严重精神障碍患者社区康复效果影响因素分析

Analysis of Influencing Factors on the Effectiveness of Community Rehabilitation for Patients with Severe Mental Disorders

目的探讨严重精神障碍患者在社区康复效果的影响因素,为社区精神卫生工作者制定个体化干预方案提供参考,以进一步提高患者康复效果.方法采用多因素logistic回归分析某城区诊断明确的严重精神障碍患者基本情况,以住院次数、社会功能为结果,分析不同诊断、性别、年龄、监护人关系、随访方式、婚姻、工作状态、合并其他疾病情况与社会功能相关性.结果监护人与患者关系、年龄、婚姻状况、工作状态、医疗待遇、家庭经济状况、起病形式、有无合并慢性病与个人生活料理能力相关;监护人与患者关系、性别、诊断、婚姻状态、文化程度、工作状态与家务劳动能力相关;监护人与患者关系、诊断、婚姻状况、工作状态、家庭经济情况与患者社交参与度和社交能力相关;起病情况和主诊断性质与生产劳动和工作能力相关.结论患者社会功能的社区康复受多种因素影响,不同社会功能水平受不同因素影响,分析患者功能水平和资源,如患者监护人的关系、文化程度、医疗待遇和危险因素如年龄、婚姻状态、服药情况等,能够更有针对性制定患者康复方案或者个体化治疗方案,发挥保护因素,纠正危险因素,提高患者社区康复效果.

Objective To explore the influencing factors of community rehabilitation outcomes for patients with severe mental disorders,in order to facilitate community mental health workers to develop personalized in-tervention plans based on the influencing factors and improve the effectiveness of community rehabilitation for pa-tients.Methods Multivariate logistic regression was used to analyze the basic situation of severely diagnosed mental disorder patients in a certain urban area.Based on the number of hospitalizations and social function,the correlation between different diagnoses,gender,age,guardianship relationships,follow-up methods,marriage,work status,and comorbidities with social function was analyzed.Results The relationship between guardians and patients,age,marital status,work status,medical treatment,family economic status,onset form,and presence or absence of comorbidities are related to patients’personal life care ability;The relationship between guardians and patients,gender,diagnosis,marital status,education level,and work status are related to patients’household chores ability;The relationship between the guardian and the patient,diagnosis,marital status,work status,and family eco-nomic situation,are related to patient's social and interpersonal communication abilities;The diagnosis and onset form are related to patients’production labor and work ability.Conclusion Community rehabilitation of patient social function is influenced by multiple factors,and different social functions are affected by different factors.An-alyzing the patient's characteristics such as the rela-tionship with the patient's guardian,educational level,medical treatment,and risk factors such as age,mari-tal status,and medication use can help develop more targeted rehabilitation plans or personalized plans for patients,utilize protective factors,correct risk factors,and improve the effectiveness of patient community rehabilita-tion.