本文選題：精神分裂癥 + 病恥感�。� 參考：《山東大學(xué)》2014年碩士論文

【摘要】：目的：分析社會(huì)功能、社會(huì)支持、面子觀、自知力等因素對(duì)住院精神分裂癥患者病恥感的影響,為今后的科研及臨床治療提供指導(dǎo)及依據(jù)。 方法：選取2012年2月～2013年5月在山東省精神衛(wèi)生中心住院符合ICD-10的368例精神分裂癥患者為受試者,在患者入院后完成一般人口學(xué)資料及疾病資料的收集,并采用陽(yáng)性與陰性癥狀量表(Positive and Negative Symptoms Scale, PANSS)、個(gè)人和社會(huì)功能量表(Personal and Social Performance, PSP)評(píng)定其病情嚴(yán)重程度及社會(huì)功能；在治療第8周末采用陽(yáng)性與陰性癥狀量表(Positive and Negative Symptoms Scale, PANSS)、個(gè)人和社會(huì)功能量表(Personal and Social Performance, PSP)、精神疾病患者病恥感評(píng)估量表(Scale of Stigma in People with Mental Illness,SSPMI)、社會(huì)支持評(píng)定量表(Social Science Research Solutions, SSRS)、面子觀量表(Consciousness of Social Face, CSF)、自知力與治療態(tài)度問(wèn)卷(Insight and Treatment Attitudes Questionnairs,ITAQ)評(píng)定患者的病情嚴(yán)重程度、社會(huì)功能、病恥感、社會(huì)支持情況、面子觀、自知力。不合格資料剔除后,采用SPSS18.0統(tǒng)計(jì)軟件對(duì)所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果：1.住院精神分裂癥患者病恥感得分34.63+17.23,病恥感三個(gè)因子(社交因子、個(gè)人能力因子、治療因子)平均得分水平無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。不同婚姻狀況的患者,其病恥感得分的比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),其中已婚同居組病恥感得分低于其他兩組,差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。 2.住院精神分裂癥患者的病恥感總分與客觀社會(huì)支持(P0.05)、主觀社會(huì)支持(P0.01)、對(duì)支持的利用度(P0.05)以及社會(huì)支持總分(P0.01)均呈負(fù)相關(guān)。 3.住院精神分裂癥患者的病恥感總分與怕掉面子(P0.01)、面子觀量表總分(P0.01)呈顯著正相關(guān),與想要面子無(wú)統(tǒng)計(jì)學(xué)意義的相關(guān)(P0.05)。其中怕掉面子得分與病恥感的三個(gè)因子得分均呈顯著正相關(guān)(均P0.01)。 4.住院精神分裂癥患者的病恥感總分與治療前、后PANSS量表總分均呈正相關(guān)(均P0.05),與治療前、后PSP量表總分均呈負(fù)相關(guān)(均P0.05),與自知力量表得分呈正相關(guān)(P0.05)。 5.多元逐步回歸分析顯示：性別、面子觀量表總分、社會(huì)支持總分、治療后PANSS量表總分、治療前后PSP量表差值為住院精神分裂癥患者病恥感主要的影響因素。 結(jié)論：1.住院精神分裂癥患者具有病恥感,其病恥感在社交、個(gè)人能力、治療等方面表現(xiàn)程度突出且相近。 2.婚姻狀況影響患者的病恥感,婚姻狀況不良者病恥感較為嚴(yán)重。 3.社會(huì)支持越多的患者,其病恥感程度越低；愛(ài)面子、怕丟臉的患者,病恥感程度較為嚴(yán)重。 4.治療后的殘留癥狀越嚴(yán)重,可導(dǎo)致患者感受到的病恥感越多,其中陰性癥狀與病恥感的關(guān)系最密切；治療后患者的社會(huì)功能越好,其病恥感越少。 5.患者的自知力越高,越容易產(chǎn)生病恥感。
[Abstract]:Objective: to analyze the influence of social function, social support, face view and insight on the stigma of inpatients with schizophrenia, and to provide guidance and basis for future scientific research and clinical treatment. Methods: 368 schizophrenic patients who were hospitalized in Shandong Mental Health Center from February 2012 to May 2013 were selected as subjects. The general demographic data and disease data were collected after admission. Positive and negative symptoms scale, PANSS scale, personal and Social performance scale (PSPs) were used to evaluate the severity of illness and social function. At the end of the 8th week of treatment, positive and negative and scale, PANSS scale, personal and Social performance, PSPN, scale of sick people in people with Mental illness, Social support scale and Social support Research scale were used. Solutions, SSRSU, face perception scale, consciousness of Social facilitiousness, CSF, Insight and treatment Attitudes questionnaire, CSFI were used to assess the severity of the patients' condition. Social function, ill sense of shame, social support, face view, insight. After disqualified data were eliminated, SPSS 18.0 statistical software was used for statistical analysis of the data. The result is 1: 1. The score of inpatients with schizophrenia was 34.63 17.23, and the average score of three factors (social factor, individual ability factor, treatment factor) had no statistical difference (P 0.05). Patients with different marital status had significant difference in score of stigma (P 0.05), and the score of stigma in married cohabitation group was lower than that in other two groups (P 0.05). The total score of stigma of inpatients with schizophrenia was negatively correlated with objective social support (P0.05), subjective social support (P0.01), utilization of support (P0.05) and total score of social support (P0.01). There was a significant positive correlation between the total score of shame and fear of face and the total score of face view scale (P0.01), and there was no significant correlation between the total score of the inpatients and those who wanted face without statistical significance (P0.05). Among them, the score of fear of face was positively correlated with the score of the three factors of stigma (P 0.01). The total score of the inpatients with schizophrenia was positively correlated with the total scores of PANSS scale before and after treatment (all P 0.05), and negatively correlated with the total scores of PSP scale before and after treatment (all P 0.05, P 0.05 and P 0.05). Multiple stepwise regression analysis showed that gender, total score of face scale, total score of social support, total score of PANSS scale after treatment, difference of PSP scale before and after treatment were the main influencing factors of stigma in inpatients with schizophrenia. Conclusion 1. Inpatients with schizophrenia have a sense of shame, the sense of shame in the social, personal ability, treatment and other aspects of the performance of prominent and similar. 2. Marital status affects the patient's ill sense of shame, poor marital status of the more serious sense of disease. 3. The more social support, the lower the degree of stigma; the more face, afraid of losing face, the more serious the degree of stigma. 4. The more serious the residual symptoms after treatment, the more the patients feel the stigma, among which the negative symptoms are most closely related to the stigma, and the better the social function of the patients after treatment, the less the stigma. The higher the patient's insight, the more likely they are to develop a sense of shame.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R749.3

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