从严重精神疾病中康复:社区环境中个人和社会心理因素的影响》。

Jie Fu, Jianwen Zhu, Jiajia Dong, Yang Wang, Sizhe Wang, Xia Zhang, Lu Wen, Hong Fan
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摘要

严重精神疾病(SMI)是一项重大的公共卫生挑战,给个人、经济和社会带来沉重负担。尽管在治疗方面取得了进步,但 SMI 患者的康复效果仍然参差不齐。本研究旨在调查社区卫生环境中个人和社会心理因素对 SMI 患者康复的影响。这项横断面研究在中国南京的 23 个社区卫生服务中心进行。我们采用随机抽样的方法,招募了924名确诊为SMI的参与者。通过多元线性回归分析了个体因素、社会心理因素与患者康复状况之间的关系。通过自引导的 Sobel 检验进一步检验了服药依从性的中介效应。924名SMI患者的晨兴康复状况量表(MRSS)平均得分为(49.82±41.52)分。影响康复状况的主要个人因素是年龄、婚姻状况、教育程度、平均年收入和病程。被家人接受的患者往往有更好的康复结果,而耻辱感和社会障碍可能会阻碍康复。用药依从性在社会心理因素和康复状况之间起着中介作用。这项研究强调了社会心理因素在 SMI 患者的治疗和康复中的关键作用。此外,坚持服药也是一个中介因素。实施有针对性的干预措施和政策,消除已识别的社会心理障碍,可为改善社区环境中 SMI 患者的康复结果提供有希望的途径。
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Recovery From Severe Mental Illnesses: The Influence of Personal and Psychosocial Factors in Community Settings.

Severe mental illnesses (SMIs) represent a significant public health challenge with substantial personal, economic and societal burdens. Despite treatment advances, recovery outcomes for SMI patients remain variable. This study aimed to investigate the influence of personal and psychosocial factors on recovery among SMI patients in community health settings. This cross-sectional study was conducted in 23 community health service centres in Nanjing, China. We recruited 924 participants diagnosed with SMIs, using a random sampling method. The relationships between individual, psychosocial factors and patients' recovery status were analysed by multiple linear regression. The mediation effect of medication adherence was further tested by the Sobel test with bootstrapping. The mean score of the Morningside Rehabilitation Status Scale (MRSS) of 924 patients with SMIs was 49.82 ± 41.52. The main influencing personal factors of recovery status were age, marital status, education, average annual income and duration of illness. Patients who were accepted by their families tended to have better recovery outcomes, while stigma and social impairment may hinder recovery. Medication adherence played a mediating role between psychosocial factors and recovery status. This study highlights the crucial role of psychosocial factors in the treatment and recovery of SMI patients. Furthermore, medication adherence emerged as a mediating factor. Implementing targeted interventions and policies addressing identified psychosocial barriers can offer promising avenues for improving recovery outcomes for SMI patients in community settings.

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