年轻人离开原生家庭后安置不稳定性及可能的心理健康影响（英文）

背景:收容机构中的儿童青少年和同龄人相比可能存在较差的心身健康水平。稳定的机构照料环境对改善早期童年经历所致破坏性影响是非常重要的,童年经历包括心理创伤、虐待和忽视。目前,澳大利亚或其他国家很少有关收容机构中儿童青少年的安置稳定性高质量研究的数据。目标:首次针对澳大利亚在收容机构生活中的儿童青少年进行系统的背景、照料类型、和安置稳定性特征的调查。方法:2014年收集了墨尔本市区的四家民间儿童青少年社区服务机构的数据。样本包括322名年轻人(女性占52.8%),年龄在12-17岁之间[平均年龄=14.86,(SD=1.63)年]。结果:在收容机构中,相对于社区收容照料类型(35.7%),大多数年轻人(64.3%)是基于家庭养育照料模式(即寄养、治疗型寄养照料、青少年照料模式、亲属照料、以及认领照料)。然而,与所有收容照料的孩子相比,这个年龄组被社区收容比例是较高的(5%)。第一次被社区收容的平均年龄为9岁(SD=4.54)。不同的照料类型均无性别差异。其中有248人(76.9%)曾在收容照料系统中有一个以上的安置场所,有117人(36.5%)经历了超过5个安置场所。相对于家庭养育照料者,社区收容的儿童青少年经历了更显著的安置不稳定性(χ~2=63.018,p0.001)。结论:安置不稳定性在收容照料机构是常见的现象。需要一个稳定的照料环境来改善被虐待儿童所导致的心理创伤和健康影响。精心设计并以干预为基础的研究能够增加安置稳定性,包括强化对儿童青少年收容照料者的治疗能力。     

青少年心理健康的家庭影响因素研究进展

<正>青少年阶段是个体从儿童期向成人期过渡的一个特殊阶段[1],心理发生剧烈变化,很容易发生心理问题[2];心理问题会影响青少年生长发育、学校表现、与同龄人交往,甚至导致自杀[3]。家庭是一个人生命中最基本、最重要的环境,也是最初最关键的影响因素。关于青少年心理健康的研究近几年逐渐增多,家庭因素的研究也越来越受到重视。现就影响青少年心理健康的家庭因素做一综述,以便更全面地了解现有因素,继之做出调整,为青少年心理     

暴力精神分裂症照料者的心理健康及影响因素分析

目的 探索暴力精神分裂症照料者的心理健康及影响因素。方法 连续纳入2014年1 月至 2016 年12 月在重庆市精神卫生中心就诊的暴力精神分裂症患者照料者487 人（暴力精神分裂症组），另 选取与暴力精神分裂症患者性别、年龄、受教育程度、病程相匹配的无暴力行为精神分裂症患者的照料 者479 例（非暴力精神分裂症组）作为对照组，采用症状自评量表90 项症状清单（SCL-90）及社会支持评 定量表（SSRS）进行评估。结果 暴力精神分裂症组照料者在SCL-90 量表中总分［（176.23±54.59）分比 （167.26±63.06）分］、躯体化［（22.72±7.25）分比（21.46±8.74）分］、强迫［（20.67±6.36）分比（19.65±6.93）分］、 人际关系敏感［（18.18±6.51）分比（17.25±6.56）分］、抑郁［（25.79±9.08）分比（24.45±9.68）分］、焦虑 ［（18.89±6.72）分比（17.96±7.16）分］、敌对［（11.22±4.93）分比（10.40±4.68）分］、恐怖［（13.05±5.62）分比 （12.28±5.76）分］、偏执［（11.97±4.54）分比（11.27±5.06）分］、精神病性［（19.91±7.20）分比（18.96±7.86）分］ 和其他［（14.25±6.16）分比（13.38±5.54）分］10个因子分及SSRS中客观支持［（6.11±1.84）分比（5.85±2.11）分］、 主观支持［（15.39±3.75）分比（14.85±3.75）分］、支持利用［（6.63±1.97）分比（5.92±2.12）分］得分均高 于非暴力精神分裂症组照料者，且差异均有统计学意义（均P＜ 0.05）。多元逐步回归分析结果显示，病 程、主观支持对照料者的心理健康有影响（F=14.567，P ＜ 0.01）。结论 暴力精神分裂症患者照料者较 不伴有暴力行为精神分裂症患者的照料者心身健康水平均明显低下，其差异受病程及主观支持两因素 影响。     

青少年心理门诊患者家庭功能与心理健康的关系

目的了解青少年心理门诊就诊患者的家庭功能对其心理健康的影响。方法采用家庭功能评定量表（FAD）及症状自评量表（SCL-90）对62例青少年心理门诊就诊者（研究组）和62名正常中学生（对照组）进行测评分析。结果研究组FAD、SCL-90评分均显著高于对照组（P〈0．05或P〈0．01）,FAD各因子、SCL-90总分及各因子分均呈显著正相关（P〈0．05或P〈0．01）。结论家庭功能与心理健康的关系密切。     

家庭教育因素对青少年心理健康的影响

采用症状自评量表(SCL-90)及家庭情况问卷封15778名大学生进行了测查。结果表明：父母文化程度与子女心理健康有一定关系,SCL——90各项因子分均有文化水平越低分值越高的趋势;父母职业为干部、知识分子的子女各因子分较低;父母为农民、翠人、个体的子女各因子分较高,尤以抑郁、焦虑为明显;父母不良教育方式如严厉、过分要求、放纵、溺爱的子女各因子分高于父母持健康成长、顺其自然态度者;父母教育有分歧的子女各因子分高于无分歧者。以上结果表明,父母文化程度、职业、教育方式等因素封青少年心理健康均有影响。     

阿尔茨海默病行为和精神症状对于照料者心理健康的影响

目的探讨阿尔茨海默病(AD)行为和精神症状(BPSD)对照料者心理健康状况的影响。方法46例AD患者均作AD病理行为评分表(BEHAVE-AD),日常生活能力量表,简易智力状态检查,临床痴呆评定表评定,并作头颅CT,脑电图检查。患者之照料者均作一般调查问卷及90项症状清单(SCL-90)测定。对相关数据作统计分析。结果SCL-90总分除与BEHAVE-AD的幻觉分量表分无统计学显著性相关外,与其他分量表分及总分均呈正相关(P＜0．05);SCL-90除强迫、精神病性两因子分与常模的差异无统计学显著性外,其他因子分和总分均较常模高(P＜0．01);高BEHAVE-AD总分组照料者的SCL一90总分、因子分中的躯体化、抑郁、焦虑、恐怖及其他均较低BEHAVE—AD总分组照料者高(P＜0．05)。逐步回归分析发现影响照料者心理健康状况的因素主要是BEHAVE-AD总分和攻击行为分量表分。结论影响AD照料者心理健康状况的因素主要是患者的BPSD。     

精神分裂症患者家庭照料者复原力的特点及影响因素

目的:探讨精神分裂症患者家庭照料者复原力的特点。方法:使用复原力量表对来本院门诊替患者取药或陪诊的家庭照料者(照料者组)进行评估,结果与正常对照者(对照组)比较。结果:照料者组复原力总分(85.55±18.84)及各维度评分显著低于对照组(100.60±18.19)(P均<0.01);不同家庭身份的照料者复原力间差异有统计学意义(P<0.01);父/母为照料者的复原力总分及各维度评分显著低于配偶和子女(P均<0.05);初中、高中文化照料者复原力总分及各维度评分显著低于大专、本科及以上文化(P均<0.05);照料者复原力评分与被照料者复发次数、病程呈负相关(r=-0.533,P<0.01;r=-0.307,P<0.05),与被照料者的发病年龄呈正相关(r=0.427,P<0.01);照料者的复原力无性别差异(P>0.05)。结论:精神分裂症患者家庭照料者复原力降低,其家庭身份、文化程度、被照料者发病次数、发病年龄、病程是影响因素。     

情感宣泄法对后疫情时期南充市青少年心理健康状况、应对方式及干预满意度的影响

目的 探究情感宣泄法对后疫情时期南充市青少年心理健康状况、应对方式及干预满意度的影响。方法 采用完全随机抽样法,于2021年1月-2022年4月选取南充市2所普通中学、2所县级中学及2所大学共390名青少年为研究对象,以随机数字表法将其分为研究组(n=195)和对照组(n=195)。研究组接受情感宣泄法干预,对照组进行自我调节放松,不接受其他干预,两组均干预3个月。于干预前后,采用症状自评量表(SCL-90)评定青少年心理健康状况,采用简易应对方式问卷(SCSQ)评定青少年应对方式,并于干预后采用自编满意度问卷评定青少年对本次干预的满意度。结果 干预后,研究组SCL-90总评分低于对照组(t=68.312,P?0.01),SCSQ积极应对因子评分高于对照组(t=30.488,P?0.01),消极应对因子评分低于对照组(t=46.562,P?0.01);研究组干预满意者190人(98.96%),对照组175人(89.74%),两组干预满意率差异有统计学意义(χ²=15.321,P<0.01)。结论 情感宣泄法可能有助于改善后疫情时期南充市青少年的心理健康状况和...     

心理健康教育多元家庭治疗对抑郁障碍患者的疗效及家庭功能的影响

目的 探讨心理健康教育多元家庭治疗（The psychoeducational multiple family group,PMFG）对抑郁障碍患者的疗效及家庭功能的影响。方法 从张家港市第四人民医院门诊中选取60名抑郁障碍患者随机分为研究组和对照组,两组研究对象均采用抗抑郁药物治疗,研究组使用PMFG模式治疗,对照组使用门诊随访及社区支持性治疗;采用汉密尔顿抑郁量表（Hamilton Depression Scale,HAMD）、汉密尔顿焦虑量表（Hamilton Anxiety Scale,HAMA）、家庭功能评定量表（Family Function Rating Scale,FAD）对两组患者治疗前后进行HAMD、HAMA、FAD评分比较。结果 干预后研究组HAMD和HAMA评分均低于对照组（t=6.749,P<0.01;t=5.165,P<0.01）;FAD评分低于对照组（P<0.01）;差异均有统计学意义。结论 心理健康教育多元家庭治疗能减轻抑郁障碍患者的临床症状,并有助于提高患者的家庭功能。     

青少年精神疾病患者父母的心理健康状况及影响因素分析

采用症状自评量表(SCL-90)对青少年精神疾病患者父母的心理健康状况及其影响因素进行分析研究，旨在为精神科护士对这一群体实施教育和干预时提供依据。     

Background,experience of abuse,and mental health among adolescents in out-of-home care: a cross-sectional study of a Swedish high school national sample

Purpose: To compare experiences for adverse events, especially sexual abuse, and mental health in a group of high school students in out-of-home care with a representative sample of peers of the same age and similar educational attainment living with their parents.

Materials and methods: A sample of 5839 students in the third year of Swedish high school, corresponding to a response rate of 59.7%, answered a study specific questionnaire. Data from 41 students living in out-of-home care were compared with data from peers not in out-of-home care in a cross-sectional analyze.

Results: Students in out-of-home care had more often an immigrant background and a non-heterosexual orientation, had more often experienced physical and penetrative sexual abuse, and more often sought healthcare for mental problems. Disclosure of sexual abuse was less common, and acts of persuasion or adults' use of their social position was more common among students in out-of-home care.

Conclusions: Even where the protective factor ‘senior educational attainment’ is present, risks for abuse and poor mental health are evident for adolescents in out-of-home care. Disclosure of adversity, when it has occurred, ought to be higher among these adolescents with regular contact with social services, but our findings indicate tendencies for the opposite. We therefore suggest routines to be established to screen for adverse life events and mental health actively, along with general and systematic assessments of adversity and mental health during care.     

Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses

Aim: Mental health literacy may be a factor in early detection and prompt treatment for mental, emotional and behavioural disorders among young people. Building on previous research in Australia, this study assessed aspects of mental health literacy among adolescents in classrooms in a small town in the eastern USA. Methods: The students were provided brief, hypothetical, gender-matched scenarios about adolescents experiencing negative emotions and exhibiting related behaviours; some scenarios depicted diagnosable disorders. The respondents were asked to characterize each scenario as describing a mental health problem or other teen problem and indicate how they would respond to a peer who had such a problem. Results: Overall levels of recognition of mental disorders were low (27.5% identified anxiety and 42.4% identified depression as ‘a mental health problem or illness’). However, the respondents who recognized a disorder were three to four times more likely than those who did not to say they would take some helping action, such as telling an adult about the problem (depression: odds ratio 3.27; CI 1.43–7.46, anxiety: OR 4.43; CI 2.23–8.79). Few students (27.7%) remembered in-class discussions of mental health, a mandated health topic for schools in their area. Conclusions: There appears to be substantial room for improvement in mental health literacy among young people, and the development of interventions to enhance mental health literacy among students may be justified.     

Satisfaction with primary and specialized mental health care among patients with mental disorders

The purpose of this article is to assess the satisfaction of patients who received primary or specialized mental health care, and to identify variables associated with each level of care. This cross-sectional study included 325 patients with mental disorders (MDs). We used a conceptual framework based on Andersen’s behavioral model, comprising predisposing factors, enabling factors, and needs; socio-demographic, clinical, needs-related, service-use, and quality-of-life variables were integrated into the model. We performed adjusted multiple linear regression models. The mean score on patient satisfaction for primary and specialized care was approximately 4 (range: 3.67–5.0). Regarding enabling factors, better continuity of care and having a case manager were associated with patient satisfaction for both types of care; help received from services and relatives was positively associated with patient satisfaction in primary care, whereas patients on welfare were more likely to be dissatisfied with specialized care. Number of needs was negatively associated with patient satisfaction in primary care and, marginally so, in specialized care. Suicidal ideation was marginally associated with patient dissatisfaction for specialized care only.

Results revealed a high level of patient satisfaction with each type of care, with significant variables related to continuity of care, case management, and needs. The study suggests the critical importance of addressing patient needs comprehensively, and of establishing long-term, individual recovery plans that promote patient satisfaction. Collaboration between relatives of patients and professionals in patient treatment is closely related to satisfaction with primary care. Accounting for the presence of suicidal ideation and patient vulnerability is fundamental to increasing patient satisfaction with specialized care. Increased patient follow-up in the community, work integration, provision of supported housing, and rapid crisis intervention may help improve patient satisfaction with mental health service (MHS) while supporting recovery.     

Touch,the essence of caring for people with end-stage dementia: A mental health perspective in Namaste Care

This article presents the mental health aspects of ‘touch’ associated with a funded research project: Avoiding ‘high tech’ through ‘high touch’ in end-stage dementia: Protocol for care at the end-of-life. These mental health aspects highlight the human need for touch that continues up until and inclusive of the final stages of life. This study was informed by Simard's (2007) ‘high touch’ protocol based on the End-of-Life Namaste Care programme for people with dementia. The article is situated in relation to the research project which used a three-phase mixed methods approach. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touch vis-a-vis mental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers.