本文選題：重性精神疾病 + 現(xiàn)狀調(diào)查　； 參考：《寧夏醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的掌握寧夏銀川市居民重性精神疾病的流行特征；了解寧夏銀川市居民首次患精神疾病后的求醫(yī)行為及影響因素；了解寧夏銀川市居民對(duì)精神衛(wèi)生知識(shí)認(rèn)知情況，為政府制定銀川市乃至整個(gè)寧夏重性精神疾病的早期防治政策提供科學(xué)參考依據(jù)，提高居民對(duì)重性精神疾病的正確求醫(yī)行為和精神衛(wèi)生知識(shí)認(rèn)知能力。 方法論文分三部分。 第一部分寧夏銀川市居民重性精神疾病現(xiàn)狀調(diào)查分析 2010年1月1日至2011年12月31日期間，對(duì)寧夏銀川市15歲及以上居民，由經(jīng)過統(tǒng)一培訓(xùn)的醫(yī)務(wù)人員組成的調(diào)查隊(duì)，采用線索調(diào)查和整群調(diào)查相結(jié)合的方法按照村/居委會(huì)、小區(qū)逐個(gè)摸底和排查，所有摸底調(diào)查出的疑似重性精神疾病患者皆經(jīng)寧夏精神衛(wèi)生中心專家確診，確診后的患者填寫問卷調(diào)查表。 第二部分寧夏銀川市重性精神疾病患者首次求醫(yī)行為及影響因素調(diào)查分析 參考1:1匹配的病例對(duì)照研究方法，已確診的銀川市重性精神疾病患者信息在Excel辦公工具中是隨機(jī)順序排列，賦予隨機(jī)數(shù)字表，進(jìn)行單純隨機(jī)抽樣，抽取有求醫(yī)行為組206份，按照性別、年齡范圍在±2歲之間的原則進(jìn)行匹配確定對(duì)照組。 第三部分寧夏銀川市普通居民精神衛(wèi)生知識(shí)認(rèn)知情況調(diào)查分析 采用分層隨機(jī)抽樣，，首先按全市三個(gè)行政區(qū)分層，使用隨機(jī)數(shù)字表,在每一層各抽1個(gè)街道。再在抽中的街道各抽取2個(gè)社區(qū)居民委員會(huì)，最終確定6個(gè)社區(qū)居民委員會(huì)。然后從社區(qū)所有有人居住的戶中按系統(tǒng)抽樣方式隨機(jī)抽取目標(biāo)戶,從抽中的每戶中用隨機(jī)數(shù)字表抽取60人作為調(diào)查對(duì)象并填寫問卷調(diào)查表。 結(jié)果第一部分2010年1月1日至2011年12月31日在寧夏銀川市15歲及以上居民進(jìn)行了重性精神疾病患者徹底的摸底和排查，共排查重性精神疾病患者3104例，患病率1.56‰，其中以精神分裂癥為主，有2362例，患病率為1.19‰，寧夏銀川市居民不同年齡階段重性精神疾病患病率差異有統(tǒng)計(jì)學(xué)意義（χ~2=522.581P=0.0000.05），經(jīng)標(biāo)化，重性精神疾病患者以40～年齡段多見，患病率0.56‰，其次以30～年齡段，患病率0.47‰，不同民族重性精神疾病患病率差異有統(tǒng)計(jì)學(xué)意義（χ~2=32.232P=0.000＜0.05），經(jīng)標(biāo)化，精神分裂癥患者漢族患病率高于回族，不同地區(qū)居民重性精神疾病患病率差異有統(tǒng)計(jì)學(xué)意義（χ~2=49.337P=0.000＜0.05），經(jīng)標(biāo)化，興慶區(qū)患病率高于其他地區(qū)患病率，重性精神疾病城市患病率與農(nóng)村患病率差異有統(tǒng)計(jì)學(xué)意義（χ~2=241.501P=0.000＜0.05）， 第二部分寧夏銀川市重性精神疾病患者患病以后，首次選擇求醫(yī)行為以非�？漆t(yī)院為主，占76%，精神�？普�15.5%，迷信、巫醫(yī)占8.5%。經(jīng)卡方檢驗(yàn)，影響患者首次選擇不同求醫(yī)行為與民族（χ~2=14.068P=0.001＜0.05）、婚姻狀況（χ~2=18.901P=0.006＜0.05）、監(jiān)護(hù)人對(duì)精神衛(wèi)生知識(shí)的了解（χ~2=15.304P=0.005＜0.05）及對(duì)精神科就診的忌諱（χ~2=18.308P=0.00＜0.05）差異有統(tǒng)計(jì)學(xué)意義。經(jīng)卡方檢驗(yàn)，影響患者首次得病后有無求醫(yī)行為因素與民族（χ~2=38.474P=0.00＜0.05）、文化程度（χ~2=10.176P=0.038＜0.05）、職業(yè)（χ~2=133.711P=0.00＜0.05）、經(jīng)濟(jì)狀況（χ~2=77.079P=0.00＜0.05）、發(fā)病形式（χ~2=14.234P=0.001＜0.05）、醫(yī)療機(jī)構(gòu)離家距離（χ~2=161.956P=0.00＜0.05）、監(jiān)護(hù)人的文化程度（χ~2=15.355P=0.004＜0.05）、對(duì)患者疾病的判斷（χ~2=19.834P=0.00＜0.05）、對(duì)精神疾病知識(shí)的了解（χ~2=12.601P=0.002＜0.05）、求醫(yī)習(xí)慣（χ~2=9.030P=0.011＜0.05）差異有統(tǒng)計(jì)學(xué)意義。經(jīng)條件Logistic回歸進(jìn)一步分析證明民族、經(jīng)濟(jì)情況、發(fā)病形式、監(jiān)護(hù)人對(duì)精神疾病知識(shí)的了解及醫(yī)療機(jī)構(gòu)離家的距離對(duì)患者是否有求醫(yī)行為有影響。 第三部分寧夏銀川市普通居民的精神衛(wèi)生知識(shí)知曉率為52.5%，普通居民性別（χ~2=42.164P=0.000＜0.05）、年齡（χ~2=42.935P=0.000＜0.05）、文化程度（χ~2=37.194P=0.000＜0.05）、職業(yè)（χ~2=41.268P=0.000＜0.05）及在銀川居住時(shí)間（χ~2=19.221P=0.000＜0.05）對(duì)精神衛(wèi)生知識(shí)認(rèn)知情況在統(tǒng)計(jì)學(xué)上有顯著性差異，通過問卷應(yīng)答正確分布，提示普通市民是否知道每年的“世界精神衛(wèi)生日”是正確應(yīng)答率最低，為10%。其次對(duì)“精神病”和“神經(jīng)病”是一樣的疾病嗎，正確應(yīng)答率為15%。對(duì)正確應(yīng)答率低于50%的精神衛(wèi)生知識(shí)，是今后宣傳精神衛(wèi)生知識(shí)的重點(diǎn)。 結(jié)論1精神分裂癥是今后疾病防治的重點(diǎn)病種，漢族及40～年齡段的精神疾病患者是宣傳和預(yù)防的重點(diǎn)特征人群，興慶區(qū)是寧夏銀川市防治精神疾病的重點(diǎn)區(qū)域。 2我們要對(duì)影響患者選擇求醫(yī)行為及其有無求醫(yī)行為的因素通過不同的途徑進(jìn)行干預(yù)，以提高寧夏銀川市重性精神疾病患者及監(jiān)護(hù)人早期就醫(yī)、糾正其求醫(yī)行為，減輕患者及其家庭、社會(huì)的疾病負(fù)擔(dān)。 3在今后的精神衛(wèi)生知識(shí)宣傳工作中,宣要注重60～年齡段、非正式上過學(xué)及無業(yè)的重點(diǎn)特征人群,要以普通群眾為陣營,深入社區(qū)、深入貧困家庭,拓寬宣傳途徑,使市民更直接獲取知識(shí),提高防范意識(shí)，為市民及早求醫(yī)和選擇合理求醫(yī)行為提供科學(xué)指導(dǎo)。
[Abstract]:Objective to understand the epidemiological characteristics of heavy mental illness in Yinchuan, Ningxia, and to understand the behavior and influencing factors of the first mental illness in Yinchuan, Ningxia, and to understand the knowledge of mental health knowledge in Yinchuan, Ningxia, and to formulate the early prevention and control policy for the government of Yinchuan city and even the whole of Ningxia. It provides scientific reference basis for improving residents' correct medical treatment behavior and mental health knowledge and cognition ability for severe mental illness.
Methods the paper is divided into three parts.
Part one survey and analysis of severe mental illness among residents in Yinchuan, Ningxia
During the period from January 1, 2010 to December 31, 2011, a survey team of 15 years old and above in Yinchuan, Ningxia, which was composed of medical personnel trained by unified training, used the method of clue investigation and cluster investigation in accordance with the village / neighborhood committee. Experts from the mental health center of the Xia Dynasty confirmed that the patients were filled in the questionnaire after diagnosis.
The second part is the investigation and analysis of the first medical seeking behavior and its influencing factors of patients with severe mental illness in Yinchuan, Ningxia.
Referring to the case-control study method matched with 1:1, the information of patients with severe mental illness in Yinchuan was arranged in random order in Excel office tools. Random numbers were given, random sampling was carried out, 206 medical treatment groups were selected, and the control group was matched according to the principle of gender and age range of 2 years.
The third part is the survey and analysis of mental health knowledge of ordinary residents in Yinchuan, Ningxia.
By stratified random sampling, we first stratified the three administrative districts in the city, used random digital tables, pumped 1 streets at each floor, and then selected 2 community residents' committees in the streets in which they were drawn. Finally, 6 community residents' committees were determined. In each household, a random number table was used to extract 60 people as the subjects and fill out the questionnaire.
Results in the first part of the first part from January 1, 2010 to December 31, 2011, people aged 15 and above in Yinchuan, Ningxia, carried out a thorough investigation and investigation of the patients with severe mental illness. 3104 cases of severe mental illness were investigated, the prevalence rate was 1.56 per thousand. Among them, schizophrenia was dominated by 2362 cases, the prevalence rate was 1.19 per thousand, and the residents in Yinchuan of Ningxia were in different years. The prevalence rate of severe mental illness in the age stage was statistically significant (x ~2=522.581P=0.0000.05). The prevalence rate of severe mental disease was 40 to age, the prevalence rate was 0.56 per thousand, followed by 30 ~ age, and the prevalence rate was 0.47 per thousand. The difference of the prevalence rate of different ethnic heavy mental diseases was statistically significant (x ~2=32.232P=0.000 < 0.05). The prevalence rate of Han nationality in schizophrenic patients was higher than that of Hui nationality, and the prevalence rate of heavy mental illness in different areas was statistically significant (x ~2=49.337P=0.000 < 0.05). The prevalence rate of Xingqing region was higher than that of other regions, and the difference between the urban prevalence rate and the rural prevalence rate was statistically significant (~2=241.501P=0.0 00 < 0.05),
The second part of the patients with severe mental illness in Yinchuan, Ningxia, was the first choice to seek medical treatment for the first time in non specialist hospitals, accounting for 76%, psychiatric specialist accounted for 15.5%, superstition, and witch doctors accounted for 8.5%. by chi square test, affecting the first choice of different medical seeking behavior and nationality (chi ~2= 14.068P=0.001 < 0.05) and marital status (x ~2=18.901P=0.006 < 0.05). The guardian's knowledge of mental health (chi ~2=15.304P=0.005 < 0.05) and the taboo of the psychiatric consultation (x ~2=18.308P=0.00 < 0.05) were statistically significant. After the chi square test, there were no medical behavior factors and ethnic groups (chi ~2=38.474P=0.00 < 0.05), cultural degree (x ~2=10.176P=0.038 < 0.05), occupation (chi Square), occupation (chi square). ~2=133.711P=0.00 < 0.05), the economic condition (x ~2=77.079P=0.00 < 0.05), the form of the disease (x ~2=14.234P=0.001 < 0.05), the distance from the medical institution (x ~2=161.956P=0.00 < 0.05), the educational level of the guardian (x ~2=15.355P=0.004 < 0.05), the judgement of the patient's disease (x ~2=19.834P=0.00 < 0.05), and the knowledge of mental illness (x ~2=12.6) 01P=0.002 < 0.05), the difference in the habit of seeking medical treatment (x ~2=9.030P=0.011 < 0.05) was statistically significant. Further analysis of the conditional Logistic regression showed that the nation, the economic situation, the form of the disease, the knowledge of the mental illness and the distance from the medical institution left home had an influence on the patient's behavior of seeking medical treatment.
In the third part, the awareness rate of mental health knowledge for ordinary residents in Yinchuan, Ningxia, was 52.5%, gender (chi ~2=42.164P=0.000 < 0.05), age (x ~2=42.935P=0.000 < 0.05), educational level (x ~2=37.194P=0.000 < 0.05), occupation (x ~2=41.268P=0.000 < 0.05) and Yinchuan residence time (x ~2=19.221P=0.000 < 0.05) on mental health There is a significant difference in knowledge cognition. Through the correct distribution of questionnaire response, it is suggested that ordinary citizens know that the annual "World Mental Health Day" is the lowest correct response rate. Is 10%. the same disease as "psychosis" and "neuropathy", and the correct response rate is lower than 50% of the correct response rate of 15%.. Mental health knowledge is the focus of mental health knowledge in the future.
Conclusion 1 schizophrenia is the focus of disease prevention and treatment in the future. The Han and 40 age group of mental diseases are the key characteristics of propaganda and prevention, and Xingqing is the key area for the prevention and treatment of mental diseases in Yinchuan, Ningxia.
2 we should interfere with the factors affecting patients' choice of seeking medical treatment and the behavior of seeking medical treatment through different ways to improve the early medical treatment of the patients and the guardians in Yinchuan, Ningxia, to correct their medical seeking behavior, and to reduce the burden of the patients and their families and the social disease.
3 in the propaganda work of mental health knowledge in the future, we should pay attention to 60 years of age, informal learning and the key characteristics of non industry. We should take the common people as the camp, go deep into the community, go deep into the poor families, broaden the way of publicity, make the public get more direct knowledge, improve the awareness of prevention, and seek medical advice and seek medical advice for the public early. To provide scientific guidance.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 方向;熊端華;陳旭先;施光

本文編號(hào)：2007346