无锡市社区严重精神障碍患者体检率调查及其影响因素分析

目的 了解无锡市社区严重精神障碍患者健康体检率及其影响因素,为提高对社区患者的健康体检服务质量提出相关建议。方法 采用分层整群随机抽样方法,对无锡市1 220名社区严重精神障碍患者及其监护人进行问卷调查,描述性分析患者健康体检状况,并探讨影响患者健康体检的因素。结果 无锡市社区严重精神障碍患者的健康体检率为50.82%。logistic回归分析显示,居住城区(OR=2.756,95%CI=1.985-3.825)、服药(规律OR=1.974,95%CI=1.380-2.823;间断OR=1.948,95%CI=1.238-3.067)、有体检意识(必要OR=5.757,95%CI=4.054-8.177;无所谓OR=1.584,95%CI=1.053-2.382)及监护人为父母(OR=2.359,95%CI=1.367-4.069)或夫妻(OR=1.860,95%CI=1.036-3.339)是患者参加体检的积极因素,而家庭经济贫困(OR=0.614,95%CI=0.444-0.849)、病程≤10年(OR=0.662,95%CI=0.461-0.949)、未曾住精神专科医院(OR=0.704,95%CI=0.514-0.963)、GAS评分≤50分(OR=0.248,95%CI=0.166-0.371)或51-60分(OR=0.500,95%CI=0.340-0.734)是影响患者体检的消极因素。结论 无锡市社区严重精神障碍患者体检率有待提高,应通过加强健康宣教改善患者对体检的认知,关注农村及贫困家庭及督促服药、稳定病情等措施提高体检率。

Physical examination rate of patients with severe mental disorders and its influencing factors,Wuxi

Objective To explore the physical examination rate and its influencing factors of patients with severe mental disorders in Wuxi,and to provide suggestions for improving health examination services.Methods A cross-sectional survey was conducted among 1 220 patients with severe mental disorders and their guardians in Wuxi community by stratified cluster random sampling.The health status and influencing factors of patients’ physical examination were analyzed.Results The physical examination rate of patients with severe mental disorders in Wuxi was 50.82%.logistic regression analysis showed that the residential area( OR =2.756,95% CI =1.985-3.825),taking medicine(regular: OR =1.974,95% CI =1.380-2.823,intermittent: OR =1.948,95% CI =1.238-3.067),having an awareness of physical examination(necessary: OR =5.757,95% CI =4.054-8.177,no conflict OR =1.584,95% CI =1.053-2.382)and guardian is parents( OR =2.359,95% CI =1.367-4.069)or husband and wife( OR =1.860,95% CI =1.036-3.339)were positive factors for patients to participate in physical examination,while poor family( OR =0.614,95% CI =0.444-0.849),duration≤10 years( OR =0.704,95% CI =0.514-0.963),did not live in a psychiatric hospital( OR =0.704,95% CI =0.514-0.963),GAS score of no more than 50 points( OR =0.248,95% CI =0.166-0.371)or 51-60 points( OR =0.500,95% CI =0.340-0.734)were the negative factors affecting the physical examination rate of patients.Conclusion Physical examination rate of patients with severe mental disorders in Wuxi community needs to be improved.It is necessary to improve the awareness of physical examination by strengthening health education,paying attention to rural and poor families,and urging medication and stabilizing the disease to improve the physical examination rate.