life of quality, psychiatric state and drug side effect; and the results of SF-36 were compared with 82 no-psychosis volunteers. Results All dimensions of the SF-36 of inpa tients with chronic schizophrenia was lower than normal control group （P 〈 0.01） ; the result showed a significant negative correlation between patients＇ Physical Functioning and TESS （r=-0. 290,P 〈0.01）; there was a significant negative correlation between Bodily Pain and PANSS-P （r =-0. 144, P〈0.05） and PANSS-N（r=-0.199,P〈 0.05）; patients＇ General Health was affected by PANSS-N （r =-0. 193 ,P〈 0.05） and PANSS G （r =-0. 219, P〈 0.01）; Vitality was affected by PANSS-N（r=-0. 342,P〈0. 01） and PANSS-G （r=-0. 186,P 〈 0.05） ; there was a significant negative correlation between Social Functioning and TESS （r = -0. 173 ,P〈 0.05） ; Role Emotional was affected by PANSS- P （r =- 0. 201 ,P 〈0. 05） ; Mental Health was affected by PANSS- N （r=-0.214,P〈0. O1）,PANSS-G（r==-0. 168,P〈0.05） andTESS（r=--0. 194,P〈0. 05）. Conclusions Inpatients with chronic schizophrenia had a lower life quality. Their low life qualities were affected by multi-factors, including inpatients＇ mental health, the effective of the medicine and the side effects of the medicine, etc.