三峡移民与当地居民心理健康状况对比及影响因素分析

目的:了解三峡移民心理健康状态及提出改进措施.方法:使用定量标准心理问卷进行面对面现状调查,辅以典型对象定性深入访谈.结果:后靠移民与当地居民焦虑和抑郁水平差别无统计学意义,外迁移民焦虑与抑郁水平高于当地居民,主要影响因素为疾病、年老、人际关系及个人收入满意度低、女性等.建议:增加移民与当地居民交流改善人际关系,持续对移民进行生产技能培训,增加就业能力等.     

三峡移民生活状况及生命质量调查分析

目的了解三峡移民与当地居民生命质量差别,以提出改进措施及建议。方法应用定性访谈和定量问卷相结合的方法,以当地居民作为对照,对三峡后靠和外迁移民的生命质量进行调查分析。结果后靠三峡库区移民生命质量与非移民差异无统计学意义,外迁三峡移民在某些维度低于当地居民。外迁移民对家庭经济改善、住房改善及人际关系的满意度显著低于当地居民。移民对当地政府照顾的期望值太高,因达不到预期期望则存在不满、焦虑情绪。结论外迁移民在就业、家庭收入、住房、人际关系等方面存在一些问题,进而影响了其生命质量和心理情绪,建议采取的措施有:组织当地居民和医生与移民交流,及时解决移民房屋的质量问题,持续对缺乏劳动技术的移民进行培训,当地企业尽量吸收移民就业,吸收够条件的移民进入村委会、教师队伍等。     

三峡后靠移民儿童的移民体验和心理适应

从儿童和监护人的视角考察三峡库区后靠移民儿童的移民体验和心理适应情况.方法 在重庆市后靠移民最为集中的万州和忠县5所中小学采用方便取样对21对移民儿童及其监护人,分别进行半结构个体访谈,儿童在访谈后填写《儿童抑郁量表》.结果 52.4%的儿童并未知觉移民给自己和家庭带来明显影响,而47.6%的监护人报告消极影响.对比有严重抑郁和无抑郁症状的儿童和监护人的访谈发现,更消极的移民体验、经济条件欠佳、家庭内应激源多、高学业压力的青少年表现出更严重的抑郁症状,而社会支持和学业成就则是消除抑郁重要的保护因素.结论 后靠移民经历对儿童造成的影响和其心理适应是其面临的风险因素和保护因素动态作用的结果.     

三峡库区移民心理健康状况及影响因素分析

目的研究三峡库区外迁移民心理健康状况与影响因素。方法采用整群分层随机抽样,调查对象接受居民基本情况表、与团体用心理社会应激调查表（PSSG）、症状自评量表（SCL-90）、社会支持评定量表（SSRS）的测查。结果（1）移民组的SCL-90除敌对、恐怖和偏执3个因子外均高于当地居民组（P〈0.001）;（2）移民组的PSSG生活事件、消极情绪体验、消极应对方式和应激总分高于地当地居民组（P〈0.001）;而积极情绪体验、积极应对方式得分低于当地居民组（P〈0.001）;（3）移民组的SSRS支持得分均低于当地居民组（P〈0.001）;（4）多因素的Logistic回归分析显示：影响移民心理健康水平的因素有年龄、健康状况、与地政府的关系和社会支持。结论移民组与当地居民组心理健康状态有明显差异,应针对影响因素采取措施,进一步做好移民工作。     

四川三峡移民心理健康状况及影响因素研究

目的了解和分析四川外迁移民的心理健康状况及影响因素。方法通过整群分层随机抽样,采用居民基本情况调查表、症状自评量表(SCL-90)、团体用心理社会应激调查表(PSSG)及社会支持评定量表(SSRS)4种问卷调查,收集和分析移民和当地居民的心理健康状况及其影响因素。结果两人群性别、年龄、婚姻状况、文化程度、职业、经济状况、性格构成均一致,外迁移民有医疗保障的明显少于当地居民(P<0.01)。外迁移民的症状自评量表得分及心理应激水平高于当地居民(P<0.01),社会支持低于当地(P<0.01),移民后56.00%的居民职业发生了变化。多元线性回归分析,是否移民、年龄、婚姻、职业、心理应激及社会支持情况与移民的心理健康水平相关。结论外迁移民的心理健康状况比较差,政府应加强对他们的经济扶持,注重对他们的人文关怀。     

高等职业院校新生心理适应能力现状调查研究

[目的] 探讨高职新生心理适应能力的现状及影响因素,采取措施其提高心理适应能力和心理健康水平.[方法] 在访谈的基础上采用问卷对471名高职新生进行问卷调查.[结果] 高职新生心理适应能力总体上是好的,但是部分同学存在着缺陷.主要有学校、社会方面的原因,也有学生自身方面的原因.[结论] 高职新生心理适应能力问题应引起关注,学校要采取心理咨询、实践活动等具体而恰当的教育措施,配合和引导高职新生提高心理适应能力.     

三峡移民与当地居民生活满意度、健康状况与医疗服务利用比较

目的：了解移民与当地居民在健康状况和医疗服务利用方面是否有明显差别,提出改善移民健康水平的建议及措施。方法：使用定性深入访谈和定量问卷相结合的方法,对三峡移民的健康状况和医疗服务利用情况进行调查,以当地居民作为对照。结果：除少数地区外,三峡移民身体健康状况、医疗服务利用以及医疗费用、新型合作医疗报销比例与当地居民差距不大。但移民对家庭经济改善、住房改善及人际关系的满意度较低,显示存在心理健康问题。建议：深入宣传新农合章程,说服未参加新农合的移民参合,组织当地居民、医生与移民交流,及时解决移民房屋的质量问题,持续对缺乏劳动技术的移民进行培训,吸收满足条件的移民进入村委会、教师队伍等。     

地震灾后早期心理状况及心理需求分析

[目的]分析地震灾后早期心理状况及心理需求.[方法]对124例地震灾民在受灾后1月内进行症状自评量表测量及心理访谈.[结果]在震后早期受灾群众便出现不同程度的心理应激反应,主要表现为焦虑、恐惧,甚至幻觉等.主要心理需求是安全感、基本生活保障、信息、归属感、爱的需求.[结论]救援人员和医务人员是与灾后群众接触最早的人群,在救援的同时,掌握受灾群众的心理需求并依据特定对象把握危机干预的原则,有效的对受灾群众进行早期心理危机干预,帮助受灾群众走出危机.     

类风湿关节炎住院妇女心理健康状况及相关因素分析

[目的]探索女性类风湿关节炎住院病人心理健康状况以及相关因素,为临床干预提供依据.[方法]应用个人深入访谈的方法,对20例符合诊断标准的女性类风湿关节炎住院病人按照统一的访谈提纲进行访谈.[结果]多数病人在发病初期并未给予足够的重视及治疗,情绪也比较稳定,随着病情的进展,大部分病人出现情绪波动,焦虑和抑郁情绪比较明显;病人在住院期间社会支持水平低,对不良情绪的应对能力差;医疗服务的内容主要是以疾病治疗为中心,无任何心理健康干预.[结论]类风湿关节炎病情的发展,对患者的生理、心理及社会各方面均产生负性影响,在医疗活动中医护人员不仅要关注患者躯体症状的消除和改善,也要关注患者的心理问题,应将心理干预作与临床治疗相结合,从而提高类风湿关节炎患者的生活质量.     

性别因素对浦东新区流动人口性病/艾滋病KAP影响的定性研究

[目的] 探讨性别因素对上海浦东新区流动人口的性病/艾滋病(STD/HIV)相关知识、态度和行为(KAP)的影响,为下一步定量研究和干预打基础.[方法] 应用专题小组访谈(focus group discussion, FGD)的方法.[结果] 浦东新区流动人口中的女性较男性缺乏STD/HIV相关知识,但男性流动人口对待性的态度较为开放,且明显存在不安全性行为的倾向.[结论] 在女性流动人口中应重点开展性病/艾滋病的相关知识的教育;在男性流动人口中则应对其开放的性态度和不安全性行为倾向进行有效干预.为今后开展的定量研究和教育干预提供了依据.     

上海市闵行区外来人口结核病发现与治疗

[目的 ]　对上海市闵行区外来人口结核病防治工作进行基线调查 ,了解外来人口结核病防治工作中存在的问题及其原因 ,提出相应对策。　 [方法 ]　对闵行区疾病预防控制中心的日常结核病报表资料进行分析 ,同时采访结核病防治工作人员和外来人口结核病患者 ,收集定性资料进行分析。　 [结果 ]　外来人口结核病新登记率高于本地人口 ,而其实际的流行情况更加严重。但是外来人口对结核病的卫生服务需要不能得到满足。　 [结论 ]　缺乏有效管理方式、经济困难以及缺乏卫生知识是外来人口结核病防治工作中面临的主要困难。应加强管理 ,提供免费诊治 ,加强宣传教育。     

药店参与流动人口结核病人发现的可行性研究

目的：探索重庆地区私人药店参与结核病病例发现的可行性，为提出新的有效的病人发现模式提供依据，提高结核病病人，尤其是流动人口结核病人的发现率。方法：采用了个人深入访谈、关键人物访谈、专题小组讨论等多种定性研究的方法，对包括药店管理人员及工作人员、结防专业机构的医护人员等进行了采访。结果：私人药店及结防人员都有合作共同发现结核病人的意愿，药店具备识别结核病人及疑似病人的潜力，但能力有待加强。结论：私人药店参与结核病病例发现是提高重庆地区结核病人发现率的客观要求。药店能够在结核病人的发现工作中起到较好的作用。     

重庆流动人口结核疑似病人就诊延迟情况及影响因素研究

[目的]了解重庆流动人口结核疑似病人就诊延迟情况,并探索其相关影响因素。[方法]对1005名结核病疑似患者采用问卷调查,结合定性研究方法,开展多次专题小组讨论,个人深入访谈和关键人物访谈。[结果]流动人口结核疑似患者在寻求卫生服务的过程中就诊延迟现象严重,年龄、性别、婚姻状况、医疗保障及病后不恰当的措施等因素都与延迟的发生有关。[结论]扩大医疗保险覆盖率,促进卫生服务利用的公平性,初步探索私人药房在结核病控制工作中可能扮演的角色。     

Impact of migration on illness experience and help-seeking strategies of patients from Turkey and Bosnia in primary health care in Basel

Migration, particularly among refugees and asylum seekers, poses many challenges to the health system of host countries. This study examined the impact of migration history on illness experience, its meaning and help-seeking strategies of migrant patients from Bosnia and Turkey with a range of common health problems in general practice in Basel, Switzerland. The Explanatory Model Interview Catalogue, a data collection instrument for cross-cultural research which combines epidemiological and ethnographic research approaches, was used in semi-structured one-to-one patient interviews. Bosnian patients (n=36) who had more traumatic migration experiences than Turkish/Kurdish (n=62) or Swiss internal migrants (n=48) reported a larger number of health problems than the other groups. Psychological distress was reported most frequently by all three groups in response to focussed queries, but spontaneously reported symptoms indicated the prominence of somatic, rather than psychological or psychosocial, problems. Among Bosnians, 78% identified traumatic migration experiences as a cause of their illness, in addition to a range of psychological and biomedical causes. Help-seeking strategies for the current illness included a wide range of treatments, such as basic medical care at private surgeries, outpatients department in hospitals as well as alternative medical treatments among all groups. Findings provide a useful guide to clinicians who work with migrants and should inform policy in medical care, information and health promotion for migrants in Switzerland as well as further education of health professionals on issues concerning migrants health.     

中国城市糖尿病低血糖症社会影响的定性研究

目的:从心理—社会—经济的角度来全面探讨糖尿病低血糖症对患者及其家庭产生的影响。方法:采用定性研究方法,针对经历过低血糖反应的糖尿病患者进行半结构式深入访谈,并采用扎根理论对结果进行分析。结果:研究发现,糖尿病低血糖症对患者产生的心理负担最为严重,易让患者产生紧张、焦虑、恐惧、抑郁等不良情绪。患者经历低血糖后,往往通过改变用药行为、疾病管理行为和生活方式来避免低血糖反应的再次发生。此外,低血糖降低了患者的社会参与度,影响患者家庭的生活,并增加了患者家庭的经济负担。结论:糖尿病低血糖症增加患者的心理负担,影响患者的生活方式,并给患者带来一定的经济负担。     

有关开展社区心理咨询的探讨

以会谈调查、临床资料总结、实地考察和文献分析相结合方法进行研究。结果表明:目前我国医院心理咨询的对象主要为病人,较基层的医院则正常人咨询比例较高,前者脱失率较高,就诊不便是重要原因之一。调查还发现,广州社区心理卫生服务尚未包括心理咨询,居民对心理卫生常识和心理咨询缺乏认识。因此建议应借鉴国外的先进经验,结合我国实际,开展有中国特色的社区心理咨询。     

Rural-urban migration and health: Evidence from longitudinal data in Indonesia

Previous studies on the impact of migration on health often face the difficulties of choosing the proper comparison group and addressing potential selection of migration. Using longitudinal data for 1997 and 2000 from Indonesia, this paper examines the effect of rural-urban migration on physical and psychological health, by (1) comparing the health of migrants with that of the appropriate group of comparison, people who remained in rural origins, and (2) studying health both prior to and after migration to adjust for possible selection bias. The research further explores various socioeconomic, psychosocial, and behavioral pathways mediating the migration effect. Results show that rural-urban labor migration increased the risk of psychological disorder as measured by depressive symptoms. This was largely a result of reduced social support due to family disruption, because the deleterious effect was particularly strong for migrants who moved alone and was negligible for migrants moving with family members. In contrast, migration had little impact on physical health in the medium term. This was largely attributed to the multiple offsetting influences of migration: migration improved economic status and living standards but led to increased work-related stressors and barriers to health utilization. In addition, despite earning higher income, migrants tend to underconsume and remit a large amount of earnings to original families, which hindered potential health gains from improved economic well-being.     

Effect of a transient, geographically localised economic recovery on community health and income studied with longitudinal household cohort interview method

STUDY OBJECTIVE: The main purpose of the study was to determine whether the health or economic status of a cohort of residents in an economically troubled geographical area changed between 1990 and 1993. DESIGN: Longitudinal, single cohort, interview survey method with the key variables of health status and economic status. Quasi-experimental pre-post design with economic rebound as the intervention. SETTING: A relatively low income geographical area in a rural, mountainous region before and after an economic rebound. In 1990, the local economy and health care system collapsed because of the closure of a series of manufacturing plants; outward migration from the area peaked. Between 1990 and 1993, new industries opened, and state and private community assistance programmes intervened, resulting in an economic rebound, migration into the area, and marked growth of the health service sector. PARTICIPANTS: A 2% sample of residents of households, using a combination of random, stratified, and clustered sampling. Residents included in the study had lived within the area throughout the 1990-1993 period of the study. MAIN RESULTS: Stable, non-migrating residents had a statistically significant 7% reduction in health status between 1990 and 1993, as measured by a composite of subjective and objective measures. The non-migrating residents also had a significant decrease in average household income ($14,700 in 1990 and $12,400 in 1993 in constant 1990 dollars) during the strong economic expansion, and therefore did not participate in or receive direct economic benefit from the expansion. There was a rapid population increase during the expansion, attributable to inward migrants who were younger and healthier than existing residents. The decline in health for the non-migrating residents was tentatively attributed to either direct or indirect effects of the decline in family income. CONCLUSIONS: Local economic development accompanied by expanded health care services availability can leave existing area residents poorer and less healthy, and this problem may be masked by an abundance of healthier, wealthier inward migrants.