昆明市300名城市社区失独者心理健康状况及影响因素分析

Status Quo of Mental Health among 300 Community People after Losing the Only-child in Kunming and Its Influence Factors

目的评估云南省昆明市社区失独人群心理健康状况并分析其影响因素,为护理人员制定科学的护理措施以提升失独人群的健康水平和生命质量提供依据。方法于2016年9月—2017年1月采用量性与质性相结合的研究方法,问卷调查300名、深度访谈19名失独者。结果失独者SCL-90得分为(161.40±24.30)分,心理健康问题检出阳性数为167名占55.67%。除敌对项目外,其他各因子得分均高于常模(P<0.001)。Logistics回归分析结果提示女性失独者SCL-90得分高;最近1年平均月收入越高、失独年限越长的失独者SCL-90得分越低。质性研究结果表明失独者的心理健康状况体现在心身、认知、行为和社会文化4个方面,受个体因素、社会支持和应对方式3个方面的影响。结论半数以上失独者存在心理健康问题;失独者的心理健康水平受诸多因素影响。医护人员要加强心理学知识的学习,站在失独者的角度,体会他们的困境,了解他们的想法,充分创造并利用影响因素中的有利因素,构建完善的失独人群心理干预方案,改善失独者的心理健康状况,最终提升失独人群的健康水平。

Objective To assess the mental health among community people after losing the only-child in Kunming and to analyze the influencing factors in order to provide the basis for scientific nursing interventions. Methods Mix-methods including quantitative research methods by using questionnaire investigated 300 people and qualitative research methods by using in-depth interviewed 19 people were used in September 2016 to January 2017. Results The SCL-90 score of people after losing the onlychild was 161.40±24.30. Totally 167 persons had mental health problems, accounting for 55.67%. The score of other factors was higher than norm, except that of aggressiveness/hostility,（P0.001）. Logistic regression analysis showed that the SCL-90 score of female was higher; the higher the average monthly income in the last year and the longer losing the only-child, the lower the score of the SCL-90. Qualitative research results showed four core categories of mental health were identified including psychosoma, cognition,behavior, and social-culture. The influence factors included 3 domains including personality, social support, and coping style.Conclusion More than half of community people after losing the only-child have mental health problems, which are influenced by numerous factors. Doctors and nurses need to enhance the psychology knowledge, to realize the plight and understand the thinking in the perspective of people after losing the only-child, to sufficiently create and use the favorable factors, in order to construct a thorough psychological intervention program to better the mental health, and ultimately improve their quality of life.