北京市某社区15例恢复期精神疾病患者生存压力调查

目的 了解生活在社区的恢复期精神疾病患者在疾病康复过程中的生存压力。方法 2017年8月至2018年1月,选取北京市某社区15例恢复期精神疾病患者,通过半结构式访谈的方式收集资料,以Colaizzi 7步分析法分析资料。结果 得出4个主题:精神疾病症状和药物不良反应等引起的生理性压力;因疾病转归和日常生活角色冲突产生的精神心理性压力;社会歧视、缺乏工作机会和难以获取社会福利资源等带来的社会环境压力;贬低歧视和家庭亲属关系恶化导致的人际交往压力。结论 恢复期精神疾病患者重返家庭和社会后存在明显的生存压力,压力源包括疾病症状、社会歧视、人际关系等多个方面,因此,应注重消除精神疾病患者的自我歧视,完善社会支持与社会福利体系,增加个性化的社区精神康复活动,以减轻患者生存压力,促进其康复。

Qualitative Study on Survival Stressors of 15 Community-dwelling People with Mental Illness

Objective To understand the survival stress of community-dwelling people with mental disorder. Methods Fifteen cases were selected by purposive sampling and received semi-structured individualized interviews.The data were analyzed by Colaizzi framework and themes were extracted. Results Four themes were extracted:physiological stress due to psychiatric symptoms and side effects of drugs;psychological stress due to the outcome of mental illness and to conflict of roles in daily life;social and environmental stress such as social discrimination,lack of job opportunities,and difficulty in obtaining social welfare resources;and interpersonal stress caused by discrimination and deteriorating family relations. Conclusions Community-dwelling people with mental illness have a higher level survival stress after returning to their families and society,with the stressors including symptoms of illness,social discrimination,and interpersonal relationship.Eliminating self-discrimination of the patients,improving social support and social welfare system,and increasing individualized community mental rehabilitation activities may reduce the survival stress of these patients and promote their rehabilitation.