广州市社区精神障碍患者中医药服务需求现状及影响因素分析

Analysis of the current situation and influencing factors of Chinese medicine services demand among community mental disorder patients in Guangzhou

目的调查广州市社区在库精神障碍患者中医药服务需求现状并分析其影响因素,为构建具有中医特色的社区精神卫生服务提供研究基础。方法自行设计调查问卷,采用系统抽样法对广州市3个行政辖区6个社区的在库精神障碍患者进行中医药服务需求调查及影响因素分析。结果共收集有效问卷1005份,精神障碍患者中有中医药需求人数为471人(46.87%),无需求人数为534人(53.13%)。单因素分析结果显示患者在广州居住年限、婚姻状况、教育程度、诊断、患病年限、是否知晓医院开展中医药服务、中医药服务是否方便、是否接受过中医药服务、是否了解中医药服务、是否对中医药服务感兴趣与患者中医药服务需求有关,差异有统计学意义(P<0.05)。以患者中医药需求为因变量,以单因素分析中有统计学意义的变量为自变量,采用logistic回归模型进行多因素分析,结果患者显示知晓社区医院开展中医服务(β=0.824,OR=2.279,95%CI:1.607~3.234)、接受过中医药服务(β=1.030,OR=2.800,95%CI:1.976~3.967)、对中医药服务感兴趣(β=0.756,OR=2.130,95%CI:1.476~3.071)、高中及中专学历(β=-0.544,OR=0.580,95%CI:0.398~0.849),患病>10~20年(β=0.454,OR=1.574,95%CI:1.009~2.457),患病>20年(β=0.707,OR=2.029,95%CI:1.333~3.088)是中医药服务需求的影响因素(P<0.05)。结论精神障碍患者对中医药服务需求偏低,其中知晓社区医院开展中医药服务、接受过中医药服务和对中医药服务感兴趣等因素显著影响患者的中医药需求,因此应主动宣传中医药服务在精神卫生领域的作用、提高中医药服务在精神卫生中的应用,从而推动中医药在社区精神卫生服务中的发展。

Objective To investigate the current situation of traditional Chinese medicine(TCM)demands and its influencing factors on community-based mental disorder patients in Guangzhou.To provide a research basis for construct a community mental health services with TCM characteristics.Methods A self-designed questionnaire was used to investigate the current situation of TCM demands and its influencing factors among mental disorder patients in six communities in three administrative districts of Guangzhou by systematic sampling method.Results A total of 1005 valid questionnaires were collected,471(46.87%)mental disorder patients have TCM demanding,and 534(53.13%)patients do not have TCM demanding.The uni-variate analysis showed that length of living in Guangzhou,marital status,education level,diagnosis,years of illness,awareness of the availability of TCM services in hospitals,the convenience of TCM services,having received TCM services,knowledge of TCM services,interest in TCM services was related to patients'TCM demand,the differences were statistically significant(P<0.05).The multi-factor analysis was performed using the logistic regression model with patients'TCM needs as the dependent variable and variables that were statistically significant in the uni-variate analysis as independent variables.The results showed that awareness of the availability of TCM services in hospitals(β=0.824,OR=2.2279,95%CI:1.607-3.234),having received TCM services(β=1.030,OR=2.800,95%CI:1.976-3.967),interest in TCM services(β=0.756,OR=2.130,95%CI:1.476-3.071),senior high school and secondary school education(β=-0.544,OR=0.580,95%CI:0.398-0.849),>10-20 years of disease duration(β=0.454,OR=1.574,95%CI:1.009-2.457),>20 years of disease duration(β=0.707,OR=2.029,95%CI:1.333-3.088)were influencing factors of TCM service demand(P<0.05).Conclusion Mental disorder patients have a low demand for TCM services,awareness of the availability of TCM services in hospitals,and having received TCM services and interest in TCM significantly influences patients'TCM needs.Therefore,initiatives should be taken to promote the role of TCM services in mental health,to improve the application of TCM services in mental health,and the development of TCM in community mental health services.