稳定期精神分裂症患者生活质量影响因素分析
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摘要
目的 :调查稳定期精神分裂症患者的生活质量,并分析其影响因素。方法 :采用一般情况调查表、生活质量综合评定问卷(GQOLI-74)、阳性和阴性综合征量表(PANSS)、心理弹性量表(CD-RISC)对5家精神病专科医院门诊就诊的455例稳定期精神分裂症患者进行调查和评估。结果 :稳定期精神分裂症患者的生活质量得分为(43.34±7.66)分;CD-RISC得分为(66.19±14.36)分;多元分层回归分析结果显示,婚姻状况、家庭人均月收入、PANSS量表得分、CD-RISC得分是稳定期精神分裂症患者生活质量的影响因素,共解释32.5%的总变异;其中心理弹性可独立解释13.0%的总变异。结论 :稳定期精神分裂症患者的生活质量普遍较差,受到婚姻状况、家庭人均月收入、症状严重程度及心理弹性的影响。鉴于心理弹性可以通过培训和干预来提高,临床工作者应开展提高心理弹性的针对性干预,进而提升精神分裂症患者的生活质量。
Objective: To investigate the quality of life in patients with stable schizophrenia and the impact factors.Methods: 455 outpatients with stable schizophrenia from 5 psychiatric hospitals were surveyed by the general situation questionnaire, Generic Quality of Life Inventory-74(GQOLI-74), Positive and Negative Symptoms Scale(PANSS), and Connor-Davidson Resilience Scale(CD-RISC). Results: The score of GQOLI-74 was(43.34±7.66); the score of CD-RISC was(66.19±14.36). Multivariate stratified regression showed that marital status, family monthly income, PANSS score, and CDRISC score were main influencing factors of quality of life in patients with stable schizophrenia, explaining 32.5% of the total variation. CD-RISC score independently explained 13.0% of the total variation. Conclusion: The quality of life in patients with stable schizophrenia is generally poor, which is affected by marital status, family monthly income, severity of symptoms and psychological resilience. The results highlight the importance of improving psychological resilience to promote the quality of life in patients with schizophrenia.
Objective: To investigate the quality of life in patients with stable schizophrenia and the impact factors.Methods: 455 outpatients with stable schizophrenia from 5 psychiatric hospitals were surveyed by the general situation questionnaire, Generic Quality of Life Inventory-74(GQOLI-74), Positive and Negative Symptoms Scale(PANSS), and Connor-Davidson Resilience Scale(CD-RISC). Results: The score of GQOLI-74 was(43.34±7.66); the score of CD-RISC was(66.19±14.36). Multivariate stratified regression showed that marital status, family monthly income, PANSS score, and CDRISC score were main influencing factors of quality of life in patients with stable schizophrenia, explaining 32.5% of the total variation. CD-RISC score independently explained 13.0% of the total variation. Conclusion: The quality of life in patients with stable schizophrenia is generally poor, which is affected by marital status, family monthly income, severity of symptoms and psychological resilience. The results highlight the importance of improving psychological resilience to promote the quality of life in patients with schizophrenia.
引文
[1]龙逢,陈刚.多巴胺受体基因在精神分裂症中的研究进展.精神医学杂志,2012,25(5):385-389.Long F,Chen G.Research progress of dopamine receptor gene in schizophrenia.Journal of Psychiatry,2012,25(5):385-389.
[2]Lambert M,Karow A,Leucht S,et al.Remission in schizophrenia:validity,frequency,predictors,and patients'perspective 5 years later.Dialogues Clin Neurosci,2010,12(3):393-407.
[3]吴小婷,章新琼,王秋萍,等.癌症患者心理弹性干预的研究进展.中华护理杂志,2017,52(3):316-320.Wu XT,Zhang XQ,Wang QP,et al.Research progress in psychological flexibility intervention for cancer patients.Chinese Journal of Nursing,2017,52(3):316-320.
[4]Min JA,Yoon S,Lee CU,et al.Psychological resilience contributes to low emotional distress in cancer patients.Support Care Cancer,2013,21(9):2469-2476.
[5]Torgalsboen AK.Sustaining full recovery in schizophrenia after 15 years:does resilience matter?.Clin Schizophr Relat Psychoses,2012,5(4):193-200.
[6]C h i u M Y,H o W W,L o W T,e t a l.Operationalization of the SAMHSA model of recovery:a quality of life perspective.Qual Life Res,2010,19(1):1-13.
[7]Johnson J,Gooding PA,Wood AM,et al.Resilience to suicidal ideation in psychosis:positive self-appraisals buffer the impact of hopelessness.Behav Res Ther,2010,48(9):883-889.
[8]中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类).中华精神科杂志,2001,34(3):59-63.Chinese Medical Association Psychiatric Branch.The third edition of the classification and diagnostic criteria for mental disorders in China(classification of mental disorders).Chinese Journal of Psychiatry,2001,34(3):59-63.
[9]Wartelsteiner F,Mizuno Y,Frajo-Apor B,et al.Quality of life in stabilized patients with schizophrenia is mainly associated with resilience and self-esteem.Acta Psychiatr Scand,2016,134(4):360-367.
[10]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版).北京:中国心理卫生杂志社,1999:81-91.Wang XD,Wang XL,Ma H,et al.Handbook of Mental Health Rating Scale(updated version).Beijing:China Mental Health Journal,1999:81-91.
[11]康红,陶建青,梁佳,等.慢性精神分裂症照料者生命质量的调查.中国健康心理学杂志,2017,25(5):652-655.Kang H,Tao JQ,Liang J,et al.Life quality of the family caregivers of chronic schizophrenia patients.Chinese Journal of Health Psychology,2017,25(5):652-655.
[12]谢焱,杨丽,张玲,等.精神分裂症患者婚姻状况与生活质量的关系.临床精神医学杂志,2010,20(1):20-22.Xie Y,Yang L,Zhang L,et al.Relationship between marital status and quality of life in patients with schizophrenia.Journal of Clinical Psychiatry,2010,20(1):20-22.
[13]何燕玲,张明园.阳性和阴性综合征量表(PANSS)及其应用.临床精神医学杂志,1997,7(6):35-37.He YL,Zhang MY.Positive and Negative Syndrome Scale(PANSS)and its application.Journal of Clinical Psychiatry,1997,7(6):35-37.
[14]Yu XN,Zhang JX.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people.Soc Behav Pers,2007,35(1):19-30.
[15]赵成香.恢复期精神分裂症患者护理干预前后效果分析.护理管理杂志,2004,4(10):3-5.Zhao CX.Analysis of the effect of nursing intervention in convalescent patients with schizophrenia.Journal of Nursing Administration,2004,4(10):3-5.
[16]杨雀屏,张国富,李达,等.社区综合康复对精神分裂症总体疗效的影响.中国康复理论与实践,2013,19(9):809-812.Yang QP,Zhang GF,Li D,et al.Effects of community-based rehabilitation on schizophrenia.Chinese Journal of Rehabilitation Theory and Practice,2013,19(9):809-812.
[17]袁勤,陆红英,陶丽,等.个案管理护理模式对精神分裂症患者生活质量的影响.中国护理管理,2015,15(2):182-185.Yuan Q,Lu HY,Tao L,et al.The impact of case management nursing model on the quality of life in schizophrenics.Chinese Nursing Management,2015,15(2):182-185.
[18]陆慧芳,金国英,陈丽丽,等.全程系统干预对康复期精神分裂症患者生活质量及社会功能的影响.护理管理杂志,2014,14(7):506-508.Lu HF,Jin GY,Chen LL,et al.The effects of whole process system intervention on quality of life and social function in convalescence schizophrenia patients.Journal of Nursing Administration,2014,14(7):506-508.
[19]练亚芬,章秋萍,傅丽娟.自我管理技能训练对精神分裂症患者生活质量影响的随访研究.中国慢性病预防与控制,2015,23(2):126-129.Lian YF,Zhang QP,Fu LJ.A follow-up study on the impact of self-management skills training on quality of life in patients with schizophrenia.Chinese Journal of Prevention and Control of Chronic Diseases,2015,23(2):126-129.
[20]刘晓伟,徐清,张明廉,等.长期门诊精神分裂症患者的生活质量研究.中国健康心理学杂志,2014,22(6):832-834.Liu XW,Xu Q,Zhang ML,et al.Quality of life of schizophrenic patients in long-time outpatient service.China Journal of Health Psychology,2014,22(6):832-834.
[21]张爱华.意外创伤者的心理弹性及其发展模型的研究.上海:第二军医大学,2012.Zhang AH.Research on the psychological elasticity of accidental trauma and its development model.Shanghai:Second Military Medical University,2012.
[22]吴逢清,汪秀云.癌症化疗患者心理弹性与生活质量的相关性研究.山西医药杂志,2016,45(17):2013-2015.Wu FQ,Wang XY.Correlation between psychological elasticity and quality of life in cancer chemotherapy patients.Shanxi Medical Journal,2016,45(17):2013-2015.
[23]赵雯雯,张爱华.心理弹性的研究进展及其对癌症患者护理的启示.解放军护理杂志,2015,32(11):33-36.Zhao WW,Zhang AH.Advances in research on resilience and its implications for the care of cancer patients.Nursing Journal of Chinese People's Liberation Army,2015,32(11):33-36.
[24]Mcdonald G,Jackson D,Wilkes L,et al.Personal resilience in nurses and midwives:effects of a work-based educational intervention.Contemp Nurse,2013,45(1):134-143.
[25]Edward K.Chronic illness and wellbeing:using nursing practice to foster resillence as resistance.Br J Nurs,2013,22(13):741-746.
[2]Lambert M,Karow A,Leucht S,et al.Remission in schizophrenia:validity,frequency,predictors,and patients'perspective 5 years later.Dialogues Clin Neurosci,2010,12(3):393-407.
[3]吴小婷,章新琼,王秋萍,等.癌症患者心理弹性干预的研究进展.中华护理杂志,2017,52(3):316-320.Wu XT,Zhang XQ,Wang QP,et al.Research progress in psychological flexibility intervention for cancer patients.Chinese Journal of Nursing,2017,52(3):316-320.
[4]Min JA,Yoon S,Lee CU,et al.Psychological resilience contributes to low emotional distress in cancer patients.Support Care Cancer,2013,21(9):2469-2476.
[5]Torgalsboen AK.Sustaining full recovery in schizophrenia after 15 years:does resilience matter?.Clin Schizophr Relat Psychoses,2012,5(4):193-200.
[6]C h i u M Y,H o W W,L o W T,e t a l.Operationalization of the SAMHSA model of recovery:a quality of life perspective.Qual Life Res,2010,19(1):1-13.
[7]Johnson J,Gooding PA,Wood AM,et al.Resilience to suicidal ideation in psychosis:positive self-appraisals buffer the impact of hopelessness.Behav Res Ther,2010,48(9):883-889.
[8]中华医学会精神病学分会.中国精神障碍分类与诊断标准第三版(精神障碍分类).中华精神科杂志,2001,34(3):59-63.Chinese Medical Association Psychiatric Branch.The third edition of the classification and diagnostic criteria for mental disorders in China(classification of mental disorders).Chinese Journal of Psychiatry,2001,34(3):59-63.
[9]Wartelsteiner F,Mizuno Y,Frajo-Apor B,et al.Quality of life in stabilized patients with schizophrenia is mainly associated with resilience and self-esteem.Acta Psychiatr Scand,2016,134(4):360-367.
[10]汪向东,王希林,马弘,等.心理卫生评定量表手册(增订版).北京:中国心理卫生杂志社,1999:81-91.Wang XD,Wang XL,Ma H,et al.Handbook of Mental Health Rating Scale(updated version).Beijing:China Mental Health Journal,1999:81-91.
[11]康红,陶建青,梁佳,等.慢性精神分裂症照料者生命质量的调查.中国健康心理学杂志,2017,25(5):652-655.Kang H,Tao JQ,Liang J,et al.Life quality of the family caregivers of chronic schizophrenia patients.Chinese Journal of Health Psychology,2017,25(5):652-655.
[12]谢焱,杨丽,张玲,等.精神分裂症患者婚姻状况与生活质量的关系.临床精神医学杂志,2010,20(1):20-22.Xie Y,Yang L,Zhang L,et al.Relationship between marital status and quality of life in patients with schizophrenia.Journal of Clinical Psychiatry,2010,20(1):20-22.
[13]何燕玲,张明园.阳性和阴性综合征量表(PANSS)及其应用.临床精神医学杂志,1997,7(6):35-37.He YL,Zhang MY.Positive and Negative Syndrome Scale(PANSS)and its application.Journal of Clinical Psychiatry,1997,7(6):35-37.
[14]Yu XN,Zhang JX.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people.Soc Behav Pers,2007,35(1):19-30.
[15]赵成香.恢复期精神分裂症患者护理干预前后效果分析.护理管理杂志,2004,4(10):3-5.Zhao CX.Analysis of the effect of nursing intervention in convalescent patients with schizophrenia.Journal of Nursing Administration,2004,4(10):3-5.
[16]杨雀屏,张国富,李达,等.社区综合康复对精神分裂症总体疗效的影响.中国康复理论与实践,2013,19(9):809-812.Yang QP,Zhang GF,Li D,et al.Effects of community-based rehabilitation on schizophrenia.Chinese Journal of Rehabilitation Theory and Practice,2013,19(9):809-812.
[17]袁勤,陆红英,陶丽,等.个案管理护理模式对精神分裂症患者生活质量的影响.中国护理管理,2015,15(2):182-185.Yuan Q,Lu HY,Tao L,et al.The impact of case management nursing model on the quality of life in schizophrenics.Chinese Nursing Management,2015,15(2):182-185.
[18]陆慧芳,金国英,陈丽丽,等.全程系统干预对康复期精神分裂症患者生活质量及社会功能的影响.护理管理杂志,2014,14(7):506-508.Lu HF,Jin GY,Chen LL,et al.The effects of whole process system intervention on quality of life and social function in convalescence schizophrenia patients.Journal of Nursing Administration,2014,14(7):506-508.
[19]练亚芬,章秋萍,傅丽娟.自我管理技能训练对精神分裂症患者生活质量影响的随访研究.中国慢性病预防与控制,2015,23(2):126-129.Lian YF,Zhang QP,Fu LJ.A follow-up study on the impact of self-management skills training on quality of life in patients with schizophrenia.Chinese Journal of Prevention and Control of Chronic Diseases,2015,23(2):126-129.
[20]刘晓伟,徐清,张明廉,等.长期门诊精神分裂症患者的生活质量研究.中国健康心理学杂志,2014,22(6):832-834.Liu XW,Xu Q,Zhang ML,et al.Quality of life of schizophrenic patients in long-time outpatient service.China Journal of Health Psychology,2014,22(6):832-834.
[21]张爱华.意外创伤者的心理弹性及其发展模型的研究.上海:第二军医大学,2012.Zhang AH.Research on the psychological elasticity of accidental trauma and its development model.Shanghai:Second Military Medical University,2012.
[22]吴逢清,汪秀云.癌症化疗患者心理弹性与生活质量的相关性研究.山西医药杂志,2016,45(17):2013-2015.Wu FQ,Wang XY.Correlation between psychological elasticity and quality of life in cancer chemotherapy patients.Shanxi Medical Journal,2016,45(17):2013-2015.
[23]赵雯雯,张爱华.心理弹性的研究进展及其对癌症患者护理的启示.解放军护理杂志,2015,32(11):33-36.Zhao WW,Zhang AH.Advances in research on resilience and its implications for the care of cancer patients.Nursing Journal of Chinese People's Liberation Army,2015,32(11):33-36.
[24]Mcdonald G,Jackson D,Wilkes L,et al.Personal resilience in nurses and midwives:effects of a work-based educational intervention.Contemp Nurse,2013,45(1):134-143.
[25]Edward K.Chronic illness and wellbeing:using nursing practice to foster resillence as resistance.Br J Nurs,2013,22(13):741-746.