生态系统理论下长期住院精神分裂症患者的生存困境及提升生存质量的路径探索

The survival dilemma of long-term hospitalized schizophrenic patients and the way to improve the quality of life under the ecosystem theory

目的:探讨长期住院精神分裂症患者当前的康复环境和生活状况,探索其现状与需求,探索改善长期住院精神分裂症患者生存质量的路径。方法:对上海市某精神卫生中心的12名长期住院患者(住院时间>1年)进行半结构式访谈。结果:通过分析归纳,整合出5个主题:长期住院的患者对疾病具有更全面的认知;家属和患者对医院存在依赖;患者对人生的态度经历了渴望到绝望的转变;患者对履行民事权利存在事实性受限。结论:本研究提示对突破长期住院精神分裂症患者困境的路径:培养患者的自我管理能力,减轻病耻感,提升自信心,创造希望;完善患者的社会支持系统,拓展患者及家庭对疾病的应对方式;畅通政策渠道,保护患者的民事权利。

Objective:To explore the current rehabilitation environment and living conditions of long-term hospitalized schizophrenic patients,explore their current situation and needs,and explore the path to improve the quality of life of long-term hospitalized schizophrenic patients.Method:A semi-structured interview was conducted with 12 long-term hospitalized patients(hospitalization time>1 year)in a mental health center in Shanghai.This study conducted participatory observation on long-term hospitalized patients in the mental health center and interviewed 12 long-term hospitalized patients with schizophrenia.Results:Through analysis and induction,five themes were concluded:long-term hospitalized patients had a more comprehensive understanding of the disease;Family members and patients were dependent on the hospital;The patient's attitude towards life had experienced a change from longing to despair;Patients had factual restrictions on the performance of civil rights.Conclusion:This study result indicates the ways to break through the plight of long-term hospitalized schizophrenic patients:cultivate patients'self-management ability,reduce the sense of shame,enhance self-confidence and create hope;Improve the social support system of patients and expand the coping styles of patients and their families;unblock policy channels and protect the civil rights of patients.