目的 了解重性精神疾病患者精神卫生服务可及性的现状,为政府提高和改善精神卫生服务可及性工作提供科学依据。方法 采用随机抽样方法,抽取深圳市龙岗区登记在册的重性精神疾病患者750例,进行精神卫生服务可及性的问卷调查,有效问卷717份。结果 调查对象中,84.24%需要相应的精神卫生服务,13.67%能够及时获取精神健康知识;55.84%首次发病能够及时就诊。92.19%认为精神病医院的医疗费用便宜。患者到精神病医院距离中位数为10.3 km;到精神病医院时间中位数为0.9 h。龙岗区内无专业精神病人康复机构,精神科执业医师11人,专职社工166人。结论 龙岗区精神卫生服务可及性有待进一步完善。需要引进和稳定精神疾病防治人才队伍;加大精神卫生投入,积极建设专业精神病人康复机构。
Abstract
Objective To understand the current situation of the accessibility of mental health services for patients with severe mental illness,and to provide scientific basis for the government to improve the accessibility of mental health services. Methods A total of 750 patients with severe mental illness registered in Longgang District of Shenzhen City were selected by random sampling method,and 717 valid questionnaires were conducted. Results Among the respondents,84.24% needed corresponding mental health services,13.67% could obtain mental health knowledge in time,and 55.84% could seek medical treatment for the first time.92.19% thought that the medical cost of psychiatric hospital was cheap.The median distance from patients to psychiatric hospital was 10.3km,and the median time to psychiatric hospital was 0.9h.There are 11 psychiatrists and 166 full-time social workers in Longgang District. Conclusion The accessibility of mental health services in Longgang District needs to be further improved.It is necessary to introduce and stabilize the team of mental disease prevention and treatment personnel,increase the investment in mental health,and actively build rehabilitation institutions for professional mental patients.
关键词
精神卫生服务 /
经济可及性 /
医疗资源可及性 /
精神卫生资源
Key words
Mental health services /
Economic accessibility /
Geographic accessibility /
Mental health resources
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 江慧,肖水源,方菁.精神卫生服务可及性的评价和影响因素[J].中国心理卫生杂志,2017,31(9):665-669.
[2] 王文萍,周成超.中国精神卫生服务体系及服务资源研究进展[J].精神医学杂志,2018,31(5):392-395.
[3] Billy B.Quality improvement in mental health services.[J].Pubmed,2020,44(1).
[4] Davies A,James W,Griffiths L.Implementing a quality improvement programme in a locality mental health service[J].RCN Publishing Company Limited,2020.
[5] Jenny H,Kristine L,Argentzell Elisabeth,Eklund Mona.Predictors of clinically important improvements in occupational and quality of life outcomes among mental health service users after completion and follow-up of a lifestyle intervention: multiple regression modelling based on longitudinal data.[J].Pubmed,2019,7(1).
[6] Hultqvist J,Lund K,Elisabeth Argentzell,Mona Eklund.Predictors of clinically important improvements in occupational and quality of life outcomes among mental health service users after completion and follow-up of a lifestyle intervention: multiple regression modelling based on longitudinal data[J].BioMed Central,2019,7(4).
[7] 王丽华,肖泽萍.精神卫生服务的国际发展趋势及中国探索:专科医院-社区一体化、以复元为目标、重视家庭参与[J].中国卫生资源,2019,22(4):315-320,325.
[8] 中华医学会精神科分会编.CCMD-3中国精神障碍分类与诊断标准[M].济南:山东科学技术出版社,2001.
[9] 国家卫生健康委员会.严重精神障碍管理治疗工作规范(2018年版)[Z].2018-05-28.
[10] 潘润德,潘天伟,黄小明,杨理荣,覃圣民.精神病人生存质量问卷的编制[J].广州医学院学报,2002,(3):22-26.
[11] 何宇,杨小丽.基于德尔菲法的精神卫生服务可及性评价指标体系研究[J].中国全科医学,2018,21(3):322-329.
[12] 封欣蔚.精神卫生服务可及性评估指标体系研究[D].重庆:重庆医科大学,2017.
[13] 校益章.大理州精神卫生服务可及性及其对重性精神疾病患者生存质量影响的研究[D].大理:大理大学,2016.
[14] Lampros Samartzis,Michael A.Talias.Assessing and Improving the Quality in Mental Health Services[J].MDPI,2019,17(1).
[15] Performance Appraisal System: A Pre-Requisite for Continuous Quality Improvement in Health Services[J].Chattagram Maa-O-Shishu Hospital Medical College Journal,2019,18(1).
[16] 校益章,杨跃涛,张迎锋,等.精神卫生服务可及性的相关研究[J].实用预防医学,2016,23(3):382-385.
[17] HUANG Y,WANG Y,WANG H,et al.Prevalence of mental disorders in China: a cross-sectional epidemiological study[J].The Lancet Psychiatry,2019,6(3):211-224.
[18] Samartzis Lampros,Talias Michael A.Assessing and Improving the Quality in Mental Health Services.[J].Pubmed,2019,17(1).
[19] 王勋,闫芳,罗建军,等.社会工作者参与精神卫生服务不同模式的比较研究[J].中国全科医学,2020,23(10):1239-1242.
[20] 张宝霞.国内外社区严重精神障碍患者管理概述[J].中国慢性病预防与控制,2019,27(02):140-143.
[21] 赵光红.云南省农村重性精神病人公共卫生服务利用现状及影响因素研究[D].昆明:昆明医科大学,2018.
[22] 茅蔚.社工介入社区精神卫生防治研究[D].南京:南京师范大学,2015.
[23] 国务院办公厅.全国精神卫生工作规划(2015-2020年)[Z].2015-06-4.
基金
深圳市龙岗区经济与科技发展专项资金医疗卫生科技计划项目(LGKCYLWS2018000018)