School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan.
Eur Arch Psychiatry Clin Neurosci. 2018 Feb;268(1):65-75. doi: 10.1007/s00406-017-0834-6. Epub 2017 Aug 11.
Schizophrenia is a common mental disorder characterized by deficits in multiple domains of functioning. This study is arguably the first of its kind in Taiwan to examine, in a multifaceted and objective manner, the disability of patients with schizophrenia and the factors affecting it. A cross-sectional design was adopted to gather data from 24,299 patients with schizophrenia who were listed in the Taiwan Databank of Persons with Disabilities. The level of disability in these patients was measured using the World Health Organization Disability Assessment Schedule 2.0. Statistical analyses were conducted through the χ statistic and Poisson regression. The highest level of disability was in participation and the lowest was in self-care. An analysis of disability in all six domains of functioning on the basis of sex, age, type of residence, and socioeconomic status (SES) showed significant differences (P < 0.05). Significant factors (P < 0.05) affecting disability in these domains were female gender, age, educational attainment, SES, type of residence, and employment status. The overall degree of disability in schizophrenia patients was moderate. Six domains were measured in this study. The degrees of disability in mobility and self-care were mild while cognition, getting along, life activities, and participation were moderate. Moreover, female gender, an age of 45 or older, low educational attainment, middle to low SES, staying at healthcare institutions, and unemployment were crucial factors affecting disability of the participants. Preventive and rehabilitation programs should be developed to delay disability and functional degeneration in schizophrenic patients with these characteristics.
精神分裂症是一种常见的精神障碍,其特征是多个功能领域存在缺陷。这项研究可以说是台湾首例以多方面和客观的方式,检查精神分裂症患者的残疾及其影响因素的研究。本研究采用横断面设计,从台湾残疾人资料库中收集了 24299 名精神分裂症患者的数据。采用世界卫生组织残疾评估量表 2.0 来衡量这些患者的残疾程度。通过卡方检验和泊松回归进行统计分析。这些患者的残疾程度最高的是参与度,最低的是自我照顾。根据性别、年龄、居住类型和社会经济地位(SES)对所有六个功能领域的残疾程度进行分析,结果显示存在显著差异(P<0.05)。影响这些领域残疾的显著因素(P<0.05)包括女性性别、年龄、受教育程度、SES、居住类型和就业状况。精神分裂症患者的总体残疾程度为中度。本研究共测量了六个领域。在移动和自我护理方面的残疾程度为轻度,而认知、相处、生活活动和参与方面的残疾程度为中度。此外,女性性别、45 岁或以上的年龄、较低的教育程度、中低 SES、居住在医疗机构和失业是影响参与者残疾的关键因素。应该制定预防和康复计划,以延缓具有这些特征的精神分裂症患者的残疾和功能退化。