成都市“阳光救助”严重精神障碍患者家庭满意度调查
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摘要
目的调查成都市"阳光救助"严重精神障碍患者家庭对项目实施效果的满意度,为政策改善提供依据。方法从成都市13家阳光救助定点医院出院的严重精神障碍患者中,每家医院抽取15名患者,对其家庭成员进行问卷调查,收集患者基本特征、诊疗特征、接受救助情况及患者家庭对病情控制结局与项目总体的满意度。采用χ~2检验与多因素Logistic回归模型分析满意度相关指标。结果从195个患者家庭中共收回有效问卷178份,回收率91. 3%。家庭对病情控制结局、项目总体满意的比例分别为47. 8%和93. 3%。Logistic回归分析结果示,家庭月收入较高、累计住院次数较少、坚持规律足量服药、当前生活状况评分较高、当年住院自付医疗费较少的患者,其家庭更可能对病情控制结局满意;成都市一二圈层相对于三圈层、诊断为精神分裂症的患者家庭更倾向于对项目总体满意。结论大多数家庭对该救助项目总体满意,后期应结合地域差异分地区推进并聚焦重点疾病类别。为提高病情控制满意度,项目应重点从提高患者服药依从性突破。
Objective To investigate family satisfaction in Chengdu patients with severe mental disorders under"Sunshine Succour"policy,and provide evidences for improving the policy effectiveness. Methods A total of15 patients were sampled from each of 13 specific hospitals under policy in Chengdu,and questionnaire was used to collect patients' basic characteristics,diagnosis and treatment characteristics,receiving assistance and patient's family satisfaction with the disease control outcome and overall project from their families. The Chi-square test and multivariable logistic model were used to analyze those potential related factors. Results Among 178 families with valid questionnaires( 195 investigated families,recovery rate 91. 3%),the proportions of being satisfied with disease control outcome and policy implementation were 47. 8% and 93. 3%, respectively.Logistic analysis suggested that patients with higher family income,less times of hospitalization,more compliance to medicine,better current living conditions,and less self-paid medical fee,seemed more likely to be satisfied with disease control outcome; while patients nearer to Chengdu city and being diagnosed with schizophrenia were inclined to be satisfied with policy implementation.Conclusion The majority of families were satisfied with the policy implementation,while the project could be promoted by focusing on the region difference and key diseases. Furthermore,the project might obtain an obvious breakthrough by improving adherence to medicine among patients,thus improving the family satisfaction with disease control.
Objective To investigate family satisfaction in Chengdu patients with severe mental disorders under"Sunshine Succour"policy,and provide evidences for improving the policy effectiveness. Methods A total of15 patients were sampled from each of 13 specific hospitals under policy in Chengdu,and questionnaire was used to collect patients' basic characteristics,diagnosis and treatment characteristics,receiving assistance and patient's family satisfaction with the disease control outcome and overall project from their families. The Chi-square test and multivariable logistic model were used to analyze those potential related factors. Results Among 178 families with valid questionnaires( 195 investigated families,recovery rate 91. 3%),the proportions of being satisfied with disease control outcome and policy implementation were 47. 8% and 93. 3%, respectively.Logistic analysis suggested that patients with higher family income,less times of hospitalization,more compliance to medicine,better current living conditions,and less self-paid medical fee,seemed more likely to be satisfied with disease control outcome; while patients nearer to Chengdu city and being diagnosed with schizophrenia were inclined to be satisfied with policy implementation.Conclusion The majority of families were satisfied with the policy implementation,while the project could be promoted by focusing on the region difference and key diseases. Furthermore,the project might obtain an obvious breakthrough by improving adherence to medicine among patients,thus improving the family satisfaction with disease control.
引文
[1]冯斯特,刘素珍.国内重性精神疾病患者社区管理现状与对策[J].中华护理杂志,2014,49(6):764-68.
[2]World Health Organization. The global burden of disease:2004 update[J]. Global burden of disease update,2008,13(12):1-146.
[3]成都市卫生局,成都市残疾人联合会,成都市劳动和社会保障局,等.关于联合下发《成都市重性精神疾病患者参加基本医疗保险实施方案》等方案的通知:成卫发[2009]70号[A]. 2009-05-13.
[4]成都市卫生和计划生育委员会,成都市财政局,成都市公安局,等.关于下达2015年严重精神障碍患者阳光救助目标任务的通知:成卫计发[2015]72号[A].2015-07-06.
[5]民政部政策研究中心课题组.中国城乡困难家庭社会政策支持系统建设[M].北京:中国社会出版社,2013.
[6]唐茂芹,邱惠敏,简佳.简明幸福与生活质量满意度问卷在中国精神障碍患者中的信效度[J].中国心理卫生杂志,2010,24(9):680-684.
[7]范云歌,马宁,马弘.重性精神疾病同伴支持服务效果的心理机制探讨[J].中国临床心理学杂志,2016,24(6):1138-1142.
[8]李丽.重性精神病防治:精神卫生法草案难给力[N].中国青年报,2011-11-01(3).
[9]康慧敏,管丽丽,王勋,等.“686项目”31个示范市(州)重性精神疾病患者经济水平及参保和治疗情况分析[J].中国公共卫生,2015,31(8):997-1001.
[10]徐俊芳,于风华,王健.重性精神疾病的住院费用和管理现状的统计分析[J].中国卫生经济,2013,32(10):53-56.
[11]吴晓波,宋立升.住院精神分裂症患者的生活满意度调查[J].上海精神医学,2000,12(3):167-168.
[12]黄建,陈菲,吴小翎,等.老年患者就医体验及服务质量第三方评估研究[J].中国卫生事业管理,2017,34(3):189-191.
[13]成都市卫生和计划生育委员会.关于印发《2017年疾病预防控制工作要点》的通知:成卫计发[2017]48号[A].2017-05-09.
[14]施露露,马小红,刘兰.基于结构方程模型的宁夏地区新农合患者满意度研究[J].中国卫生统计,2017,34(6):947-950.
[15]王海雯,张淑华.情绪劳动策略与工作满意度关系的元分析[J].心理科学进展,2018,26(4):599-613.
[2]World Health Organization. The global burden of disease:2004 update[J]. Global burden of disease update,2008,13(12):1-146.
[3]成都市卫生局,成都市残疾人联合会,成都市劳动和社会保障局,等.关于联合下发《成都市重性精神疾病患者参加基本医疗保险实施方案》等方案的通知:成卫发[2009]70号[A]. 2009-05-13.
[4]成都市卫生和计划生育委员会,成都市财政局,成都市公安局,等.关于下达2015年严重精神障碍患者阳光救助目标任务的通知:成卫计发[2015]72号[A].2015-07-06.
[5]民政部政策研究中心课题组.中国城乡困难家庭社会政策支持系统建设[M].北京:中国社会出版社,2013.
[6]唐茂芹,邱惠敏,简佳.简明幸福与生活质量满意度问卷在中国精神障碍患者中的信效度[J].中国心理卫生杂志,2010,24(9):680-684.
[7]范云歌,马宁,马弘.重性精神疾病同伴支持服务效果的心理机制探讨[J].中国临床心理学杂志,2016,24(6):1138-1142.
[8]李丽.重性精神病防治:精神卫生法草案难给力[N].中国青年报,2011-11-01(3).
[9]康慧敏,管丽丽,王勋,等.“686项目”31个示范市(州)重性精神疾病患者经济水平及参保和治疗情况分析[J].中国公共卫生,2015,31(8):997-1001.
[10]徐俊芳,于风华,王健.重性精神疾病的住院费用和管理现状的统计分析[J].中国卫生经济,2013,32(10):53-56.
[11]吴晓波,宋立升.住院精神分裂症患者的生活满意度调查[J].上海精神医学,2000,12(3):167-168.
[12]黄建,陈菲,吴小翎,等.老年患者就医体验及服务质量第三方评估研究[J].中国卫生事业管理,2017,34(3):189-191.
[13]成都市卫生和计划生育委员会.关于印发《2017年疾病预防控制工作要点》的通知:成卫计发[2017]48号[A].2017-05-09.
[14]施露露,马小红,刘兰.基于结构方程模型的宁夏地区新农合患者满意度研究[J].中国卫生统计,2017,34(6):947-950.
[15]王海雯,张淑华.情绪劳动策略与工作满意度关系的元分析[J].心理科学进展,2018,26(4):599-613.
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