职业病患者社会支持与心理健康的相关性研究

目的 研究职业病患者的社会支持与心理健康状况及其之间的相关性,为提高职业病患者的心理健康水平提供决策依据。 方法 采用社会支持评定量表(SSRS)和症状自评量表(SCL-90)对135例职业病住院患者的社会支持、心理健康状况及其影响因素进行研究,运用SPSS 19.0软件对调查数据进行统计学处理。 结果 135例职业病患者SCL-90的平均总分为(178.56 ±66.96)分,9项因子平均分最小值为(1.72 ±0.73)分,最大为(2.25 ±1.01)分。总分和9项因子分均高于国内常模,各项得分在两者之间比较,差异均有统计学意义(P<0.01)。职业病患者的社会支持总分、客观支持、主观支持及支持利用度得分均低于国内常模(P<0.01)。男性职业病患者的各项得分均高于女性患者(P<0.05或0.01),年龄大的职业病患者的各项得分均高于年龄小的患者(P<0.05或0.01),工伤医疗组和单位支付组各项得分均高于自费组(P<0.05),学历高的职业性病患者在客观支持上得分高于学历低的患者(P<0.05或0.01),已婚组获得的社会支持总分、主观支持、客观支持得分都高于未婚组及离异或丧偶组(P<0.05),重度病情的职业病患者在社会支持总分、客观支持得分上高于中、轻度两组患者(P<0.01),家庭收入低的患者在其社会支持总分、客观支持、支持利用度上的得分低于家庭收入高的患者(P<0.05或0.01)。职业病患者的社会支持总分、主观支持得分与其躯体化、强迫症状、人际关系敏感、焦虑、恐怖、偏执等因子均呈负相关(P<0.05或0.01)。 结论 职业病患者获得的社会支持较低,与其心理健康状况差有一定的相关性,应引起我们注意。     

Disparities in mental health,social support and coping among individuals with mobility impairment

BackgroundCDC estimated that 19.4 million (7.8%) US adults are living with mobility impairment, who are unable to walk a quarter mile. Individuals with physical disability reported greater depression and, in some cases, insufficient social support.ObjectivesThis study explores the extent of disparities in psychological health, social support, and coping mechanisms among those with mobility impairment as compared to those without such impairment, and the longitudinal effect of onset of mobility impairment on subsequent psychosocial health and coping.MethodsIndividuals with mobility impairment were matched to controls from a nationally representative sample, using the propensity score method. The final sample included 345 matched pairs. Regression models with robust standard errors were used to assess disparities in outcomes by mobility status. Autoregressive models were used to assess the longitudinal effect of the onset of mobility limitation on these outcomes.ResultsThose with impaired mobility fared significantly higher on negative affect (p < .05) and pessimism (p < .05), and significantly lower on life satisfaction (p < .05) and positive affect (p = .001). In terms of coping, they showed disparities in health locus of control (self) (p < .05), planning (p < .05), active coping (p < .05), and problem-focused coping (p < .05), as compared to those without mobility limitation. The onset of mobility impairment had significant effects in similar psychological and coping domains.ConclusionOur work revealed a piece of reality of individuals living with mobility impairment and will inform designing effective interventions to mitigate psychosocial health disparities in this population.     

Self injurious behavior among homeless young adults: A social stress analysis

Although self-mutilation has been studied from medical and individual perspectives, it has rarely been examined within a social stress context. As such, we use a social stress framework to examine risk factors for self-mutilation to determine whether status strains that are often associated with poorer health outcomes in the general population are also associated with self-mutilation among a sample of young adults in the United States who have a history of homelessness. Data are drawn from the Homeless Young Adult Project which involved interviews with 199 young adults in 3 Midwestern United States cities. The results of our path analyses revealed that numerous stressors including running away, substance use, sexual victimization, and illegal subsistence strategies were associated with more self-mutilation. In addition, we found that certain social statuses exacerbate the risk for self-mutilation beyond the respondents' current situation of homelessness. We discuss the implications of our findings for the social stress framework and offer suggestions for studying this unique population within this context.     

云南不明原因猝死病区人群社会支持对心理健康的影响

目的 了解云南不明原因猝死病区人群的社会支持现况,分析社会支持对心理健康的影响.方法 采用社会支持评定量表、焦虑和抑郁自评量表进行横断面入户调查,用Epi Data 3.1软件建立数据库,用SPSS 11.0统计软件进行统计分析.结果 病区组和对照组相比,在社会支持方面,两组的总得分、主观支持和客观支持得分差异均有统计学意义(均有P＜0.05);在心理健康方面,两组在焦虑和抑郁得分差异均有统计学意义(均有P＜0.05),进一步进行了焦虑程度和抑郁程度比较,虽两组中无重度抑郁患者,但焦虑程度和抑郁程度上的差异均有统计学意义(均有P＜0.05).结论 病区人群因社会支持低于一般人群,导致心理健康状况较差,希望相关部门提供足够的社会支持,以改善病区人群心理健康状况.     

医务人员社会支持与心理健康状况调查

目的 了解北京市三级综合医院医务人员的社会支持、应对方式及心理健康水平,发现可能存在的心理问题.方法 运用社会支持评定量表(SSRS)、简易应对方式问卷(SCSQ)、症状自评量表(SCL-90)及人口学特征问卷,对北京市5所三级综合医院的2460名医务人员进行调查.结果 不同人口学特征的医务人员,在积极应对和支持各维度上存在差异.相关分析表明,SCL总分、总症状指数、阳性症状痛苦水平、各因子均分与消极应对方式呈正相关,P<0.01;与主客观支持、支持利用度、支持总分呈负相关,P<0.01,结论 医疗管理部门应对40岁以下、女性、丧偶或离异、大专及以下学历、初级及以下职称、无职务、急诊和重症监护室人员、医生和护士、经常夜班、自我评价过低、患有慢性病的医务人员进行重点干预,缓解其心理压力.     

Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults

Research has illuminated the problem of untreated mental illness among young adults, including evidence that young people who exit public care systems often discontinue mental health services in adulthood. The present study explored mental health service use experiences during the transition to adulthood among sixty young adults, ages 18-25, from a Midwestern U.S. state. In-depth semi-structured interviews were conducted. All participants had mood difficulties, and shared three childhood experiences: (a) mood disorder diagnosis; (b) use of public mental health services; and (c) experience with social service systems. Immersion and grounded theory coding techniques were applied to the interview data. Two major themes about mental health service use emerged from the findings, namely the changing nature of service use over time and characterizations of experiences associated with service use at a given point in time. Categories of explanatory constructs that emerged in the latter theme included perceived need, emotions, perceived efficacy of services, and social considerations, among others. Findings suggested a four-facet mid-level theory of service utilization, highlighting both the cross-sectional and time-variant character of service use and decision-making within context. Links between broader theoretical frameworks of service utilization and social psychological models of decision making were noted, and guidelines were presented for ten classes of variables that researchers interested in understanding service use by young adults should consider.     

Area social fragmentation, social support for individuals and psychosocial health in young adults: evidence from a national survey in England

This paper uses national survey data for young adults in England to explore empirically the relationships between social fragmentation in communities (measured for geographical areas), social support experienced by individuals from their immediate social circle, and psychosocial health of young adults. After reviewing previous research about these associations, we adopted an empirical approach to these questions, which was innovative in using data on area social fragmentation from a different source to the survey data on individuals. Also, we have examined the relevance for mental health of interactions between individual social support and area social fragmentation, as well as their independent associations with health. To test these ideas empirically, we present a statistical analysis, using survey data from the national Health Survey for England on young people aged 16-24 years, linked to a geographical indicator of social fragmentation, derived from the population census and with a measure of material poverty. The outcome variable was distress measured by the General Health Questionnaire (GHQ). In a logistic regression model that controls for grouping of individuals within areas we included data on individuals' sex, ethnic group, employment status, social class and educational level. Controlling for these indicators, we demonstrate that risk of individual distress (indicated by GHQ score of 3+) was significantly and positively associated with area social fragmentation and there was a significant association with social support received within the individual's immediate social circle, which was negative ('protective'). An index of material poverty in one's area of residence did not predict individual distress. There was no evidence that social support was more 'protective' in areas of greatest social fragmentation. We also note that while being in employment was associated with better mental health in this sample, higher educational level was associated with worse average levels of distress (controlling for age). We consider some of the policy implications of the findings.     

下岗职工精神健康及其社会支持和应付方式的调查

目的 了解社会支持和应付方式与下岗职工精神健康的关系。方法 对468名下岗职工以及512名在岗职工进行症状自评量表(SCL-90)、社会支持评定量表、应付方式评定量表测定，比较其心理健康水平、应付方式和社会支持强度。结果 大约有61．32％的下岗职工存在不同程度的心理健康问题，主要症状为躯体化、焦虑、抑郁等。与对照组职工相比，下岗组职工多采用回避、幻想等消极的应付方式，而且其客观支持、主观支持以及对社会支持的利用程度均低于对照组。同时，女性下岗职工的精神健康水平低于男性下岗职工，而且其应付方式以及社会支持量表的评分也低于同组男性职工。结论 如果缺乏适当的应付措施和社会支持，下岗可能导致比较强烈的心理应激反应，从而损害下岗职工的身心健康。     

车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

Perceived social position and health in older adults in Taiwan

We examined whether perceived social position predicted mental and physical health outcomes (depressive symptoms, cognitive impairment, mobility restrictions, and self-assessed health) in a prospective study based on a nationally representative sample of older persons in Taiwan. Cross-sectional and longitudinal models were used to demonstrate the relationship between perceived social position and health, as reported by participants in the Social Environment and Biomarkers of Aging Study in Taiwan (SEBAS). Lower perceived social position predicted declining health beyond what was accounted for by objective indicators of socioeconomic position. As predicted, the effect was substantially reduced for all health outcomes in the presence of controls for baseline health. After including these controls, perceived social position was significantly related only to depressive symptoms. The findings suggest that the strength of the association between perceived social position and health may have been overstated in cross-sectional studies.     

青海高职护生心理健康状况及其与社会支持因素的相关性分析

目的研究分析青海高职护生心理健康状况与社会支持的相关性。方法采用精神症状自评量表(SCL-90)、社会支持量表(SSRS)对427名高职护生进行测试,并分别与常模组进行比较。结果被试中至少有一个SCL-90因子的得分大于或等于3分的学生占4.45%。SCL-90中9个因子的得分均低于女性常模组(P<0.001);一年级学生、少数民族学生的心理健康问题相对较为突出。心理健康与社会支持有相关性。结论应加强高职护生心理健康教育及完善社会支持系统,尤其是加强新生、少数民族学生的心理健康教育。     

多元社会参与及家庭支持对中国老年人心理健康的影响研究

目的：了解不同社会参与类型和家庭支持对老年人心理健康的影响及交互作用,为促进老年人心理健康提供决策依据。方法：基于2018年中国老年健康影响因素跟踪调查（CLHLS）数据筛选获得12 686名老年人,使用描述性分析、Pearson相关性检验、二元logistic回归模型研究不同社会参与、家庭支持特征的老年人心理健康现状及相关性,分析其对老年人积极、消极情绪的影响,探讨多元社会参与类型间的交互作用。结果：有社会参与和家庭支持的老年人心理健康较好的发生比高达5.72%~17.50%;休闲娱乐型、社会交往型社会参与及与家人同住对老年人心理健康有显著促进效应,且该两类社会参与间存在显著交互作用,家务型社会参与则对心理健康有负向影响。结论：不同类型社会参与对老年人心理健康的影响存在差异和部分互替性,与家人同住为代表的家庭支持能显著改善老年人的心理健康水平,应鼓励老年人更多地参与社会活动、与家人共同居住,以提高老年人的积极情绪,降低消极情绪的发生风险。     

The importance of social context: neighborhood stressors, stress-buffering mechanisms, and alcohol, drug, and mental health disorders

This study examines the relationship among neighborhood stressors, stress-buffering mechanisms, and likelihood of alcohol, drug, and mental health (ADM) disorders in adults from 60 US communities (n=12,716). Research shows that larger support structures may interact with individual support factors to affect mental health, but few studies have explored buffering effects of these neighborhood characteristics. We test a conceptual model that explores effects of neighborhood stressors and stress-buffering mechanisms on ADM disorders. Using Health Care for Communities with census and other data, we found a lower likelihood of disorders in neighborhoods with a greater presence of stress-buffering mechanisms. Higher neighborhood average household occupancy and churches per capita were associated with a lower likelihood of disorders. Cross-level interactions revealed that violence-exposed individuals in high crime neighborhoods are vulnerable to depressive/anxiety disorders. Likewise, individuals with low social support in neighborhoods with high social isolation (i.e., low-average household occupancy) had a higher likelihood of disorders. If replicated by future studies using longitudinal data, our results have implications for policies and programs targeting neighborhoods to reduce ADM disorders.     

大学生村官职业倦怠对心理健康的影响机制

目的 探讨社会支持和自我效能对大学生村官职业倦怠与心理健康关系的影响机制.方法 对山西省太原市560名大学生村官施测职业倦怠量表、社会支持量表、自我效能问卷和一般健康问卷,依次进行层次回归和复回归分析,检测社会支持和自我效能在大学生村官职业倦怠和心理健康之间的中介与调节效应.结果 ①简回归结果显示:大学生村官高、中、低社会支持组,职业倦怠对心理健康的解释权重分别为43％、30％和9％;而高、中、低自我效能组,职业倦怠对心理健康的解释权重分别为43％、30％和20％.②复回归分析结果显示:引入社会支持和自我效能中介变量后,职业倦怠对大学生村官总体心理健康水平影响的标准回归系数由引入前的0.55下降为引入后的0.47/0.49.结论 职业倦怠对大学生村官心理健康的影响过程中,社会支持具有调节效应,自我效能具有中介效应.     

Perceived stigma, strain, and mental health among caregivers of veterans with traumatic brain injury

Background

Family caregivers of individuals with stigmatized conditions can experience stigma-by-association and discrimination. Moderate-to-severe traumatic brain injury (TBI) may elicit a stigma response if there are visible physical or neurobehavioral effects of the injury. Stigma is a considerable source of stress and may contribute to caregiver strain and stress-related mental health outcomes. We measured the frequency of perceived stigma and discrimination among caregivers of veterans with TBI and examined whether perceived stigma and discrimination are associated with caregiver strain, social isolation, depression, and anxiety.

Methods

Seventy caregivers of veterans with TBI completed a mailed survey that assessed perceptions of discrimination toward themselves or their care recipient, stigma associated with caregiving, and whether they felt the need to cover up or provide an explanation for their care recipient’s injury. Caregiver strain, social isolation, depression, and anxiety were also assessed via the questionnaire. Multivariate linear regression was used to test the associations between stigma and discrimination measures and outcomes, controlling for potential confounders and other caregiver or care recipient characteristics.

Results

Both perceptions of caregiver discrimination and stigma associated with caregiving were significantly associated with caregiver strain, social isolation, depression, and anxiety. Perceived discrimination against the individual with TBI was associated with caregiver strain and social isolation.

Conclusions

Our findings suggest that perceived discrimination and stigma experienced by caregivers of individuals with TBI are stressors that may lead to poor caregiver mental health outcomes. In order to promote both caregiver and care recipient health, we suggest that mental health support services consider these important stressors.     

中小学教师社会支持与心理健康的关系:工作家庭冲突的中介作用

目的 了解中小学教师工作家庭冲突在社会支持与心理健康间的作用机制。方法 采用工作家庭冲突、社会支持以及心理健康量表对565名中小学教师进行调查。结果 （1）控制了性别、学校类型与职称的影响后,社会支持与自我肯定存在统计学意义上的正性关系,与忧郁及焦虑存在统计学意义上的负性关系;工作家庭冲突与自我肯定存在统计学意义的负性关系,与忧郁及焦虑存在统计学意义上的正性关系;社会支持与工作家庭冲突存在统计学意义上的负性关系。（2）控制了性别、学校类型与职称的影响后,工作家庭冲突在社会支持与自我肯定和忧郁之间发挥着部分中介作用(ab自我肯定 = 0.198, 95%CI = [0.130, 0.265];ab忧郁 = -0.265, 95%CI = [-0.348, -0.182]),并在社会支持与焦虑之间发挥着完全中介作用（ab焦虑 = -0.308, 95%CI = [-0.405, -0.212])。结论 中小学教师的社会支持水平越高,工作家庭冲突对他们造成的负面影响越小,心理越健康。     

中国城市老年人自感健康与社会网络的关系研究

目的探讨中国城市老年人自感健康与社会网络的相关性,为制定有效的老年人健康促进策略提供参考依据。方法利用2008年开展的第四次国家卫生服务调查数据,从社会支持和社会参与两个方面,用最优尺度回归分析评估社会网络对城市老年人自感健康状况的影响。结果中国城市60岁及以上老年人自感健康评分均值为70.96±14.79分,最主要经济来源为自己或配偶的比例为83.53%;每周与邻居交往、参加亲戚朋友聚会、社会聚会和从事力所能及劳动的比例分别为76.08%、25.96%、10.94%和18.31%;对自感健康评分的影响重要性分别为0.039、0.070、0.023和0.022,仅次于身体健康状况。结论社会支持/参与是独立于身体健康状况之外的自感健康的风险因素。社会参与情况对自感健康的影响程度可能超过区域经济水平和来自配偶和子女的支持。社会网络内部不同构成要素对自感健康的影响程度存在差异。     

医学硕士研究生社会支持及心理控制源与孤独感的关系研究

目的:了解在校医学硕士研究生的社会支持、心理控制源和孤独感的现状,探讨三者之间的关系。方法:采用社会支持量表、内在-外在心理控制源量表和孤独感量表对240名在校医学硕士研究生进行调查。结果:女生客观支持高于男生;非独生子女主观支持高于独生子女;不同的恋爱情况下客观支持、主观支持和社会支持存在差异。社会支持与内、外控呈负相关;社会支持与孤独感存在负相关;内外控与孤独感存在正相关。结论:社会支持各维度在不同的变量上存在差异,社会支持、内外控和孤独感两两相关。     

独生子女新兵心理应激及其应对方式、社会支持水平的研究

目的研究独生子女新兵心理应激状况及其应对方式、社会支持水平,为开展心理服务提供依据.方法应用症状自评量表(SCL-90)、简易应对方式量表和领悟社会支持量表,对929名独生新兵和3 686名非独生新兵进行心理测评.结果独生新兵SCL-90总分、阳性均分及4个因子分显著性高于非独生新兵(P<0.05或P<0.01);独生新兵积极应对和消极应对评分均显著性高于非独生新兵(P<0.05或P<0.01),且前者家庭外支持及总社会支持评分前者显著性低于后者(P<0.01);独生和非独生新兵各应对方式类型人数所占比例差异有显著性 (P<0.05或P<0.01).结论入伍初期独生新兵心理应激较非独生新兵强烈,这与其不恰当的应对方式和获取较少家庭外支持有关.     

39例吸毒合并HIV感染者心理健康与社会支持的调查

滥用毒品直接损害人类的身心健康，而静脉吸毒又是导致艾滋病快速传播的因素之一。本研究旨在调查吸毒合并HIV感染者的社会支持与心理健康状况，为提高该人群的心理健康水平提供科学依据。