严重精神障碍患者病耻抵抗现状及影响因素分析

Stigma resistance and influence factors in people with severe mental illness

目的:探讨严重精神障碍患者的病耻抵抗水平及影响因素。方法:对北京市1家精神专科医院就诊的和4家社区卫生服务中心管理的406例严重精神障碍患者采用病耻抵抗量表、贬低—歧视感知量表、病耻感应对量表、病耻感应激量表、自尊量表、心理韧性量表、一般自我效能感量表进行调查。结果:病耻抵抗量表得分为(3.97±0.84)分。多元线性回归分析显示,病耻感应激(β=-0.165)、挑战(β=0.264)和心理弹性(β=0.430)进入回归方程,调整后R 2为0.372。结论:严重精神障碍患者的病耻抵抗处于中等偏上水平;病耻感应激、挑战的应对方式及心理弹性是病耻抵抗的影响因素。提示干预措施应侧重改善患者对病耻感的认知评价和应对方式,并提高心理弹性。

Objective:To explore the level and related factors of stigma resistance in people with severe mental illness.Method:406 people with severe mental illness from one psychiatric hospital and four community healthcare centers in Beijing were selected as samples,and were investigated with Stigma Resistance Scale,Perceived Devaluation Discrimination,Stigma Coping Orientation Scale,Stigma Stress Scale,Rosenberg Self-esteem Scale,10-item Conner-Davidson Resilience Scale and General Self-efficacy Scale.Results:The score of Stigma Resistance Scale was(3.97±0.84).Multiple linear regression analysis showed that stigma-related stress(β=-0.165),challenge(β=0.264)and resilience(β=0.430)entered the regression equation,and adjusted R 2 was 0.372.Conclusion:The stigma resistance among people with severe mental illness is above medium level.Intervention should focus on patients'cognitive evaluation of stigma,coping orientations and resilience,so as to improve stigma resistance.