老年精神分裂症患者自我管理现状及其与家庭关怀度、社会支持的关系

Self-management status in elderly patients with schizophrenia and its relationship with family caring degree and social support

目的探讨老年精神分裂症患者自我管理现状及其与家庭关怀度、社会支持的关系。方法采用便利抽样法选取2021年3月至2024年3月期间在上海宝山区精神卫生中心就诊的95例老年精神分裂症患者作为调查对象,采用一般资料调查表、精神分裂症患者自我管理量表(SSMIS)、家庭关怀度量表(APGAR)及社会支持评定量表(SSRS)评估患者的基本情况、自我管理现状、家庭关怀度及社会支持程度,采用Pearson相关分析法分析老年精神分裂患者自我管理现状及与家庭关怀度、社会支持程度的相关性,采用Bootstrap中介效应检验法分析三者间的中介效应关系。结果本研究共发放问卷95份,回收有效问卷90份,有效率为94.74%(90/95);90例患者中男性47例(52.22%),女性43例(47.78%);老年精神分裂症患者以70~79岁(37例,占比41.11%)、病程>10年(35例,占比38.89%)、初中及以下(38例,占比42.22%)、已婚(44例,占比48.89%)、父母/子女照料(60例,占比66.67%)、城市居住(46例,占比51.11%)、医保支付(57例,占比63.33%)、家庭人均月收入≤3000元/年(45例,占比50.00%)、合并慢性疾病≤1种(48例,占比53.33%)患者居多;老年精神分裂症患者SSMIS总分为(53.50±4.29)分,APGAR总分为(4.17±0.74)分,SSRS总分为(22.64±3.93)分,均处于中低水平;Pearson相关性分析结果显示,老年精神分裂症患者SSMIS总分及各维度分值与APGAR总分及各维度分值、SSRS总分及各维度分值均呈正相关(P<0.01);Bootstrap检验分析结果显示,家庭关怀度通过社会支持程度对老年精神分裂症患者自我管理水平的中介效应值为0.492(95%CI:0.693~1.145),占总效应的32.22%。结论老年精神分裂症患者自我管理水平较低,与家庭关怀度、社会支持水平呈正相关,且家庭关怀度在社会支持和自我管理水平间具有中介效应作用。

Objective To explore the self-management status in elderly patients with schizophrenia and its relationship with family caring degree and social support.Methods Adopting convenience sampling method,95 elderly patients with schizophrenia in Shanghai Baoshan Mental Health Center from March 2021 to March 2024 were selected as the investigation subjects.The general data,Schizophrenia Self-Management Instrument Scale(SSMIS),Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)scale,and Social Support Rating Scale(SSRS)were used to evaluate the basic situation,self-management status,family caring degree,and social support degree of patients.Pearson correlation analysis was used to analyze the self-management status in elderly patients with schizophrenia and its correlation with family caring degree and social support degree.Bootstrap mediating effect test was adopted to analyze the mediating effect relationship among the three.Results A total of 95 questionnaires were distributed in this study,and 90 valid questionnaires were collected,with an effective rate of 94.74%(90/95).Among the 90 patients,47(52.22%)were male and 43(47.78%)were female.Elderly patients with schizophrenia were mostly 70-79 years old(37 cases,41.11%),with course of disease>10 years(35 cases,38.89%),with education level of junior high school or below(38 cases,42.22%),married(44 cases,48.89%),with caring of parents/children(60 cases,66.67%),urban residence(46 cases,51.11%),with medical insurance payment(57 cases,63.33%),with family per capita monthly income≤3000 yuan(45 cases,50.00%),and with chronic diseases≤1 type(48 cases,53.33%).The total scores of SSMIS,APGAR,and SSRS in elderly patients with schizophrenia were(53.50±4.29)points,(4.17±0.74)points,and(22.64±3.93)points,respectively,which were at medium and low levels.Pearson correlation analysis showed that the total score and the scores of each dimension of SSMIS in elderly patients with schizophrenia were positively correlated with the total score and the scores of each dimension of APGAR and the total score and the scores of each dimension of SSRS(P<0.01).Bootstrap test revealed that the mediating effect value of family caring degree on self-management level of elderly patients with schizophrenia through social support degree was 0.492(95%CI:0.693-1.145),accounting for 32.22%of the total effect.Conclusion The self-management level in elderly patients with schizophrenia is low,and it is positively correlatedwith family caring degree and social support.In addition,family caring degree plays a partial mediating effect betweensocial support and self-management level.