成都市基层医疗卫生机构社区精神卫生服务队伍工作现状调查

Mental health service status in Chengdu Communities

为了解成都市基层医疗卫生机构社区精神卫生服务的现状,2013年3月对成都市21个区（市）县319家公立基层医疗卫生机构从事重性精神疾病管理治疗的319名工作人员（精防人员）使用自编调查问卷进行调查,包括精防人员的一般人口学资料、对社区精神卫生服务的主观看法,所在社区的工作开展情况等.结果回收有效问卷252份,252名精防人员年龄19 -61岁,平均（33.12±9.39）岁;专业背景以临床医学为主（59.5％）,公共卫生及全科医学专业者共占16.3％;受教育程度以大专及以下者为主（84.9％）.从事精防工作时间平均18个月;86.5％的精防人员为兼职.87.4％的社区精防人员认为完成此项工作比较困难;仅25.3％对工作表示满意.受访社区中仅有16.3％的社区回答本社区重精患者有康复场所;开展大众健康教育次数（2.21±1.62）次/年,开展精神障碍患者及家属健康教育次数（1.62±1.83）次/年.患者检出率合格组与非合格组精防人员仅在接受培训总次数上差异有统计学意义（P=0.012）,在从事精防工作时限、是否在编、是否接受专业技术人员指导、是否和片区民警有联系、是否和残联人员有联系等方面差异无统计学意义（均P＜0.05）.提示目前社区精防专业队伍薄弱,社区的健康教育及康复工作开展不理想,应加强精防人员培训力度以增强其开展工作的能力.

A questionnaire survey was conducted among 319 mental health workers from 319 grassroots health institutions of 21 districts （cities,counties） in Chengdu in March 2013.The items of survey included general information of participants,subjective perceptions and status of community mental health services.Total 252 effective questionnaires were received,the average age of participants was （33.12 ± 9.39） years （19-61）;59.5% had clinical medicine and 16.3% had public health background;most of them had educational levels of three-year college or below （84.9%）;the average duration of working experience was 18 months;86.5% was part-time;most of participants （87.4%） thought that the mental health service was a hard job and only 25.3% expressed satisfaction with the work.Only 16.3% of community health service centers had rehabilitation facilities for mental illness patients.Public health education was carried out for average （2.21 ± 1.62） times/year,the education for mental patients and family members was （1.62 ± 1.83） times/year.Between areas with sufficient detection rate of mental illness and those with insufficient detection rate,there was significant difference in training frequency of mental workers （P =0.012）,there were no significant differences in having formal employment of mental workers （P =0.064）,professional guidance,co-working with police officers,co-working with Disabled Persons＇ Federation,and the duration of working experience （all P 〉 0.05）.The results suggest that the capacity of mental health service in community levels is relatively weak in Chengdu,and the personnel training,public education and rehabilitation work of mental health need to be strengthened.