精神病学课程及精神科工作经历对精神疾病态度的影响（英文）

目的:探索针对医学生的精神病学课程及精神科工作经历在改善歧视态度中发挥的作用。方法:采用问卷形式对156名没上过精神病学课程的医学生,161名已完成精神病学课程的医学生及120名精神科医生进行调查,通过协方差分析比较三组人群从四个因素方面对精神疾病的态度。结果:与已完成精神病学课程的医学生及精神科医生相比,未上过精神病学课程的医学生在与精神病人的社交意愿方面表现出更多的歧视和更负面的态度。已完成精神病学课程的大学生与精神科医生的态度不存在显著性的差异。结论:开展规范的精神病学课程有助于提高医学生对精神疾病的病因认识、培养对精神病人积极的态度以及降低歧视。     

中国乡镇医生精神疾病知识以及对精神病人态度的调查（英文）

目的:本文旨在调查乡镇医生对于精神病知识的知晓程度以及他们对于精神病人的态度,并分析与两者相关的关键因素。方法:采用精神疾病知识调查问卷(MHKQ)、病例分析问卷(CAQ)以及态度调查问卷(APMDQ)对340名湖南省乡镇医生进行调查。结果:知识调查问卷的正确率为74.1%,平均误诊率为41.8%,对精神病人的歧视率为64.5%。其中乡镇医生对精神病患者的社会距离歧视程度比对精神病患者能力低估的歧视更为严重。结论:乡镇医生对精神卫生知识知晓率较低,对精神疾病误诊率高,并对精神病患者存在歧视。     

不同人群对精神病的态度

目的：了解社会不同人群对精神病的态度。方法：采用定性研究方法建立精神病态度问卷,然后使用该问卷在北京地区对精神分裂症病人及其病人家属、社区居民和精神科医护人员进行调查,结果：病人认为宝现人不会给他人带来危险,对精神病人的社会人才 治疗希望持最积极态度;家属与病人的看法趋向一致。但对精神病人的可治疗性和社会贡献不乐观;与病人、家属比较、社区居民对精神病则持最悲观和最消极态度;精神科医护人中峄精神病人的社会价值,行为的危险性以及是否要限制精神病人的社会活动等问题的看法,与病人,家属比更显悲观,但较社区居民的看法更开明,在精神病因上精神科医护人员的看法与其他三组人群不同,更倾向精神病是生物因素导致,而非人和家庭问题引起。论：尽快实施有效的干预措施,改变人对精神病的人不良态度,消除歧视,提高病人,家属的自信心和适应能力,将会对精神病的治疗与健康,改善精神病人的生活质量有着重大意义。     

精神分裂症患者及家属参与医疗决策的意愿

目的:了解精神分裂症患者及家属参与医疗决策的意愿。方法:选取符合国际疾病和相关健康问题统计分类第十版(ICD-10)诊断标准的精神分裂症患者162例及承担照护责任的家属120例,采用自编问卷,从信息需求、沟通意愿和决策意愿三方面调查患者及家属参与医疗决策的意愿,比较二者的差异。结果:在信息需求方面,患者主动了解疾病相关信息的比例低于家属[(40.1%~72.2%)vs.(65.0%~97.5%),均P<0.01];在沟通意愿方面,患者主动与医生沟通的比例也低于家属[(40.1%~80.2%)vs.(74.2%~91.7%),均P<0.05];在决策意愿方面,患者与家属选择"完全由医生决定"的比例均最高,两组比较,患者选择"医生提出建议,患者决定"的比例高于家属[(13.0%~22.8%)vs.(0.8%~1.7%),P<0.01],选择"医生提出建议,家属决定"的比例低于家属[(2.5%~8.6%)vs.(13.3%~23.3%),P<0.01]。结论:患者和家属在医疗决策方面表现均比较被动,但家属的信息需求、沟通意愿较患者主动,在决策意愿方面,二者的意见不完全一致。     

重性精神疾病管理治疗项目保定市示范区精神卫生知识调查

目的 了解重性精神疾病管理治疗项目(以下简称"686项目")示范区不同群体对精神卫生知识的知晓程度与差别.为进一步普及精神卫生知识奠定基础.方法 以河北省"686项目"城乡2个示范区为调查群体,重点调查社区干部,社区医生、精神疾病患者家属及普通人群,并对4个群体进行调查比较.结果 ①被调查者总知晓率为56.91%,其中...     

城乡居民精神卫生知识知晓率调查

目的 了解保定市城乡居民精神卫生知识知晓现状,为进一步有钟对性地开展宣传教育,普及精神卫生知识提供依据.方法 以重性精神疾病管理治疗项目(以下简称"686项目")城乡2个示范区为调查群体,重点调查社区医生、社区干部、精神疾病患者家属及普通人群共3854名进行问卷调查.结果 ①被调查者总知晓率为56.91%,城市居民知晓...     

《精神卫生法》实施后精神病人长期住院原因调查

目的了解《精神卫生法》实施后精神病人长期住院的原因。方法统计2013年5月1日和2014年1月1日两个时点在本院普通精神科住院的精神病人总数和住院超过1年的病人数;并随机选择2014年1月1日在本院普通精神科病房住院超过1年的370名合作患者,采用自编长期住院原因调查问卷进行调查。结果 2013年5月1日和2014年1月1日在本院普通精神科住院的精神病人总数分别为1170人和1157人;住院超过1年的人数分别为1033人和1042人。精神病人长期住院有主观因素,也有客观因素。主观因素主要表现在"出不出院无所谓"(34.1%)、"不会照顾自己"(28.1%)、"担心出院后再发病"(20.3%)、"病未治好不能出院"(19.5%)和认为"住院比出院后单独生活条件好"(18.4%)等。客观因素主要是"家人不同意"(64.6%)、"没有经济来源"(54.1%)、"没有房子住"(38.6%)、"没有监护人"(21.6%)、"医院(医生)不同意"(20.5%)和"街道领导不同意"(18.4%)等。知道国家出台了《精神卫生法》的只有34.6%;知道《精神卫生法》主要内容的仅占8.4%;认为《精神卫生法》对自己"没有好处"和"不知道"有没有好处的患者高达70.8%;小部分患者认为对自己"有一点好处"(27%);认为"有很大好处"的仅占2.2%。结论精神病人长期住院的主要原因受主客观多因素影响。     

北京三所精神病医院医护人员对精神疾病态度调查

涉及医护人员对精神疾病和病人态度的研究较少。 1999年 2月我们在北京对不同人群关于精神病态度进行了调查。本文就医护人员对精神疾病及病人态度报告如下 :调查对象为北京回龙观医院、北京安定医院和北京民康医院直接为病人服务的医生和护士。预调查后设计问卷结构与条目 ,由     

患方对医方了解和信任程度影响因素的初步调查

目的:探讨患方对医方了解和信任程度及其影响因素。方法:在北京市3家三级甲等综合性医院,采用自行设计的自评问卷对438名住院患者或家属进行典型调查。结果:自行设计的调查表内容及结构效度和同质性信度符合要求。患方对医院和医生的了解度分别为56.6%和41.8%,患方对医院、医生的技术和医德的信任度分别为98.2%、92.7%和90.9%,了解度和信任度之间呈正相关(P0.001)。多重线性回归分析显示,患者对医院和医生的了解和户籍影响其对医方信任,"对医院的信任"、"对医生的了解"、手术治疗和性别影响对医生的信任,患方对医院和医生的信任和对医生的了解影响医疗结果满意度。结论:三级甲等医院就诊患方在对医方了解不足的情况下做出的信任选择存在不同层面的矛盾心理。建议加强健康教育和就医选择指导,帮助患方多渠道获得医方信息,提高正确的医疗决策及参与能力。     

精神病人刑事责任能力的多因素判别分析

目的:探讨影响精神障碍患者刑事责任能力评定的相关因素。方法:通过回顾性病例对照分析及随访调查,采用一般人口学资料调查表、简明精神症状评定量表(BPRS)、刑事责任能力评定量表对接受司法精神医学鉴定的147例刑事案件责任能力评定的相关因素进行调查。结果:①在鉴定为无刑事责任能力的精神分裂症组中,BPRS评分总粗分及思维障碍、激活性、敌对猜疑等因子分分别高于有刑事责任能力组(P<0.01)。有刑事责任能力组与无刑事责任能力组的精神分裂症病人除审讯或检查时对事实掩盖这一条目差异无统计学意义外,其余条目差异均有显著统计学意义(P<0.01)。②精神分裂症案例与非精神分裂症案例一般资料比较,凶杀、伤害案例的精神分裂症组显著高于非精神分裂症组,差异有统计学意义(P<0.01);③通过逐步判别分析,既往精神病史、鉴定诊断、思维障碍、激活性、及精神病人刑事责任能力量表中反映作案时情况的因子2、作案后对后果认识的因子3、作案后对自我保护能力因子4、疾病严重程度因子5等8个变量最终入选判别方程。结论:精神病人刑事责任能力受疾病种类、精神病性症状的影响;在刑事责任能力的评定中,疾病严重程度、作案时的诱因、作案后对后果认识、作案后对自我保护能力等因素对刑事责任能力评定有重要贡献率。     

张家口市青年社区居民对精神疾病的态度

目的:了解张家口市青年社区居民对精神疾病的态度及影响因素。方法:采用方便抽样方法,选取河北省张家口市103名青年社区居民为调查对象,以公众对精神疾病态度问卷作为调查工具。结果:居民对精神疾病的态度总体得分为(33.62±5.97)分。不同性别、不同受教育程度居民对精神疾病整体态度差异无统计学意义,但对个别问题的态度差异有统计学意义。女性对待精神疾病患者更包容(t=-2.022,P=0.046),对接受精神科专业人员的帮助态度更积极(t=-2.030,P=0.045);受教育程度较高者对康复后的精神疾病患者更信任(t=-2.100,P=0.038)。结论:张家口市青年社区居民对精神疾病及精神疾病患者存在歧视和误解。尚需要大力开展基层精神卫生知识宣传,改善基层群众对精神疾病的认识和接纳程度。     

Attitude Matters! How Attitude towards Bariatric Surgery Influences the Effects of Behavioural Weight Loss Treatment

IntroductionMultidisciplinary obesity services at university hospitals usually treat patients with more complex and severe obesity. In addition, patients with Class 3 obesity, in particular, have different attitudes regarding the choices of therapy.MethodsThis explorative study investigated the effect of patient attitudes towards bariatric surgery on body weight change (primary outcome) and psychological improvement (secondary outcomes: quality of life, depression, anxiety, and eating behaviour) in a 6-month moderate behavioural weight loss (BWL) programme in a university outpatient setting.Results297 patients with mostly Class 3 obesity participated in the programme. The patients did not yet have any indications for bariatric surgery. Of the participants, 37% had a positive attitude towards bariatric surgery (POS), whereas 38% had a negative attitude (NEG). The drop-out rate was 8%. NEG participants lost significantly more body weight than the POS participants (intention-to-treat population: 4.5 [SD: 6.3] kg versus 0.4 [SD: 5.8] kg; p < 0.001). In both subgroups, anxiety, depression, the mental score for quality of life, and eating behaviour improved.ConclusionA BWL treatment in a clinical setting identified 2 distinct groups with different attitudes towards bariatric surgery that were associated with different body weight change outcomes. These groups may require differently targeted programmes to achieve the best body weight loss results.     

Factors associated with patients' knowledge of and attitudes towards treatment with lithium

BACKGROUND: Treatment with lithium is often compromised by poor adherence, by side-effects and by patients' having serum levels outside the therapeutic range. These factors may be affected by patients' knowledge and attitudes towards lithium, and we set out to establish factors associated with knowledge about and attitudes towards lithium among a large representative sample of patients. METHOD: Patients known to be taking lithium in Grampian during 1995 were surveyed postally during 1998 with the Lithium Knowledge Test (LKT) and the Lithium Attitudes Questionnaire (LAQ). Scores on these measures were analysed against patients' sociodemographic and clinical characteristics by stepwise multiple regression. RESULTS: Of 742 patients, 411 (55%) completed an LKT and 362 (49%) completed an LAQ. Stepwise multiple regression established that positive attitudes towards lithium on the LAQ were associated with higher serum lithium levels (P=0.005) and with continuing to take lithium (P<0.001). Higher knowledge on the LKT was associated with positive attitudes on the LAQ (P=0.002), with younger age (P<0.001), and with shorter duration of treatment (P=0.01) LIMITATIONS: The study was retrospective and the response rate was relatively low. CONCLUSIONS: Education about lithium is likely to be of particular importance in the elderly and 'refresher courses' are advisable for those who have been on lithium for lengthy periods. Interventions which modify attitudes, rather than enhancing knowledge, are likely to be helpful in promoting adherence.     

Reproductive health and midwives: does occupational status differentiate their attitudes on assisted reproduction technologies from those of the general population?

BACKGROUND: Advancements within assisted reproduction technologies (ART) raise ethical questions; however, research on health care professionals' attitudes towards their application is limited. This study aimed at assessing certified (CMs) and Student (SMs) midwives' attitudes towards various aspects of ART as well as comparing them with public opinion. METHODS: The final sample included 567 female CMs and 605 women from the general population (age range: 25-62 years), 221 SMs and 209 female non-SMs (age range: 18-24 years). The questionnaire administered included socio-demographic information, items addressing knowledge issues and attitude statements. Data were analysed using principal components analysis, one-way analysis of variance and Friedman's test, as well as multiple linear regression. RESULTS: Four attitudinal factors emerged: 'genetic counselling' (GC), 'application of ART', 'moral dilemmas' and 'socio-ethical aspects'; occupational status did not affect attitudes towards GC, however SMs expressed more positive attitudes regarding the latter three factors (P<0.001: 17.49, 14.14 and 11.55). Student groups expressed more negative attitudes for multifetal pregnancy reduction (SMs: 1.88+/-0.83; non-SMs: 2.17+/-0.77) whereas the other two groups were least favourable towards embryo donation (2.30+/-0.80, CM; 2.32+/-0.83, general population). Sex selection and the use of ART by menopausal or homosexual women were the least acceptable practices for all groups (P<0.001). A high level of relevant knowledge was positively associated with 'application of ART' and acceptability of its use by specific population groups (b=0.469, b=0.19). Findings on factors influencing attitudinal patterns are further discussed. CONCLUSIONS: In this first attempt, it was revealed that CMs express the same conservative attitudes as the general population.     

Perceptions of Mental and Physical Illnesses in North-western Ethiopia: Causes, Treatments, and Attitudes

Four hundred and fifty adults (mean age 34 years; 55 percent males) from northwestern Ethiopia were interviewed to explore their causal beliefs about, perceived importance of various treatments for, and attitudes towards, six mental and three physical illnesses. Principal components analysis identified four meaningful illness causal belief dimensions: Psychosocial Stressors, Supernatural Retribution, Biomedical Defects, and Socio-Environmental Deprivation. Psychosocial Stressors and Supernatural Retribution were rated more important causes of mental than physical illnesses. Prayer and home/family care were suggested more strongly for treating mental than physical illnesses. Systematic associations were found between causal beliefs, treatment beliefs, and attitudes towards patients. Respondents' educational level was negatively related with traditional beliefs and positively related with favorable attitudes towards patients. It is concluded that causal beliefs, perceived importance of treatments, and attitude towards patients among northwestern Ethiopians are meaningfully interrelated. Implications for health services and research are discussed.     

Migraine life-time prevalence in mental disorders: concurrent comparisons with first-degree relatives and the general population

The authors quantified the prevalence of migraine in subjects with mental disorders, first-degree relatives and the adult general population (GP) in Mérida, Venezuela. After validation, a modified, short version of the Lipton's diagnostic scale was administered to consecutively admitted in- and out-patients (n = 1059), their first-degree relatives (n = 445) and a probabilistic sample of the GP (n = 516). In the GP, the frequency of migraine (percentage and 95% confidence interval) was 14.9 (11.8-17.9). The migraine frequencies were (percentage and odd ratio probability against the GP: bipolar disorder (15.7%, p = 0.5), schizophrenia (8.3%, p = 0.08), depression and dysthimia (24.4%, p = 0.2), anxiety disorders (10.0%, p = 0.02), personality disorders (11.4%, p = 0.15), all other disorders (15.5%, p = 0.4), relatives of bipolar patients (4.4%, p < 0.001), relatives of schizophrenia patients (3.5%, p = 0.003), and relatives of patients with all other mental disorders (12.8%, p = 0.4). Migraine was more common in women (p < 0.001), and the bipolar patients presented the highest female to male ratio (8:1). A high variability was observed in migraine prevalence among the diagnostic categories, but it was particularly high in subjects with affective disorders, mainly in women, who thus deserve special attention from clinicians.     

Changes in patients' attitudes towards the management of minor ailments

BACKGROUND: Patients' attitudes towards the management of minor ailments influence help-seeking behaviour. Up-to-date information about patients' attitudes is valuable for understanding changes in help-seeking behaviour. AIM: To describe changes in patients' attitudes between 1987 and 2001, and to explain the relationship between patients' attitudes and attributes of practices, practitioners and patients. DESIGN: Two cross-sectional, Dutch National Surveys of General Practice (1987 and 2001; n = 9579 and n = 8405 patients, respectively). SETTING: General practice in the Netherlands. METHOD: Patients' attitudes were evaluated in health interviews. Data were analysed using multilevel regression analysis. RESULTS: In 2001, patients' attitudes showed a shift away from consulting their GP for minor ailments. Attitudes are uniform across different types of practice, and mainly differ between patients. In 1987 as well as in 2001 the factors associated with firm beliefs about the benefits of GP's care in case of minor ailments were male, older age, lower educational level, a non-Western cultural background, and a visit to the GP in the past 2 months. Furthermore, the association between health status and beliefs about GPs dealing with minor ailments is more marked in 2001. Compared to 1987, the influences of GPs and the practice are more intertwined in 2001. CONCLUSIONS: Patients' attitudes towards the management of minor ailments have changed over the years, which implies that strategic action by the profession and the government has affected the way the public uses primary care. However, a marginal group of patients (elderly, less-educated, non-Western) is lagging behind this trend, and continuing to consult GPs for minor ailments.     

The effect of pedometer use in combination with cognitive and behavioral support materials to promote physical activity

OBJECTIVE: 1. To demonstrate that combining pedometer use with cognitive and behavioral support materials has a positive effect on physical activity (PA) and attitudes towards pedometer use. 2. To investigate how familiar the study sample is with pedometers and the '10,000 steps/day' recommendation. METHODS: From a random sample, drawn from the phone book, 304 volunteered (18-75 year) to complete a questionnaire about familiarity with pedometers and the '10,000 steps/day' recommendation. A sample of 103 participants agreed to wear a pedometer for 3 weeks, and was randomly assigned to a condition with cognitive and behavioral support materials (n=51) or without these materials (n=52). Participants completed the International Physical Activity Questionnaire before and after 21 days of pedometer use and an additional questionnaire on the attitudes towards pedometer use. RESULTS: More than 58% had never heard of a pedometer. In both conditions, walking (F=10, p=0.002), moderate PA (F=11, p=0.001), and vigorous PA (F=14, p<0.001) increased over time, however no interaction effects could be found. Significantly more participants in the condition with support materials had a positive attitude towards pedometer use. CONCLUSION: Wearing a pedometer, with or without support materials, may increase PA. In our study, cognitive and behavioral support materials only affected attitudes towards pedometer use. PRACTICE IMPLICATIONS: More research is needed to investigate the effect of combining pedometer use with support materials on a longer time base and in less motivated people.     

Knowledge and attitudes of children towards cigarette smoking and its damage

The present study reports the results of knowledge and attitudes of 280 children (mean age = 6.9 +/- 0.75 years) towards cigarettes and smoking. Subjects were divided into two groups: (I) children of parents who smoked (n = 178) and (II) children whose parents did not smoke (n = 102). The scoring for knowledge in the topics of cigarettes, smoking and the consequences was similar in the two groups (6.2 +/- 2.2 vs 6.1 +/- 2) (N.S.). The differences between the two groups were obvious and significant (p = 0.001) in their attitude towards smoking and its damage; children in group I displayed tolerant attitudes towards smoking even though they knew its consequences in comparison with the children of group II (6.1 +/- 2.4 vs 7.0 +/- 2.2). Without any exceptions among the children of the two groups, 7.4% believe that even at this young age they will begin to smoke one day. In addition, 2.1% pointed out that it is possible they will belong one day to the smokers' group. Of the population study, 90.2% believe that instruction about smoking damage should be included starting from the first grade of elementary school, and certainly, it should be at the level which will be understandable for them. As the pupils' knowledge about the consequences of smoking was lacking, we could add that the important topic of smoking and the damage it can inflict should be taught in all schools from the level of the first grade and during all subsequent years of study. Pupils should be familiar with all aspects of negative consequences caused by cigarette smoking. This knowledge may have influence upon their attitude towards smoking and smokers. More studies should be done to find what may change the positive attitudes of these pupils towards cigarettes and smoking.     

Attitudes of genetic counselors towards expanding newborn screening and offering predictive genetic testing to children

There is movement to expand newborn screening (NBS) to include conditions that challenge the traditional public health screening criteria. Little is known about the attitudes of genetic counselors towards expanding NBS and offering predictive genetic tests to children. For our study genetic counselors completed an internet survey posted on the National Society of Genetic Counselors Listserv regarding five conditions: cystic fibrosis (CF), Duchenne muscular dystrophy (DMD), glucose-6-phosphate dehydrogenase deficiency (G6PD), fragile X (FraX), and type 1 diabetes (T1D). The survey addressed attitudes towards: (1) testing high-risk infants; (2) mandatory NBS; (3) population screening beyond the newborn period; and (4) testing one's own child. Two hundred sixty-seven usable surveys were received. Over two-thirds of respondents supported testing high-risk infants for all conditions except T1D (22%). CF was the only condition for which there was majority support for both mandatory NBS (56%) and later population screening (60%). For all other conditions, later population screening was preferred over NBS (P 相似文献