社区老年严重精神障碍患者的自理能力与社会支持现况
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摘要
【目的】了解社区老年严重精神障碍患者的日常生活能力和社会支持现状,为社区照护与卫生服务提供依据。【方法】随机抽取400名社区在册老年严重精神障碍患者,采用日常生活能力量表(ADL)、社会支持评定量表(SSRS)进行现况调查和专题小组讨论。【结果】社区老年严重精神障碍患者ADL筛查发现,功能有明显障碍者为34.25%,性别间无显著差异(P>0.05),年龄和受教育程度间有差异(P<0.01)。共患多种慢性躯体疾病者ADL功能受损增多;社会支持评定总得分为(31.81±3.82)、客观支持得分为(7.10±2.09)、主观支持得分为(16.81±2.74)、支持的利用度得分为(7.84±2.07),低于社区一般老年人群(P<0.01),不同居住状况者社会支持评定得分差异有统计学意义(P<0.01);专题小组讨论印证了上述调查结果。【结论】社区老年精神障碍患者日常生活功能受损严重、社会支持评定结果低,应重视这些脆弱人群的日常生活功能的维护和康复,并提供相应的社会支持。
[Objective] To investigate the status of activity of daily living and social support for the elderly patients with severe mental disorders in community,and to provide the basis for community care and health services. [Methods] A total of 400 elderly patients with serious mental disorders were sampled randomly,and the Activity of Daily Living Scale(ADL) and Social Support Rating Scale(SSRS) were used for status survey and panel discussion. [Results] ADL screening was done of elderly patients with severe mental disorder in community.The number of patients with significant functional impairment was 34.25%.There was no significant difference between sexes(P>0.05).The results of ADL screening with different ages and educational levels were different(P<0.01).People with multiple chronic somatic diseases were found to have more impairment of their daily life function.The total score of social support assessment was(31.81±3.82).Objective support score was(7.10±2.09),the score of subjective support was(16.81±2.74),the score of availability of support was(7.84±2.07),lower than the general elderly in the community(P<0.01).There were significant differences in the scores of social support assessment among the elderly patients with different living conditions(P<0.01).Panel discussion confirmed the findings in this regard. [Conclusion] Elderly patients with mental disorders in the community are seriously impaired in their daily life function and the results of social support evaluation are low.Attention should be paid to the maintenance and rehabilitation of the daily life function for these vulnerable groups,and social support should be provided.
[Objective] To investigate the status of activity of daily living and social support for the elderly patients with severe mental disorders in community,and to provide the basis for community care and health services. [Methods] A total of 400 elderly patients with serious mental disorders were sampled randomly,and the Activity of Daily Living Scale(ADL) and Social Support Rating Scale(SSRS) were used for status survey and panel discussion. [Results] ADL screening was done of elderly patients with severe mental disorder in community.The number of patients with significant functional impairment was 34.25%.There was no significant difference between sexes(P>0.05).The results of ADL screening with different ages and educational levels were different(P<0.01).People with multiple chronic somatic diseases were found to have more impairment of their daily life function.The total score of social support assessment was(31.81±3.82).Objective support score was(7.10±2.09),the score of subjective support was(16.81±2.74),the score of availability of support was(7.84±2.07),lower than the general elderly in the community(P<0.01).There were significant differences in the scores of social support assessment among the elderly patients with different living conditions(P<0.01).Panel discussion confirmed the findings in this regard. [Conclusion] Elderly patients with mental disorders in the community are seriously impaired in their daily life function and the results of social support evaluation are low.Attention should be paid to the maintenance and rehabilitation of the daily life function for these vulnerable groups,and social support should be provided.
引文
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[2]林益强,章晨琦.社区健康促进:技能与实践[M].上海:上海中医药大学出版社,2002:27-31.
[3]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1993:165-167.
[4]肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.
[5]陈芳,刘堃.社区老年人日常活动功能及其影响因素[J].中国老年学杂志,2015,35(16):4662-4664.
[6]尹德挺.国内外老年人日常生活自理能力研究进展[J].中国老年学杂志,2008,28(10):1032-1035.
[7]宋新明,齐铱.新城区老年人慢性病伤对日常生活功能的影响研究[J].人口研究,2000,24(5):45-50.
[8]TENDOLKAR I,RUHRMANN S,BROCKHAUS A,et al.Remembering or knowing:electrophysiological evidence for an episodic memory deficit in schizophrenia[J].Psychol Med,2002,32(7):1261-1271.
[9]周英.精神病患者遭受的社会歧视、感知的病耻感及影响因素的研究[D].广州:南方医科大学,2012.
[10]李磊,施帆帆,张强,等.城市社区老年人社会支持现状及影响因素分析[J].中国卫生事业管理,2014,31(6):412-415,418.
[11]傅伟忠,张明,秦虹云,等.社区综合康复模式对慢性精神分裂症患者疗效评估[J].上海预防医学,2013,25(3):113-116.
[12]张琼婷,沈颉,鞠康,等.上海市长宁区社区精神康复服务资源的现况及建议[J].上海预防医学,2016,28(7):498-501.