重性精神障碍女性住院患者保护性约束现状及影响因素调查
|
摘要
目的:探讨重性精神障碍女性住院患者保护性约束现状,并对影响因素进行调查。方法:回顾性分析2015年1月~2017年7月我院收治的女性重性精神障碍患者846例,统计保护性约束例数,并调查保护性约束患者年龄、病程、既往约束经历等;使用SPSS18.0进行单因素分析,logistics回归分析法进行多因素分析。结果:保护性约束患者415例,占比49.05%;保护性约束患者约束平均次数为(3.28±1.14)次,每次约束平均时间(8.62±2.31)h;经单因素分析发现,年龄≤35岁、病程≤5年、精神分裂症、复发次数≤2次、内向、有既往约束经历、有攻击行为、有出走行为、有消极言行及治疗依从性差患者实施保护性约束构成比显著高于年龄>35岁、病程>5年、双相障碍、分裂情感性障碍、其他疾病、复发次数>2次、外向、无既往约束经历、无攻击行为、无出走行为、无消极言行及治疗依从性优患者(P<0.05);多因素分析显示,影响保护性约束因素中由大至小依次为有攻击行为(OR=11.864)、有出走行为(OR=10.214)、有既往约束经历(OR=9.814)、治疗依从性差(OR=8.025)、精神分裂症(OR=7.033)、有消极言行(OR=6.816)、病程≤5年(OR=6.624)、年龄≤35岁(OR=4.258)、复发次数≤2次(OR=1.012)。结论:重性精神障碍女性住院患者保护性约束比例较高,约束时间长,有攻击行为、有出走行为、有既往约束经历、治疗依从性差、精神分裂症、有消极言行患者是保护性约束实施的独立危险因素。
Objective: To explore the investigation on the present situation and influencing factors of protective restraint of female in patients with severe mental disorders. Methods: To analyze retrospectively 846 cases of female patients with severe mental disorders admitted to our hospital from January 2015 to July 2017,statistical protective constraint cases,and investigate the age,course of disease,past constraint experience of the patients with protective restraint,using SPSS18. 0 to carry out single factor analysis,logistics regression analysis method for multiple-factor analysis. Results: The 415 patients of protective restraint were 49. 05%,and the average number of restraint was( 3. 28 ± 1. 14),the average time of each restraint was( 8. 62 ± 2. 31) h; by single factor analysis,it was found that constituent ratio of patients in age ≤ 35 years old,the disease course ≤ 5 years,schizophrenia,relapse ≤ 2 times,introversion,have past restraint experience,have the aggressive behavior,has the run-away behavior,has the negative words and behavior and the poor treatment compliance to carry on the protective restraint was obviously higher than the patients in age > 35 years old,course of disease > 5 years,bipolar disorder,schizo-affective psychosis,other diseases,relapse > 2 times,extroversion,no past restraint experience,no aggression,no run-away behavior,no negative words and behavior and excellent treatment compliance( P < 0. 05); multiple-factor analysis showed that the factors that affect the protective restraint were aggressive behavior( OR = 11. 864),runaway behavior( OR = 10. 214),past restraint experience( OR = 9. 814),poor treatment compliance( OR = 8. 025),Schizophrenia( OR = 7. 033),negative words and behavior( OR = 6. 816),and the disease course ≤ 5 years( OR = 6. 624),age ≤ 35 years old( OR = 4. 258),relapse ≤ 2 times( OR = 1. 012) in descending order. Conclusion: Female patients with severe mental disorders had higher protective restraint ratio,long restriction time,aggressive behavior,runaway behavior,past restraint experience,poor treatment compliance,schizophrenia,and negative words and behavior were independent risk factors for the implementation of protective restraint.
Objective: To explore the investigation on the present situation and influencing factors of protective restraint of female in patients with severe mental disorders. Methods: To analyze retrospectively 846 cases of female patients with severe mental disorders admitted to our hospital from January 2015 to July 2017,statistical protective constraint cases,and investigate the age,course of disease,past constraint experience of the patients with protective restraint,using SPSS18. 0 to carry out single factor analysis,logistics regression analysis method for multiple-factor analysis. Results: The 415 patients of protective restraint were 49. 05%,and the average number of restraint was( 3. 28 ± 1. 14),the average time of each restraint was( 8. 62 ± 2. 31) h; by single factor analysis,it was found that constituent ratio of patients in age ≤ 35 years old,the disease course ≤ 5 years,schizophrenia,relapse ≤ 2 times,introversion,have past restraint experience,have the aggressive behavior,has the run-away behavior,has the negative words and behavior and the poor treatment compliance to carry on the protective restraint was obviously higher than the patients in age > 35 years old,course of disease > 5 years,bipolar disorder,schizo-affective psychosis,other diseases,relapse > 2 times,extroversion,no past restraint experience,no aggression,no run-away behavior,no negative words and behavior and excellent treatment compliance( P < 0. 05); multiple-factor analysis showed that the factors that affect the protective restraint were aggressive behavior( OR = 11. 864),runaway behavior( OR = 10. 214),past restraint experience( OR = 9. 814),poor treatment compliance( OR = 8. 025),Schizophrenia( OR = 7. 033),negative words and behavior( OR = 6. 816),and the disease course ≤ 5 years( OR = 6. 624),age ≤ 35 years old( OR = 4. 258),relapse ≤ 2 times( OR = 1. 012) in descending order. Conclusion: Female patients with severe mental disorders had higher protective restraint ratio,long restriction time,aggressive behavior,runaway behavior,past restraint experience,poor treatment compliance,schizophrenia,and negative words and behavior were independent risk factors for the implementation of protective restraint.
引文
[1]苏雅芳,陈爱学,江爱玉,等.重性精神障碍患者家属心理健康状况分析[J].中国预防医学杂志,2015,16(5):355-359.
[2]严芳,职彦敏,王剑英,等.人体约束衣的设计及在精神障碍患者中的应用[J].中华护理杂志,2017,52(1):111-114.
[3]胡景荣,宗艳红,孙秀丽,等.精神卫生法实施前后男性住院患者保护性约束使用情况对照分析[J].精神医学杂志,2014,27(3):222-224.
[4]艾伯,王彩霞,柴森,等.住院精神疾病患者保护性约束存在的缺陷及对策[J].国际精神病学杂志,2015,42(2):41-44.
[5]褚丽红,陈文琪,洪善娟,等.200例首发精神分裂症患者家属对保护性约束的认知及态度调查分析[J].实用临床医药杂志,2014,18(4):51-53.
[6]艾伯,王彩霞,柴森,等.住院精神疾病患者保护性约束存在的缺陷及对策[J].国际精神病学杂志,2015,42(2):41-44.
[7]陈兆红,张燕红,宗薇,等.优化保护性约束流程对精神分裂症患者约束率的影响[J].中华现代护理杂志,2014,20(33):4225-4227.
[8]王西建,焦宁波,亢晓燕,等.社区医生督导对重性精神障碍患者服药依从性和疗效的影响[J].国际精神病学杂志,2017,44(3):450-453.
[9]Nguyen TT,Tran TD,Tran T,et al.Postpartum change in common mental disorders among rural Vietnamese women:incidence,recovery and risk and protective factors[J].Br J Psychiatry,2015,206(2):110-115.
[2]严芳,职彦敏,王剑英,等.人体约束衣的设计及在精神障碍患者中的应用[J].中华护理杂志,2017,52(1):111-114.
[3]胡景荣,宗艳红,孙秀丽,等.精神卫生法实施前后男性住院患者保护性约束使用情况对照分析[J].精神医学杂志,2014,27(3):222-224.
[4]艾伯,王彩霞,柴森,等.住院精神疾病患者保护性约束存在的缺陷及对策[J].国际精神病学杂志,2015,42(2):41-44.
[5]褚丽红,陈文琪,洪善娟,等.200例首发精神分裂症患者家属对保护性约束的认知及态度调查分析[J].实用临床医药杂志,2014,18(4):51-53.
[6]艾伯,王彩霞,柴森,等.住院精神疾病患者保护性约束存在的缺陷及对策[J].国际精神病学杂志,2015,42(2):41-44.
[7]陈兆红,张燕红,宗薇,等.优化保护性约束流程对精神分裂症患者约束率的影响[J].中华现代护理杂志,2014,20(33):4225-4227.
[8]王西建,焦宁波,亢晓燕,等.社区医生督导对重性精神障碍患者服药依从性和疗效的影响[J].国际精神病学杂志,2017,44(3):450-453.
[9]Nguyen TT,Tran TD,Tran T,et al.Postpartum change in common mental disorders among rural Vietnamese women:incidence,recovery and risk and protective factors[J].Br J Psychiatry,2015,206(2):110-115.