佛山市某社区精神病现况调查和生活质量测量

目的了解社会人群精神疾病的患病情况,指导开展精神病的社区防治和康复工作.方法采用普查的方法,调查佛山市城区祖庙街社区l5岁以上人群精神疾病的流行状况,并对患者和社区对照组进行生活质量平行测量.结果该社区共有15岁以上精神疾病患者335例,时点患病率和终生患病率分别为I1.62‰和12.11%o;精神分裂症、精神发育迟滞和老年性痴呆是社区人群中3种最主要的精神疾病;离婚、丧偶、文化程度低者患病率较高;精神病患者的生活质量显著低于正常对照组,P<0.01.结论必须重视社区中的精神疾病的防治.精神疾病的社区调查,有利于确定精神疾病的社区防治和康复工作重点.     

社区重性精神疾病患者的流行病学特征及相关因素分析

目的探讨社区重性精神疾病患者病种构成及精神分裂症、双相障碍、癫痫所致精神障碍和精神发育迟滞4种主要重性精神疾病的流行病学特征,并对社区重性精神疾病患者分析其是否同意参加社区网络管理的相关因素。方法以中国精神障碍分类诊断标准第2版修订本为标准,将2011年8月至2012年7月厦门市国家重性精神疾病数据收集基本分析系统的5220例社区患者进行统计分析。结果社区重性精神疾病患者男性多于女性,男女比为1.23:1,平均年龄为(46.45±14.48)岁,平均发病年龄为(30.13±13.98)岁,平均发病病程为(16.32±11.09)年。病种构成中居于前4位的依次为精神分裂症(88.20%),双相障碍(4.23%),癫痫所致精神障碍(2.99%)和精神发育迟滞(2.84%)。四种主要重性精神疾病在年龄、性别、职业、婚姻状况、受教育程度和经济状况上均有统计学差异(均P<0.05)。单因素logistic回归分析显示,同意参加社区网络管理患者多为36-55岁、有职业、现婚、小学和经济状况为贫困人群;多因素logistic回归分析结果显示性别、受教育程度、婚姻状况、居住地和经济状况为独立的危险因素,女性、受教育程度为小学及以上人群、现婚人群和其他(离异或丧偶)人群、农村和贫困人群同意参加社区网络管理的可能性更大。结论不同重性精神疾病发病与患者性别、年龄、职业、婚姻状况、受教育程度和经济状况等等因素有关,社区精神卫生防治人员须重点关注受教育程度为文盲、未婚、城镇和非贫困等不同意参加社区网络管理的患者。     

南岸区重性精神疾病患者社区管理模式研究

目的：研究分析重性精神疾病患者的社区管理模式。方法针对本区内200例重性精神疾病患者，制定合理的社区管理模式。结果经过为期一年的社区管理，全部患者病情状况稳定，没有复发，没有肇事肇祸现象，没有发生自杀现象。结论重视加强对重性精神疾病患者的社区管理，是保障社会秩序稳定，降低突发事件发生的关键措施。     

江阴市乳腺癌患者总体健康和生活质量调查报告

目的：评估江阴市乳腺癌患者的总体健康和康复情况、生活质量、患者参加癌症康复活动的情况，以及参加协会活动对自己的健康和生活产生的影响，从而为今后全市癌症康复工作更有针对性和更有成效的开展提供支持，也为政府部门制订相关政策提供依据。方法：本研究采用横断面设计，所使用的调查工具为乳腺癌患者总体健康和生活质量调查问卷（参考全国乳腺癌患者生命质量及其影响因素研究项目）。结果：有效调查315例乳腺癌患者，研究结果显示患者的年龄大多分布在40~69岁之间，且文化程度普遍偏低，大部分处于退休或无工作状态，处于偏低的收入水平。患者的婚姻关系或亲密关系并没有因为罹患乳腺癌而受到破坏性的影响。通过协会开展的各类活动，患者对自我健康、生命质量和压力感受性等方面内容显示出积极评价倾向，有利于缓解乳腺癌患者的心理痛苦，促进创伤后康复。结论：乳腺癌患者心理康复支持项目在康复期乳腺癌患者心理康复中起到了积极的作用，其形式和活动方式等具有一定的借鉴意义。     

精神疾病患者幽门螺旋杆菌感染流行病学现况研究

目的 研究精神疾病患者幽门螺旋杆菌(Hp)感染的流行病学现状.方法 通过系统抽样,对2015年-2018年济宁市精神病防治院收治人院的1 759例精神疾病患者进行血清抗Hp尿素酶抗体检测,并收集背景资料进行分析.同时纳入194例一般人群作为对照.结果 精神疾病患者抗Hp尿素酶抗体阳性720例,阳性率为40.93％;一般...     

成都市重性精神疾病社区防治现况调查

目的了解成都市社区精神卫生服务及重性精神疾病社区防治工作开展情况。方法采用两阶段分层抽样方式,选取6个区县共16家社区卫生服务中心/乡镇卫生院进行问卷调查。结果不同圈层的重性精神疾病患者管理率、重性精神疾病患者规范管理率、管理患者肇事肇祸率及管理患者体检率等指标有较大差异。结论 （1）社区卫生服务中心在管理的规范性方面普遍好于乡镇卫生院,但乡镇卫生院在工作总量和工作的扎实程度上好于社区卫生服务中心;（2）一、三圈层工作开展情况好于二圈层。     

上海市中小学生生活质量状况调查

目的了解上海市中小学生的生活质量及其影响因素，为改善学生生活质量提供依据。方法采用多阶段分层整群抽样的方法抽取学生4708名，用华中科技大学儿少卫生教研室编制的儿童少年生活质量量表进行无记名调查。结果不同地区、年级和性别的学生生活质量差异有显著性，市区学生得分高于郊区学生；小学生得分高于初中生和高中生；男生生理状况得分高于女生其他方面女生高于男生。4种不同家庭类型比较，大家庭和核心家庭的学生生活质量得分较高，单亲家庭较低。学习成绩、学习年限、与父母的关系桨家庭生活环境等因素与生活质量有密切关系。结论随学生年龄的增长，生活质量呈下降趋势。家庭生活状况对学生生活质量有很大影响。     

深圳市167例社区重性精神疾病患者服药现况分析

目的 了解深圳市福田区在社区康复的重性精神疾病患者的服药情况. 方法 调查2012年4月167例深圳市福田区户籍贫困精神疾病患者到本院精神卫生科参加“福田区贫困精神疾病患者服药补贴”项目的具体服药情况.结果 (1)使用频率在前六位的抗精神病药依次是利培酮、氯氮平、奥氮平、富马酸喹硫平、阿立哌唑、奋乃静.(2)在167例患者中,105例(62.87％)接受单一抗精神病药治疗,其中31人(18.56％)单纯使用典型抗精神病药,74人(44.31％)单纯使用非典型抗精神病药,62例(37.13％)联合2种及以上抗精神病药. 结论 非典型抗精神病药在深圳市福田区社区康复的精神疾病患者的维持用药方案中占主导地位.单纯使用非典型抗精神病药的患者的社会功能明显好于单纯使用典型抗精神病药以及合并使用非典型和典型药物的患者的社会功能.     

南京市糖尿病患者社区自我管理小组活动前后生活质量评价

目的 探索糖尿病患者生活质量的影响因素,评估自我管理小组活动前后生活质量变化情况。方法 采用患者自我管理小组活动的干预方式对社区糖尿病患者进行管理,在小组活动前后分别采用中国疾病预防控制中心设计的评估问卷进行调查。结果 共登记自愿参加自我管理小组的糖尿病患者521例,完成全部6次小组活动的患者494例,应答率为94.8%。生活质量各维度评分,除躯体疼痛（bodily pain,BP）、活力（vitality,VT）、精神健康（mental health,MH）外,其他5个方面评分均较中国一般人群低,差异均有统计学意义（均有P<0.05）。糖尿病患者生活质量的主要影响因素为并发症（t=-3.235,P=0.001）、慢性病史（t=-3.197,P=0.002）、血糖监测（t=2.303,P=0.022）、饮食习惯（t=2.341,P=0.020）、每周参与中等强度体力活动频次（t=-5.643,P<0.001）。糖尿病患者生存质量在不同维度上得分,活动后均较活动前升高（均有P<0.001）。结论 社区自我管理小组活动能够有效提高糖尿病患者生活质量。     

山西省农村地区艾滋病病毒感染者生活质量研究

目的了解山西省农村地区HIV感染者生活质量。方法采用横断面研究方法,应用MOS-HIV量表调查HIV感染者的生活质量。结果195例HIV感染者的平均年龄为（45．6±8．2）岁,其中男性119例（61．0％）,女性76例（39．0％）;大多已婚（77．9％）;83．0％的患者系通过既往采供血途径感染HIV;在心理健康总评分,总体健康感受、精力／疲劳、生活质量、心理功能和健康转变5个维度,男性评分高于女性;在生理健康总评分,躯体功能和疼痛2个维度,低年龄组评分高;在总体健康感受、生活质量、心理功能、躯体功能和角色功能5个维度,收入高组评分高。结论重点关注女性、老年、收入较低HIV感染者生活质量,将有助于提高该人群的生活质量。     

Measuring subjective quality of life in people with serious mental illness using the SEIQoL-DW

In response to suggestions that available measures may not adequately reflect the idiosyncratic nature of subjective quality of life, the schedule for the evaluation of individual quality of life (SEIQoL) was developed to allow individuals first to select and define their own dimensions of quality of life, and then to assign a relative weight to each of the dimensions they have chosen. A simplified version of the instrument, the SEIQoL-direct weighting (SEIQoL-DW), can be used to elicit similar information from subjects with impaired cognitive functioning. The present study explored the feasibility of using this technique with a sample of 35 clients with serious mental illness served by assertive community treatment (ACT) teams. The SEIQoL-DW was well accepted by the study cohort. The SEIQoL-DW's global index was correlated with the satisfaction with life scale (SWLS), and with the quality of life inventory (QOLI). The SEIQoL-DW may have potential as a clinical planning tool that allows respondents to define personally relevant quality of life dimensions upon which attainable goals can be based. This revised version was published online in June 2006 with corrections to the Cover Date.     

Predictors and course of vocational status, income, and quality of life in people with severe mental illness: a naturalistic study

Due to high unemployment rates, people with mental illness are at risk of poverty and are deprived of the social and psychological functions of work, such as the provision of social support, structuring of time, and self-esteem, with a negative effect on their perceived quality of life (QoL). Two distinct processes are held responsible for the low work force participation of people with mental illness: 'Social underachievement' and 'social decline'. Social underachievement signifies that, due to early illness onset, the educational attainment of people with mental illness is low and entry to the labor market fails. Social decline, on the other hand, describes the loss of competitive employment after illness onset, followed by prolonged periods of unemployment and difficulties to re-enter the labor market. This study examines how social underachievement and decline are reflected in the course of vocational status, income, and QoL of people with severe mental illness in the years after a psychiatric admission in a naturalistic longitudinal design. A total of 176 participants diagnosed with schizophrenia or affective disorders were interviewed during an index hospitalization in two large psychiatric hospitals in Zurich. Follow-up interviews were conducted 12 and 30 months after. Random coefficient models (multilevel models) were used to examine simultaneously the predictors and course of the variables of interest. A low number of psychiatric hospitalizations, a higher educational degree, a diagnosis of schizophrenia, and years of work experience predicted a higher vocational status. Vocational status decreased in first-admission participants with prolonged hospitalizations during the follow-up period. Income did not change over time and was positively influenced by a higher age of illness onset, competitive employment, higher education, and not having had a longer hospitalization recently. Subjective QoL significantly improved and was rated higher by people with any kind of employment than by participants without a job. Participants with an affective disorder, those with few hospitalizations but a recent inpatient stay of longer duration, showed lower QoL. Including employment issues early in treatment is especially important for people with an early illness onset and those with more severe forms of psychiatric disorder. A life course perspective enhances the understanding of patients' vocational potential and needs for support.     

上海市某街道外来流动人口生存质量的现况研究

目的了解上海市某街道外来流动人口生存质量的现况。方法通过系统抽样的方法抽取480名外来流动人口,采用世界卫生组织生存质量测定量表中文版(WHOQOL-BREF)对其生存质量进行调查,拟合多元线性回归模型来分析各因素与量表四个领域得分的关系。结果外来流动人口生理领域得分为(14.09±2.09)分、心理领域得分为(11.28±2.18)分,均低于全国一般水平,分别为(15.8±2.9)分、(14.3±2 5)分。女性社会关系得分高于男性(P=0.017),生理领域、心理领域得分随年龄增加而降低(生理领域P=0.030、心理领域P=0.023),各领域得分随家庭摩擦对生活影响程度加深而减少(P<0.01),随食欲增加而增加(P<0.01)。结论年轻女性的生存质量较高,但是从外来流动人口总体生存质量状况来看,更需重视他们的生理和心理方面的需求。     

A new patient focused index for measuring quality of life in persons with severe and persistent mental illness

The quality of life in persons with severe and persistent mental illness is often poor. Most treatment programmes have the goal of increasing quality of life. Unfortunately, existing methods to assess qualtiy of life are cumbersome and oriented towards research rather than clinical settings. This study describes preliminary steps in the development, testing and application of a new patient focused index for measuring quality of life in persons with severe mental illness. The Quality of Life Index for Mental Health (QLI-MH) differs from existing instruments in that it is based on an easy to use, self-administered questionnaire that assesses nine separate domains that together encompass quality of life. Each domain can be individually weighted depending on its relative importance to the patient. Different parts of the instrument solicit information from the patient, the primary clinician and, when available, the family. The instrument and its scoring system address limitations of previous approaches to quality of life measurement.     

The impact of mental illness on quality of life: A comparison of severe mental illness,common mental disorder and healthy population samples

Patient-centred outcomes such as quality of life (QOL) are valued and used extensively in mental healthcare evaluations, but concerns remain about their practical application due to perceived measurement issues, including responsiveness and relationships with objective indicators and depression. Evidence from general population studies challenge some assumptions, suggesting that measurement difficulties might relate to the characteristics of mental health samples, rather than measurement itself. This paper assesses the impact of mental illness on QOL and its measurement, examining whether the life-conditions, opportunities and QOL of different mental health-status groups vary, and if explanatory models of domain-specific and global QOL differ. Objective life-conditions, access to life-opportunities and subjective QOL were assessed over 2 years, using the same methodology in severe mental illness (SMI; n = 149 (baseline)/n = 126 (follow-up)), common mental disorder (CMD; n = 794/354) and no disorder (n = 1119/583) groups. Objective life-conditions were worse in the SMI group than in mentally healthy population and CMD groups, but the opportunities available to the SMI group were no more restricted than the CMD group. Subjective QOL ratings reflected this; SMI group scores were lower than the healthy population and in some life-domains the CMD group. Models of QOL suggested that life-quality was explained differently in the three groups. QOL studies combining mental health samples should control for health-status group, and domain-specific and global indicators of lifestyle and opportunity.     

综合性心理干预对狼疮性肾炎患者负性情绪及生存质量的影响

目的探讨综合性心理干预对狼疮性肾炎患者负性情绪及生存质量的影响。方法将60例狼疮性肾炎患者随机分为对照组（n=30）和干预组（n=30）,对照组给常规治疗及护理;干预组在与对照组同样治疗护理的基础上,给予为期8周的综合性心理干预。于入组时和8周末采用汉密尔顿抑郁量表（HRSD）,汉密尔顿焦虑量表（HAMA）为测评工具,测评干预前后两组患者的负性情绪;并采用世界卫生组织生存质量测定量表简表（WHOQOL—BREF）测评干预组患者干预前后的生存质量。结果人组时两组的患者HAMA、HRSD评分比较无统计学意义（P〉0．05）;干预治疗后干预组较对照组患者的HAMA、HRSD评分均显著降低,差异有统计学意义（P〈0．05）;干预组干预治疗前后评分比较（HAMA：t=4．29,P〈0．05;HRSD：t=5．43,P〈0．05）差异有统计学意义;干预组干预后生存质量总分、生理领域、心理领域等得分较对照组差异有显著性（P〈0．05）。结论综合性心理干预能够改善狼疮性肾炎患者负性情绪,提高其生存质量。     

山东省不同类型学校高中生生活质量状况

目的了解不同类型学校高中生生活质量状况,为采取相应的干预措施提供依据。方法采用多阶段整群抽样方法,选取山东省5所高级中学高一～高三年级学生共1322名,选用高中生生活质量量表进行调查。结果不同类型学校的高中生生活质量状况差异有统计学意义,其中,城市重点高中学生的生活质量状况最好,城乡结合处学校的学生生活质量最差。结论学校周边环境、学生生源等因素影响高中生生活质量,不同类型学校应针对其薄弱环节采取相应的干预措施。     

临床护理路径对老年白内障手术患者心理健康和生活质量的影响

目的探讨临床护理路径对老年白内障手术患者心理健康和生活质量的影响。方法选择50例老年白内障患者,择期在局麻下行超声乳化联合人工晶体植入术,随机均分为观察组和对照组,对照组采用眼科围术期常规护理,观察组实施临床护理路径护理。观察两组护理前后心理健康[Zung氏焦虑自评量表（SAS）、Zung氏抑郁自评量表（SDS）]和生活质量（Quality of Life,QOL）的变化。结果护理前,两组SAS、SDS评分和QOL各项评分差异有统计学意义（P〉0．05）;护理后,观察组SAS、SDS评分为（39．52±5．11）和（40．36±4．48）分,显著低于对照组的（43．16±5．30）和（43．44±4．66）分（P〈0．05）;QOL量表中的自理能力、活动能力、社交、心理状态和QOL总分分别为（83．48±4．88）、（61．88±7．18）、（45．96±7．46）、（80．48±5．94）和（266．20±26．50）分,显著高于对照组的（78．72±8．04）、（56．56±7．38）、（39．56±6．79）、（75．52±7．34）和（247．92±29．59）分（P〈0．05）。结论临床护理路径显著能改善老年白内障手术患者的心理健康,提高其生活质量。     

The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh

The present study aims to determine the quality of life (QOL) and general mental health of leprosy patients compared with the general population, and evaluate contributing factors such as socio-economic characteristics and perceived stigma. A total of 189 patients (160 outpatients, 29 inpatients) and 200 controls without leprosy or other chronic diseases were selected from Dhaka district, Bangladesh, using stratified random sampling. A Bangladeshi version of a structured questionnaire including socio-demographic characteristics-the Bangla version of the World Health Organization Quality of Life Assessment BREF (WHOQOL-BREF)-was used to assess QOL; a Self-Reporting Questionnaire (SRQ) was used to evaluate general mental health; the Barthel Index to control activities of daily living (ADL); and the authors' Perceived Stigma Questionnaire was used to assess perceived stigma of patients with leprosy. Medical records were examined to evaluate disability grades and impairment. QOL and general mental health scores of leprosy patients were worse than those of the general population. Multiple regression analysis revealed that factors potentially contributing to the deteriorated QOL of leprosy patients were the presence of perceived stigma, fewer years of education, the presence of deformities, and a lower annual income. Perceived stigma showed the greatest association with adverse QOL. We conclude that there is an urgent need for interventions sensitive to the effects of perceived stigma, gender, and medical conditions to improve the QOL and mental health of Bangladeshi leprosy patients.