住院精神分裂症患者孤独感现状及其与应对方式的相关性

目的了解精神分裂症患者的孤独感现状并探讨其与应对方式的相关性。方法 2018年3—8月,采用自编的一般情况调查表、UCLA孤独量表和简易应对方式问卷对100例住院的精神分裂症患者进行调查,并对数据进行分析。结果患者的孤独感得分为45.29±9.22,具有轻度以上孤独的患者有71例;经单因素及多重回归分析发现,性别、年龄、婚姻状况、住院次数及病程是影响患者孤独感的个人因素;患者的积极应对得分低于国内常模(t=2.34,P0.05),消极应对得分高于国内常模(t=2.13,P0.05);患者的孤独感水平与积极应对方式呈负相关(r=-0.485,P0.01),与消极应对方式呈正相关(r=0.219,P0.05)。结论精神分裂症患者多数具有轻度以上的孤独感;性别、年龄、婚姻状况、住院次数及病程是影响患者孤独感的个人因素;应对方式越积极,孤独感程度越低。     

决策树模型及logistic回归模型对精神分裂症患者自杀的影响因素分析

目的使用决策树模型与logistic回归模型对精神分裂症患者自杀的影响因素进行分析。方法选取2013年3月-2015年3月我院的精神分裂症住院患者为研究对象。采用决策树模型与logistic回归模型回顾性分析精神分裂症患者自杀的相关影响因素。结果多因素logistic回归模型分析结果显示,病程较长、发病年龄过早、阴性评分过高、总积极因素评分过低及症状评分过高均为精神分裂症患者自杀的独立危险因素。由决策树模型可得,病程、发病年龄、阴性评分、症状评分是精神分裂症患者自杀的独立危险因素,其中病程的影响最为显著。结论精神分裂症患者自杀的影响因素众多,决策树模型和logistic回归模型互为补充,可从不同方面描述精神分裂症患者自杀发生的影响因素,为进一步制订预防措施提供参考依据。     

流动儿童受歧视知觉对抑郁症状的影响:社会支持和孤独感的中介作用

目的考察流动儿童受歧视知觉对抑郁症状的影响,并分析社会支持和孤独感的中介作用。方法采用个体歧视知觉问卷、社会支持问卷、儿童孤独量表和流调中心用抑郁量表对504名流动儿童进行测查。结果有29.56%的流动儿童具有明显的抑郁症状;不同性别和流动时间的流动儿童在受歧视知觉、社会支持、孤独感和抑郁症状上的得分差异有统计学意义;受歧视知觉直接正向预测抑郁症状[β=0.39(0.33(0.45)];社会支持和孤独感在受歧视知觉对抑郁症状的影响中发挥中介作用[β=0.05(0.02(0.08)、β=0.08(0.05(0.11)、β=-0.03(-0.01(-0.05)]。结论受歧视知觉是流动儿童抑郁症状的危险因素,受歧视知觉可以通过降低流动儿童的社会支持并增加孤独感进而提高流动儿童的抑郁风险。     

精神分裂症住院患者危险行为发生情况及相关因素分析

目的 探讨精神分裂症住院患者危险行为的发生现状及相关危险因素。方法 选取2020年1月—2022年6月江西省康宁医院收治的126例精神分裂症住院患者,根据危险行为发生情况将患者分为危险组(n=35)和非危险组(n=91)。采用多因素Logistic回归分析精神分裂症住院患者发生危险行为的危险因素。结果 多因素分析结果显示,发病前受刺激(OR=4.159,95%CI:1.348～12.832)、SSRS评分<20分(OR=2.990,95%CI:1.142～7.830)、PSS-Fa评分<6分(OR=4.984,95%CI:1.892～13.131)、MMAS-8评分<6分(OR=3.242,95%CI:1.064～9.875)和SDS评分≥53分(OR=3.147,95%CI:1.031～9.599)是精神分裂症住院患者发生危险行为的独立危险因素。结论 精神分裂症住院患者发生危险行为的风险较高。发病前受刺激、SSRS评分<20分、PSS-Fa评分<6分、MMAS-8评分<6分和SDS评分≥53分会增加精神分裂症住院患者发生危险行为的风险。     

老年精神分裂症患者尿路感染的病原学特点及危险因素分析

目的 分析老年精神分裂症患者合并尿路感染的病原学特点及危险因素，为尿路感染防治提供参考依据。方法 分析2013年1月—2021年12月住院的530例老年精神分裂症患者发生尿路感染的临床特征，分析尿路感染患者病原菌分布特点。采用单因素及多因素回归分析发生尿路感染的危险因素。结果 126例患者发生尿路感染，感染率为23.77%;尿频、尿急、尿痛等尿路刺激症状为主要临床表现；分离出106株病原菌，以革兰阴性菌为主，共71株，占66.98%;患者年龄、住院天数、联合应用抗菌药物、行为能力衰退、精神疾病症状控制差是老年精神分裂症合并尿路感染的独立危险因素(P<0.05)。结论 老年精神分裂症患者尿路感染病原菌以革兰阴性菌为主，与患者高龄、病程长、合并严重基础疾病、精神疾病症状控制差、行为能力衰退等因素密切相关，临床应对相关危险因素采取针对性干预措施，提高老年精神分裂症尿路感染防治水平。     

临床观察量表对118例住院精神病人的测评分析

目的使用临床观察量表对精神病住院病人进行测评,同时对影响量表评定结果的因素进行分析。方法对118例住院精神病人进行临床观察量表测查,通过相关分析,探讨年龄、病程、首发年龄、受教育年限、婚姻、家族史、诊断对临床观察量表评定结果的影响。结果年龄、病程与病情总估计,总积极因素呈显著负相关,受教育年限与之呈显著正相关,精神分裂症较其它精神病的病情总估计分和总积极因素分低。结论临床观察量表是一种易于掌握的测评量表,其影响评定结果的因素也是多方面的。     

广州市脑科医院精神分裂症患者孤独感与自尊水平的相关性分析

目的探讨住院精神分裂症患者孤独感与自尊水平的相关性。方法采用自制的一般资料问卷、UCLA孤独量表、自尊量表对120例精神分裂症患者进行调查分析和比较。结果患者的孤独感均分为42.69±9.47,轻度孤独感以上的患者有84例。自尊均分为(24.46±5.78),低于国内常模(28.75±4.86),差异有统计学意义(P=0.023)。患者的孤独感与自尊水平呈显著负相关(r=-0.242,P=0.008)。结论住院精神分裂症患者大多具有轻度以上的孤独感;自尊水平越低,孤独感越严重。     

精神分裂症患者长期住院的影响因素分析

目的分析精神分裂症患者长期住院(住院时间60 d)的影响因素。方法纳入浙江省立同德医院精神科2011—2015年收治的460例精神分裂症患者为研究对象,对患者的一般情况和病情特征进行问卷调查,采用Logistic回归模型分析患者长期住院的危险因素。结果 460例精神分裂症患者中,男性262例,占56.95%,女性198例,占43.05%;平均(50.51±15.40)岁;已婚354例,占76.96%;高中以下文化程度278例,占60.43%;退休/失业338例,占73.48%;病程5年377例,占81.96%;长期住院患者216例,占46.96%,短期住院患者244例,占53.04%。Logistic回归分析结果显示,40岁(OR=3.846,95%CI:1.988~7.440)、病程5年(OR=5.816,95%CI:2.948~11.472)是导致患者长期住院的危险因素;女性(OR=0.580,95%CI:0.352~0.954)、文化程度高(OR=0.072,95%CI:0.040~0.129)是保护因素。结论 40岁、病程5年、文化程度低和男性精神分裂症患者住院时间相对较长。     

精神分裂症住院患者并发糖尿病的危险因素研究

目的探讨精神分裂症患者伴发糖尿病的可评估性危险因素。方法回顾性调查符合CCMD-3诊断标准的住院精神分裂症患者中的糖尿病发病情况以及抗精神病药物的使用情况等相关因素,并观察体重、血糖和血脂的变化。结果在230例精神分裂症患者中,并发糖尿病者为22例,其发生与患者年龄、病程、使用抗精神病药物以及体重、血脂和阳性糖尿病家族史有相关性。结论精神病人群,年龄较大、病程较长以及长期使用抗精神病药物均可增加糖尿病的发生率。     

精神分裂症缓解期患者的孤独感及社会支持状况的研究

目的探讨精神分裂症缓解期患者的孤独感、社会支持状况及二者的相关关系,为对其进行必要的心理干预提供理论基础。方法采用问卷法,利用孤独量表及社会支持量表对92例精神分裂症缓解期患者和80例健康人进行调查分析。结果精神分裂症缓解期患者孤独感得分（40.30±9.41）,健康对照组孤独感得分（34.18±7.78）,差异有统计学意义;精神分裂症缓解期患者总社会支持得分（40.51±8.37）、客观支持得分（11.04±2.71）、主观支持得分（20.99±4.55）、支持利用度得分（8.51±2.33）,健康对照组总社会支持得分（44.14±8.53）、客观支持得分（11.96±2.77）、主观支持得分（22.84±5.06）、支持利用度得分（9.31±1.97）,差异均有统计学意义。精神分裂症缓解期患者的孤独感与总社会支持（R=-0.653）、客观支持（R=-0.441）、主观支持（R=-0.692）、支持利用度（R=-0.485）均呈负相关。结论精神分裂症缓解期患者的社会支持明显低于健康人,孤独感高于健康人,精神分裂症缓解期患者的孤独感与社会支持呈负相关,随社会支持的增多而降低。     

Correlates of loneliness among older Newar adults in Nepal

OBJECTIVE: The purpose of this study was to identify significant factors for loneliness in older adults METHODS: The subjects (N = 195) were members of the Newar caste/ethnicity, aged 60 years and above (mean(+/- SD) 68.81 (+/- 7.69) years and 52% male) and living in Katmandu City. Data were collected by face-to-face interview using a three-item loneliness scale, developed based on the University of California at Los Angeles (UCLA) Loneliness Scale and prepared with a translation and back translation technique from English into Nepalese. The data were analyzed using logistic regression analyses. RESULTS: More than two-thirds of Newar elderly experience some type of loneliness. A statistically significant correlation was found between feelings of loneliness and age, sex, household status, total family size, network size, social participation, self-reported health, chronic health problems, working status, instrumental activities of daily living (IADL), and perceived economic satisfaction. Results of logistic regression analyses showed age, network size, and perceived economic satisfaction to be significant factors for loneliness. CONCLUSION: Loneliness is an important public health issue, predicting low quality of life among older adults. The present results indicate many elderly Nepalese experience some form of loneliness, with age, network size and perceived economic satisfaction as significant factors. However, this result may not be generalized to the greater population of Nepalese older adults and the external validity of the UCLA Loneliness Scale is an important criterion to examine in future research.     

Impacts of social integration and loneliness on mental health of humanitarian migrants in Australia: evidence from a longitudinal study

Objective: To examine the impacts of social integration and loneliness on the mental health of humanitarian migrants (HMs) in Australia over time. Methods: A total of 1,723 HMs who held permanent visas from the first to third waves (2013–2016) of a longitudinal study in Australia (Building a New Life in Australia) were included in the study. Dependent variables included poor general health, post‐traumatic stress disorder (PTSD) and severe mental illness (SMI). Predictors were social integration stressors and loneliness. We used generalised linear mixed models to assess impacts of the changing status of social integration and loneliness on dependent variables over time. Results: HMs with increased social integration stressors reported poor general health (aOR:1.56, 95%CI:1.19–2.03); PTSD (aOR:1.67; 95%CI: 1.32–2.13); and SMI (aOR: 1.46; 95%CI: 1.15–1.86) over time when compared to those without stressors. Increased loneliness during resettlement was also associated with poor general health (aOR: 1.56; 95%CI:1.28–1.91); PTSD (aOR: 1.57; 95%CI: 1.28–1.93) and SMI (aOR: 1.59; 95%CI: 1.31–1.94). HMs who reported overcoming loneliness (aOR:1.50, 95%CI: 1.24–1.83 for SMI and aOR:1.51; 95%CI: 1.22–1.86 for PTSD) and persistent loneliness (aOR:1.99; 95%CI: 1.51–2.61 for SMI) reported poorer mental health over time than those who did not report loneliness. Implications for public health: Culturally competent settlement services addressing social integration stressors and loneliness are required to improve the mental health of humanitarian migrants.     

You become afraid to tell them that you are gay: health service utilization by men who have sex with men in South African cities

We describe the utilization of health services by men who have sex with men (MSM) in South African cities, their perceptions of available health services, and their service preferences. We triangulated data from 32 key informant interviews (KIIs), 18 focus group discussions (FGDs) with MSM in four cities, and a survey of 285 MSM in two cities, recruited through respondent-driven sampling in 2008. FGDs and KIIs revealed that targeted public health sector programs for MSM were limited, and that MSM experienced stigma, discrimination, and negative health worker attitudes. Fifty-seven per cent of the survey participants had used public health services in the previous 12 months, and 69 per cent had no private health insurance, with no difference by HIV status. Despite these findings, South Africa is well placed to take the lead in sub-Saharan Africa in providing responsive and appropriate HIV services for MSM.     

The deterioration of health status among immigrants to Canada

Abstract

A growing body of literature suggests that immigrants to Canada experience deterioration in their health status after settling in the country. While self-selection processes and Canadian immigration policy ensure that, at the time of arrival, immigrants are healthier than the Canadian-born population, this health advantage does not persist over time. This study uses new data from the Longitudinal Survey of Immigrants to Canada (N=7720) to examine how health transitions vary among immigrants. Logistic regression analyses indicate that visible minorities and immigrants who experienced discrimination or unfair treatment are most likely to experience a decline in self-reported health status. The results also confirm a clear inverse socioeconomic gradient with respect to increasing levels of feelings of sadness, depression and loneliness. These findings reflect important dimensions driving population health patterns in Canada, a country with a highly lauded health care system based on the principles of universality and comprehensiveness. Our findings suggest that discrimination and inequality partly drive the health transitions of immigrants. These factors, which largely operate outside of the formal health care system, need to be understood and addressed if health inequities are to be reduced.     

孤独感在中学生儿童期虐待与躯体亚健康的作用研究

目的了解蚌埠市中学生儿童期虐待与躯体亚健康的关系以及孤独感在其中的中介和调节作用,为改善青少年身心健康状况提供依据。方法采用分层整群随机抽样方法,从蚌埠市抽取5 116名中学生,使用青少年亚健康多维评定问卷、儿童期虐待问卷、孤独感自评量表对研究对象进行问卷调查。结果中学生躯体亚健康状态的报告率为26.2%。中学生躯体亚健康与孤独感和儿童期虐待得分均呈负相关(r值分别为-0.136,-0.127,P值均0.01),儿童期虐待和孤独感得分呈正相关(r=0.079,P0.01)。Logistic回归分析结果显示,女生、高孤独感、高儿童期虐待及高中生均为中学生躯体亚健康的危险因素(P值均0.01)。孤独感在儿童期虐待和身体亚健康之间具有部分中介效应,中介效应占总效应的比例为30.27%。孤独感在儿童期虐待和身体亚健康之间具有调节效应,随着孤独感程度的加重,儿童期虐待对身体亚健康的负向预测作用增强。结论孤独感在中学生儿童期虐待对躯体亚健康的影响中具有中介和调节作用。     

Older people living alone in Shanghai: A questionnaire survey of their life experience

Globally the number of older people living alone is increasing. Little is known about the life experience of older people living alone in Mainland China. This study aimed to explore older people's experience regarding different components of their lives. A cross‐sectional survey of 387 older people aged 60 years and above and living alone in two communities in Shanghai was conducted from April to July 2015. A structured questionnaire including 15‐item Geriatric Depression Scale, Activity of Daily Living Scale, UCLA Loneliness Scale version 3, Social Support Rate Scale and Older People's Quality of Life Questionnaire was used to assess the health status, loneliness, social support, quality of life and demographic information. A total of 15.7% of the participants rated their health as poor with 56.8% reporting chronic diseases and 26.9% reporting being depressed. A total of 71.1% of the participants reported a high level of functional ability. However, 54.3% and 21.7% of the participants reported a moderately and moderately high level of loneliness respectively. The median of SSRS was 30 and the mean of Older People's Quality of Life Questionnaire was 120.2, indicating a lower level of social support and quality of life. There were statistically significant differences in health, loneliness, social support and quality of life across the participants with different characteristics. Interventions to improve the health status, reduce loneliness, increase social support and maintain or improve quality of life of older people living alone in Shanghai could be developed and implemented. Potential interventions include providing frequent home care services, early detection of depression, encouraging more contacts from children and other family members, and providing support from other sources.     

抚州市基本公共卫生服务居民满意度及影响因素分析

目的：了解居民对基本公共卫生服务的满意度及其相关的影响因素,为更好的开展基本公共卫生服务项目提供依据。方法采用自行设计的调查问卷对全市34家基层医疗机构辖区居民进行问卷调查,计算基本公共卫生服务满意度,采用多元线性回归分析法分析居民满意度的影响因素。结果共调查研究对象3378名,满意度介于66.49%~77.53%之间,健康档案管理的管理满意度最高,对重症精神疾病患者管理满意度最低,医疗机构服务内容、服务态度和技术水平及被调查对象的学历水平是居民满意度的影响因素。结论在国家财政允许的情况下,有必要进一步加大对基本公共卫生服务项目的投入力度,扩大基本公共卫生服务的覆盖面和内容,加强培训提高服务提供人员的业务素质,让更多的服务惠及居民,提升居民对基本公共卫生项目的满意度。     

合肥市公共场所从业人员吸烟及其影响因素研究

目的了解合肥市公共场所从业人员吸烟和被动吸烟现状以及吸烟的相关影响因素,为开展针对性控烟干预提供依据。方法本研究调查现场为合肥市区5个疾病预防控制中心体检门诊,采用分层抽样的方法抽取前来进行健康体检的公共场所从业人员作为调查对象,采用自行设计调查表进行问卷调查,了解从业人员吸烟和被动吸烟的情况及其影响因素。结果共调查合肥市公共场所从业人员1 211人,其中男性608人,女性603人。调查对象的吸烟率为25.9%,男性吸烟率48.8%,女性吸烟率2.8%。吸烟影响因素的多因素Logistic分析发现,男性、年龄、幼年时母亲吸烟、好朋友吸烟、认为＂吸烟看起来很酷/很有魅力＂是影响吸烟的危险因素,大专文化程度（相对于小学及以下）、好朋友不能接受吸烟、母亲不能接受吸烟、认为＂吸烟看起来缺乏教养＂是影响吸烟的保护因素。结论对公共场所从业人员吸烟情况应重点关注,并采取针对性的措施开展控烟干预。     

基本职业卫生服务试点工作中服务模式的探讨

目的对国内外基本卫生服务模式进行对比研究,探索在我国经济发展水平不同的地区,与本地情况相适应的基本职业卫生服务工作模式。方法通过对西方经济发达国家及发展中国家在基本职业卫生服务方面的探索和经验的研究,结合我国近几年在试点工作方面的经验,寻求适合我国具体国情的基本职业卫生服务的主要几种模式。结果①在各主要经济发达国家其基本卫生服务已经可以覆盖绝大多数职业人群。②在部分发展中国家也通过采取与初级卫生保健相结合,协调发展的模式,有效提高了职业人群基本职业卫生服务覆盖率。③我国在基本职业卫生服务试点工作中,取得了一定的经验,但也发现存在着一些问题。结论我国应结合各地经济发展的水平,根据本辖区企业的规模、行业特点、存在的主要职业危害因素来制定符合本地情况的基本职业卫生服务模式,重点解决当地最主要的基本职业卫生问题,促进我国职业卫生工作的进一步开展。     

新形势下基层公共卫生服务体系建设中的问题及对策

目的进一步了解公共卫生服务体系建设状况,探索可持续发展的基层公共卫生服务模式,保障广大人民群众身体健康和生命安全。方法于2007年7月。2008年6月对山东省滨州市滨城区公共卫生体系建设状况进行调查。结果建立了部门协作、社会参与、齐抓共管的公共卫生服务模式。调查中发现在人员、经费和体制等方面存在制约因素。结论加大财政投入,加强管理,逐步完善公共卫生服务体系建设。