精神分裂症患者的病耻感及其与社会支持的相关性

目的：了解康复期精神分裂症患者病耻感体验现状，考察社会支持与其病耻感的关系。方法采用自制一般情况调查表，Link病耻感量表和社会支持问卷对213名具有自知力的精神分裂症患者进行测试。结果①患者“贬低-歧视感知”维度的平均得分为2.5794分；应对方式中“保密”、“退缩”维度的平均得分为2.5804、2.5103分，但“教育”、“挑战”、“分离”三个维度平均得分都低于量表中点2.5分；在情感体验方面，“误解”和“不同/羞耻”两个维度平均得分都高于量表中点2.5分；②精神分裂症患者社会支持、主观支持、客观支持都与病耻感各个维度呈负相关（均P 〈0.05），患者对社会支持的利用度分别与贬低-歧视感知（r =-0.306，P 〈0.01）、保密（r =-0.259，P〈0.01）、退缩（r=-0.412，P〈0.01）、挑战（r=-0.216，P〈0.01）、误解（r=-0.178，P〈0.05）及不同/羞耻（r=-0.292，P〈0.01）呈负相关。结论精神分裂症患者普遍感知到较高水平的病耻感，认为自己不能被理解，感到与他人不同，通常采取保密、退缩的应对方式；应对精神分裂症患者的病耻感给予充分关注，消除人们对精神分裂症患者的歧视和偏见，提高患者的社会支持利用度，促进患者全面康复。

The correlation analysis between sigma and social support in schizophrenic patients

Objective To explore the perceived stigma and the relationship between the perceived stigma and social support. Methods Total 213 patients with rehabilitation schizophrenia involved in the survey using the Stigma Scale for mental illness, social support rating scale and the self-designed general condition questionnaire. Results ①The mean score of the perceived devaluation-discrimination scale was 2.5794 points. The mean scores of secrecy and flinching was 2.5804, 2.5103 points, but the means of education, challenging and separating were significant lower than the 2.5 mid-point;the means score of stigma-related feelings were significant higher than the 2.5 midpoint.②The perceived stigma was negatively correlated to social support, subjective support and objective support （P〈 0.05）. The utility of support was negatively correlated to devaluation-discrimination （r = -0.306, P〈 0.01）, secrecy （r = -0.259, P〈 0.01）, flinch-ing （r= -0.412, P〈 0.01）, challenging （r=-0.216, P〈0.01）, misunderstand （r= -0.178, P〈 0.05） and difference/shame （r=-0.292, P〈0.01）. Conclusion People with schizophrenia frequently suffer from stigma, and feel that people are unable to understand their situation. The use of secrecy and flinching are the most frequently endorsed way of cop-ing with stigma. The perceived stigma needs our more concerns so as to diminish discrimination and bias against them, enhance their utility of social support and ultimately promote their general rehabilitation.