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中国农村精神分裂症患者的家庭照料者与预后:14年随访研究

Family caregivers and outcome of people with schizophrenia in rural China: 14-year follow-up study.

作者信息

Ran Mao-Sheng, Chui Cheryl H K, Wong Irene Yin-Ling, Mao Wen-Jun, Lin Fu-Rong, Liu Bo, Chan Cecilia Lai-Wan

机构信息

Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China.

School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2016 Apr;51(4):513-20. doi: 10.1007/s00127-015-1169-0. Epub 2016 Jan 2.

Abstract

OBJECTIVE

This study examined the differences in 14-year outcomes of persons with schizophrenia with and without family caregiver(s) in a rural community in China.

METHODS

All participants with schizophrenia (n = 510) aged 15 years and older were identified in a 1994 epidemiological investigation of 123,572 people and followed up in 2004 and 2008 in Xinjin County, Chengdu, China.

RESULTS

Individuals without family caregiver in 1994 had significantly higher rate of homelessness (23.8 %) and lower rate of survival (47.5 %) in 2008 than those with family caregivers (5.1 and 70.9 %). Compared with individuals with family caregivers, those without family caregivers were more likely to be male, live alone, have fewer family members, lower family economic status, lower rates of marriage and complete remission, higher mean scores on PANSS and lower mean score on GAF in 2008. The predictors of participants without family caregiver in 2008 included having a small number of family members at baseline and being male.

CONCLUSIONS

The absence of a family caregiver is a predictive factor of poorer long-term outcome of persons with schizophrenia in the rural community. The critical role of family caregiving should be incorporated in the planning and delivering of mental health policies and community-based mental health services.

摘要

目的

本研究调查了中国农村社区中有无家庭照顾者的精神分裂症患者14年的预后差异。

方法

1994年对123572人进行流行病学调查,确定了所有年龄在15岁及以上的精神分裂症参与者(n = 510),并于2004年和2008年在中国成都新津县进行随访。

结果

1994年没有家庭照顾者的个体在2008年的无家可归率显著更高(23.8%),生存率更低(47.5%),而有家庭照顾者的个体分别为5.1%和70.9%。与有家庭照顾者的个体相比,没有家庭照顾者的个体在2008年更可能为男性、独居、家庭成员较少、家庭经济状况较低、婚姻率和完全缓解率较低、PANSS平均得分较高、GAF平均得分较低。2008年没有家庭照顾者的参与者的预测因素包括基线时家庭成员数量少和为男性。

结论

缺乏家庭照顾者是农村社区精神分裂症患者长期预后较差的一个预测因素。家庭照顾的关键作用应纳入心理健康政策和社区心理健康服务的规划与提供中。

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