急诊精神分裂症患者亲属照料者自杀意念及相关影响因素(1)
[摘要] 目的 了解急诊精神分裂症患者亲属照料者自杀意念及其相关影响因素，为制订科学的干预措施提供依据。 方法 采用自编的社会人口学问卷调查表、健康状况问卷(SF-36)、社会支持评定量表(SSRS)及自杀意念自评量表(SIOSS)对150名海南省某精神病院急诊精神分裂症患者的亲属照料者的自杀意念进行调查。 结果 急诊精神分裂症患者亲属照料者自杀意念发生率为25.3%(38/150)。不同性别、年龄、婚姻、经济状况、有无慢性病及不同患者病程、有无暴力、住院行为的亲属照料者自杀意念发生率差异均有统计学意义(均P < 0.05)。非条件Logistic回归分析显示，女性、受教育程度高、家庭人均年收入低及患者病程长的亲属照料者自杀意念强(OR=3.736、8.868、83.333、42.754，均P < 0.05)。 结论 急诊精神分裂症患者亲属照料者的自杀意念发生率较高，针对上述自杀意念风险较高的人群，相关政府部门应给予更多的社会关怀及支持，以最大限度预防自杀。
[关键词] 急诊；精神分裂症；亲属照料者；自杀意念
[中图分类号] R749.3 [文献标识码] A [文章编号] 1673-7210(2015)02(b)-0137-04
[Abstract] Objective To assess the suicidal ideation of relative caregivers of emergency patients with schizophrenia and the related influecing factors， in order to provide scientific basis for formulation of scientific intervention measures. Methods 150 relative caregivers of schizophrenia patients treated in Emergency Department of a mental hospital of Hainan Province were selected. The self-made general data questionnaire， short form 36 health survey questionnaire (SF-36)， social support rating scale (SSRS) and self-rating idea of suicide scale (SIOSS) were used to survey the suicidal ideation of relative caregivers. Results 25.3% (38/150) relative caregivers of schizophrenia patients had suicidal ideation. There were significant differences in the rates of suicidal ideation among different sex， ages， marriage status， economy status， suffered chronic disease of the relative caregivers； and the course of disease， previous violence， previous hospitalizations of schizophrenia patients (all P < 0.05). Unconditional Logistic regression analysis showed that female relative caregivers， relative caregivers with higher educational status， lower income of a year in family and lengthy pathogenesis of patients had more suicidal ideation (OR=3.736， 8.868， 83.333， 42.754， all P < 0.05). Conclusion The rate of suicidal ideation in relative caregivers of emergency patients with schizophrenia is high. Aimed at the risk population， related government department should give more social care and support to prevent suicide.
[Key words] Emergency； Schizophrenia； Relative； Suicidal ideation
随着20世纪60年代精神病患者非住院化运动(deinstitutionalization)的开展，大多数精神分裂症患者已回归社区由其亲属照料。全球有2400万～2900万精神分裂症患者[1-2]，因大型精神卫生机构数量急剧减少及社区精神卫生机构未能很好建立，照料者负担仍然是一个全球性的问题[2]。精神分裂症患者亲属作为主要的社区照料者，其在照料患者的漫长过程中所引发的身心健康问题正日益受到精神卫生界的关注。史红[3]研究发现，精神分裂症患者患病后，家属中80.4%出现了紧张、焦虑、恐惧、担忧等各种心理障碍；国外一项针对50名来自印度及马来西亚精神分裂症患者亲属照料者的研究发现，照料者抑郁和焦虑(印度66%比马来西亚40%)、睡眠困难(印度58%比马来西亚34%)发生率较高[4]。精神分裂症患者多次、难以预料的急性病情发作，往往给其亲属照料者带来巨大的精神刺激及反复的心理创伤，甚至触发照料者不堪重负自杀。回顾国内外相关研究文献，鲜有涉及精神分裂症患者亲属照料者有关自杀意念方面的研究。本研究对精神科急诊的精神分裂症患者亲属照料者这一特殊群体的自杀意念进行调查并分析其相关因素，以期为下一步的干预措施提供依据。 (宋名扬等)
[关键词] 急诊；精神分裂症；亲属照料者；自杀意念
[中图分类号] R749.3 [文献标识码] A [文章编号] 1673-7210(2015)02(b)-0137-04
[Abstract] Objective To assess the suicidal ideation of relative caregivers of emergency patients with schizophrenia and the related influecing factors， in order to provide scientific basis for formulation of scientific intervention measures. Methods 150 relative caregivers of schizophrenia patients treated in Emergency Department of a mental hospital of Hainan Province were selected. The self-made general data questionnaire， short form 36 health survey questionnaire (SF-36)， social support rating scale (SSRS) and self-rating idea of suicide scale (SIOSS) were used to survey the suicidal ideation of relative caregivers. Results 25.3% (38/150) relative caregivers of schizophrenia patients had suicidal ideation. There were significant differences in the rates of suicidal ideation among different sex， ages， marriage status， economy status， suffered chronic disease of the relative caregivers； and the course of disease， previous violence， previous hospitalizations of schizophrenia patients (all P < 0.05). Unconditional Logistic regression analysis showed that female relative caregivers， relative caregivers with higher educational status， lower income of a year in family and lengthy pathogenesis of patients had more suicidal ideation (OR=3.736， 8.868， 83.333， 42.754， all P < 0.05). Conclusion The rate of suicidal ideation in relative caregivers of emergency patients with schizophrenia is high. Aimed at the risk population， related government department should give more social care and support to prevent suicide.
[Key words] Emergency； Schizophrenia； Relative； Suicidal ideation
随着20世纪60年代精神病患者非住院化运动(deinstitutionalization)的开展，大多数精神分裂症患者已回归社区由其亲属照料。全球有2400万～2900万精神分裂症患者[1-2]，因大型精神卫生机构数量急剧减少及社区精神卫生机构未能很好建立，照料者负担仍然是一个全球性的问题[2]。精神分裂症患者亲属作为主要的社区照料者，其在照料患者的漫长过程中所引发的身心健康问题正日益受到精神卫生界的关注。史红[3]研究发现，精神分裂症患者患病后，家属中80.4%出现了紧张、焦虑、恐惧、担忧等各种心理障碍；国外一项针对50名来自印度及马来西亚精神分裂症患者亲属照料者的研究发现，照料者抑郁和焦虑(印度66%比马来西亚40%)、睡眠困难(印度58%比马来西亚34%)发生率较高[4]。精神分裂症患者多次、难以预料的急性病情发作，往往给其亲属照料者带来巨大的精神刺激及反复的心理创伤，甚至触发照料者不堪重负自杀。回顾国内外相关研究文献，鲜有涉及精神分裂症患者亲属照料者有关自杀意念方面的研究。本研究对精神科急诊的精神分裂症患者亲属照料者这一特殊群体的自杀意念进行调查并分析其相关因素，以期为下一步的干预措施提供依据。 (宋名扬等)