摘要
目的了解社区发病期精神分裂症患者暴力行为的流行特征和影响因素,为社区与家庭护理和康复提供针对性指导.方法以方便取样法抽取2018年3-7月湛江地区某2家专科医院和某综合医院精神科新入院的精神分裂症患者235例为调查对象,采用自编问卷对主要照顾者面对面调查患者的一般情况、患者因素、患者家庭因素和暴力行为.分析患者因素和患者家庭因素对暴力行为的影响.问卷填写规范、完整的患者226例.结果226例患者入院前1周发生暴力行为共161例(71.24%),其中发生一般攻击行为129例(57.08%)、发生危险暴力行为32例(14.16%),65例(28.76%)未发生暴力行为.有序Logistic回归分析显示,患者因素中患者病前存在品行障碍、既往存在语言攻击、既往存在打砸毁坏财物、既往存在针对他人人身攻击、以及情绪易波动、暴力行为前受到语言刺激或周围人行为/动作刺激是患者暴力行为的危险因素(P<0.05);和谐、融洽的家庭关系和主要监护人医嘱执行力度到位是患者暴力行为的保护因素(P<0.05).结论既往存在语言攻击、打砸毁坏财物、或针对他人人身攻击、病前存在品行障碍的患者应作为社区及家庭护理的重点关注对象.营造和谐的家庭及社区康复环境应是家庭和社区护理精神分裂症患者的重要内容.应加强患者、主要照顾者和社区的精神疾病相关知识健康教育.
Objective To investigate the prevalence,characteristics and influencing factors of violent behaviors in patients with schizophrenia during the onset stage of the disease in the community,and to provide targeted guidance for community and family when delivering care and rehabilitation for the patients.Methods From March to July in 2018,a total of 235 newly admitted schizophrenic patients in two specialized hospitals and one general hospital in Zhanjiang city were selected by convenience sampling.By the use of the self-designed questionnaire,the main caregivers were investigated directly about the patients'general information,patients factors,family factors and violent behaviors.The influences of the patients factors and family factors on the violent behaviors were analyzed.A total of 226 properly filled questionnaires were retrieved.Results Among the 226 patients,a total o￡161 cases(71.24%)committed violence one week before admission in which 129 cases(57.08%)were general attack,and 32 cases(14.16%)were dangerous violence,65 patients(28.76%)did not committed any violent behaviors.Ordinal Logistic regression analysis showed that the risk factors of the violence were the presence of conduct disorder before illness,previous verbal attacks,destruction of property,or personal attacks against others,as well as emotional vulnerability,verbal stimulation or behavior/action stimulation from surrounding environments(P<0.05).Harmonious family relations and the main Guardians'good execution of doctors*advice were the protective factors(P<0.05).Conclusions Patients who have previously had verbal attacks,property damage,physical attacks against others,and who have behavioral disorders before illness should be the focus of community and family care.Creating a harmonious family and rehabilitation environment in community should be an important part of family and community care for schizophrenic patients.Health education of mental illness for patients,primary caregivers and community should be strengthened.
作者
杨琼花
易海
杜育如
何娜
Yang Qionghua;Yi Hai;Du Yuru;He Na(Social Defense Division,the Third People's Hospital of Zhanjiang City,Guangdong Province,Zhanjiang 524000,China;Clinical DepartmentⅡ,the Third People's Hospital of Zhanjiang City,Guangdong Province,Zhanjiang 524000,China)
出处
《中华现代护理杂志》
2019年第16期2029-2035,共7页
Chinese Journal of Modern Nursing
基金
湛江市科技局非资助项目(2018B01056).
