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经常到基层医疗就诊的青少年:心理社会因素的影响。

Adolescents who are frequent attenders to primary care: contribution of psychosocial factors.

机构信息

Academic Unit of Child and Adolescent Psychiatry, 3rd Floor QEQM Building, Imperial College, St.Mary's Campus, Norfolk Place, London, W2 1PG, UK.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2012 Feb;47(2):323-9. doi: 10.1007/s00127-010-0326-8. Epub 2010 Dec 18.

Abstract

BACKGROUND

Frequent attendance to primary care services has shown an association with psychosocial factors in adult and child populations. Little is known about the psychosocial correlates of attendance in adolescents.

AIMS OF THE STUDY

To study the contribution of psychosocial factors to frequent primary care attendance in a community sample of young British people.

METHOD

The method used was a cross-sectional survey of 1,251 secondary school pupils, using self-report questionnaires for socio-demographic, physical and psychological health data.

RESULTS

A total of 1,116 pupils [mean age 13.51 years (SD 1.5), 52% female] completed questionnaires and provided information about contact with their general practitioner (GP) in the previous year; 30% were frequent attenders (≥4 appointments). Frequent attenders were significantly younger; they were more likely to come from lower socioeconomic backgrounds, report significantly more past and current physical problems, have more hospital visits in the previous year, have more recent intense somatic symptoms made worse by stress and causing impairment, and have more days off school. Frequent attendance was also significantly associated with the presence of emotional symptoms and a history of mental health consultations. Logistic regression analysis identified seeing a hospital doctor, current illness, having days off school, a history of mental health consultations and younger age as independent predictors of frequent attendance.

CONCLUSION

In addition to physical health problems, social factors and psychiatric difficulty are linked to and require attention in young people who are frequent attenders at primary care health services.

摘要

背景

频繁就诊于初级保健服务与成年和儿童人群的心理社会因素有关。关于青少年就诊频率的心理社会相关因素知之甚少。

研究目的

研究在英国青少年的社区样本中,心理社会因素对频繁就诊初级保健的影响。

研究方法

采用横断面调查,对 1251 名中学生使用自我报告问卷收集社会人口学、身体和心理健康数据。

结果

共有 1116 名学生[平均年龄 13.51 岁(SD 1.5),52%为女性]完成了问卷,并提供了他们在过去一年中与全科医生(GP)接触的信息;30%为频繁就诊者(≥4 次就诊)。频繁就诊者显著更年轻;他们更可能来自社会经济地位较低的家庭,报告更多过去和现在的身体问题,在过去一年中更多次去医院就诊,最近有更多因压力而加重并导致身体不适的强烈躯体症状,且有更多天缺课。频繁就诊也与情绪症状的存在和心理健康咨询的历史显著相关。逻辑回归分析确定了看医院医生、当前疾病、缺课、心理健康咨询史和年龄较小是频繁就诊的独立预测因素。

结论

除身体健康问题外,社会因素和精神疾病与经常就诊于初级保健服务的年轻人有关,需要加以关注。

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