上海市远郊某镇居家严重精神障碍患者管理现状

Management status of home-based patients with severe mental disorders from a town in outer suburbs of Shanghai

目的掌握上海市远郊某镇居家严重精神障碍患者管理现状,为加强辖区严重精神障碍患者管理工作提供科学依据。方法采用整群随机抽样方法抽取上海市远郊某镇居家严重精神障碍患者开展现况研究分析。结果上海市远郊某镇共有居家严重精神障碍患者670例,以≥60岁、小学及以下文化程度、农民和精神分裂症为主,构成比分别为43.58%、54.03%、41.97%和51.19%。病程以≥20年为主,构成比为72.69%。大多起病缓慢、无家族史,构成比分别为65.22%和91.19%。治疗以门诊和定期就诊为主,构成比分别为54.33%和48.66%,仍有45.37%的患者未接受治疗。多数患者与家庭医生签约,签约率为82.99%,由配偶监护的构成比为43.28%,参与残疾评定的构成比为54.78%,能参加正常工作的构成比为13.43%。城镇与农村地区严重精神障碍患者主要在学历、发病前职业、疾病种类、治疗及时性、家庭医生签约、残疾评定、参与社会情况等因素差异有统计学意义(χ^(2)=62.277、109.745、13.588、13.301、9.561、22.413、16.178,P均<0.05)。结论上海市远郊某镇居家严重精神障碍患者管理现状较为严峻,需加强管理体系建设。

Objective To grasp the management status of home-based patients with severe mental disorders from a town in the outer suburbs of Shanghai,and to provide scientific basis for tightening controls on patients with severe mental disorders.Methods The cluster random sampling method was applied to select patients with severe mental disorders at home from a town in the outer suburbs of Shanghai for analysis and research.Results Six hundred and seventy patients with severe mental disorders at home from a town in the outer suburbs of Shanghai were mainly composed of≥60 years old,primary school education or below,farmers and schizophrenia,accounting for 43.58%,54.03%,41.97%and 51.19%,respectively.The course of disease was≥20 years,accounting for 72.69%.Most of patients had slow onset progress without family history,accounting for 65.22%and 91.19%,respectively.The outpatients and regular visits dominated in terms of treatments,accounting for 54.33%and 48.66%,respectively,and 45.37%of patients were still untreated.Most of patients concluded contracts with signing rate of 82.99%with family doctors,43.28%patients were supervised by their spouses,54.78%patients participated in disability assessment,and only 13.43%patients got involved in normal work.Differences in educational background,occupation before onset,disease type,timeliness of treatment,contract conclusion of family doctor,disability assessment,participation in society and other factors were found with urban and rural patients with severe mental disorders(χ^(2)=62.277,109.745,13.588,13.301,9.561,22.413,16.178,all P<0.05).Conclusions The current situation of home-based management of patients with severe mental disorders from a town in the outer suburbs of Shanghai remain being severe,and the setup of management system is required to be strengthened.