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中国大陆患者及照料者对精神疾病的认知与信念:一项系统综述

Patients' and caregivers' knowledge and beliefs about mental illness in mainland China: A systematic review.

作者信息

Li Wenjing, Reavley Nicola

机构信息

Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia.

出版信息

Asia Pac Psychiatry. 2021 Jun;13(2):e12423. doi: 10.1111/appy.12423. Epub 2020 Sep 16.

Abstract

This review aimed to systematically investigate patients' and caregivers' knowledge and beliefs about mental illness in mainland China. A total of 48 eligible studies (N = 11 895) were retrieved from eight electronic databases. Prevalence statistics were computed for themes (eg, stress) under each construct relating to knowledge or belief about mental illness (eg, beliefs about causes). Effect size r was calculated for each correlation with an identified construct. We found that only 27.8% of patients recognized the symptoms of schizophrenia. Although 65% of caregivers declared that they knew the names of the disorders that their ill relatives had, depression (43.6%), schizophrenia (28.5%) and anxiety disorders (18.1%) had low recognition rates. Both caregivers and patients preferred psychosocial explanations of mental illness. Pharmacological interventions (eg, antipsychotics), non-specific actives (eg, "getting out and learning more"), mental health professionals (eg, psychiatrists) and informal support (eg, family) were each considered helpful for different disorders by caregivers, whereas regular contact with mental health professionals was not highly rated as helpful by patients. Additionally, while more patients knew about the effects of the medications that they were taking, more caregivers emphasized the importance of medicine adherence. Psychosocial variables (eg, family burden) demonstrated significant effects on both groups' mental health literacy. The government should invest more in supporting caregivers of people with mental disorders and monitor the implementation of mental health policies.

摘要

本综述旨在系统调查中国大陆患者及其照料者对精神疾病的认知和信念。从八个电子数据库中检索到48项符合条件的研究(N = 11895)。计算了与精神疾病知识或信念相关的每个结构(如关于病因的信念)下各主题(如压力)的患病率统计数据。计算了与已识别结构的每个相关性的效应量r。我们发现,只有27.8%的患者认识到精神分裂症的症状。尽管65%的照料者宣称他们知道其患病亲属所患疾病的名称,但抑郁症(43.6%)、精神分裂症(28.5%)和焦虑症(18.1%)的识别率较低。照料者和患者都倾向于对精神疾病进行社会心理解释。照料者认为药物干预(如抗精神病药物)、非特异性活动(如“走出去并多学习”)、心理健康专业人员(如精神科医生)和非正式支持(如家庭)对不同疾病都有帮助,而患者对与心理健康专业人员的定期接触评价不高,认为其帮助不大。此外,虽然更多患者了解他们正在服用的药物的效果,但更多照料者强调坚持服药的重要性。社会心理变量(如家庭负担)对两组的心理健康素养都有显著影响。政府应加大对精神障碍患者照料者的支持力度,并监督心理健康政策的实施情况。

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