家庭动力对精神分裂症患者病耻感的影响

Investigation the influence of family dynamics on stigma in schizophrenics

目的对康复期精神分裂症患者家庭动力与病耻感的分析,为临床上改善患者病耻感,促进康复提供实践参考。方法以方便取样的方式顺序入组,抽取上海市浦东新区辖区10个街镇在社区康复的精神分裂症患者以及上海市浦东新区精神卫生中心住院患者各300名。研究采用问卷法,评估精神分裂症患者的家庭动力特征及病耻感。结果住院与社区精神分裂症患者在首发年龄(P1=0.018)、住院次数上差异均有统计学意义(P2=0.00)。住院与社区精神分裂症患者在病耻感总量表得分及分量表分(P1=0.000;P2=0.002;P3=0.001;P4=0.000),家庭动力总分及疾病观念因子(P5=0.012;P6=0.006)上都有显著差异。精神分裂症患者病耻感所有因子均与家庭动力量表中家庭氛围、个性化因子呈中度正相关。结论精神分裂症患者减少住院次数,选择在社区康复,有利于减轻病耻感。临床实践中,引导改善患者的家庭氛围,提升家庭成员个性化程度也能够减轻病耻感,有利于患者的康复进程。

Objective To study the family dynamics and stigma in schizophrenics in order to provide practical reference for improving stigma and promoting rehabilitation. Methods A total of 600 schizophrenic(hospitalized group n=300,community group n= 300)were selected by simple sampling. Questionnaires were used to assess family dynamics and stigma in schizophrenics. Results There were statistically significant differences in the age of first episode and the number of hospitalizations between the two groups(P=0.018,0.000,respectively). There were statistically significant differences in the scores and subscales of stigma between the two groups(P=0.000,0.002,0.001,0.000,respectively). And there were significant differences in the total score of family dynamics and the factor of disease concept between the two groups(P=0.012,0.006,respectively). Besides,all factors of stigma were moderately positively correlated with their family atmosphere and personality factors in the family dynamics scale. Conclusions Schizophrenia patients reduce the number of hospital admissions,the choice of community rehabilitation,is conducive to reducing stigma. In clinical practice,guidance to improve the patient’s family atmosphere and enhance the degree of individuation of family members can also reduce stigma,which is conducive to the patient’s recovery process.