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2018 年,在贡德尔大学综合专科医院,严重精神障碍患者的危险性行为及其相关因素。

Risky sexual behavior and its associated factors among patients with severe mental disorder in University of Gondar Comprehensive Specialized Hospital, 2018.

机构信息

Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Psychology, College of Social Sciences and the Humanities, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Psychiatry. 2021 Jan 21;21(1):51. doi: 10.1186/s12888-021-03054-z.

Abstract

BACKGROUND

People with severe mental disorders are more likely to engage in high-risk sexual behaviors. As a result of these high-risk behaviors, they might contract sexually transmitted infections and become pregnant unintentionally. Despite the high burden of this problem, very little is known about the association between mental disorders and high-risk sexual behaviors; for this reason, the current study aimed at determining the association between these two behaviors in patients with mental disorders attending an outpatient clinic at the University of Gondar Comprehensive Specialized Hospital, Psychiatric Clinic.

METHODS

A total of 223 study participants were recruited via a stratified sampling followed by a systematic sampling technique. An institutional-based cross-sectional study was conducted from April to May 2018. Data were collected using a pretested interviewer-based questionnaire. A four-item questionnaire was adopted from a behavioral surveillance survey and different literature sources. A multivariable logistic regression model was fitted to assess the strength in addition to the direction of the association between risky sexual behavior and independent variables. An interpretation was made based on the adjusted odds ratio and p-value at a 95% confidence interval (CI).

RESULT

Nearly half of the study participants (49.8, 95% CI; 43.9-56.5%) presented risky sexual behavior. The study found that male gender (2.98; adjusted odds ration [AOR] = 2.98; 95% CI; 1.49-5.95), no ability to read and write (3.99; AOR = 3.99; 95% CI: 1.53-10.4), history of hospitalization (3.95; AOR = 3.95; 95% CI: 1.87-8.32), perceived internal stigma (2.45, AOR = 2.45; 95% CI: 1.18-5.11), and poor social support (3.07, AOR = 3.07; 95% CI: 1.29-7.30) were significant predictors of risky sexual behaviors among patients with severe mental disorder.

CONCLUSION

Risky sexual behavior among patients with a severe mental disorders was high (49.8%). Special attention should be given to male patients, incorporating people with severe mental disorders into the adult education programs, continuous health education regarding risky sexual behavior and utilization of condoms, building self-esteem, and engaging others to provide good social support systems are strongly recommended to alleviate this type of behavior in this population.

摘要

背景

患有严重精神障碍的人更有可能从事高风险的性行为。由于这些高风险行为,他们可能会感染性传播感染并意外怀孕。尽管这个问题的负担很重,但人们对精神障碍与高风险性行为之间的关联知之甚少;因此,目前的研究旨在确定在大学冈达尔综合专科医院精神病诊所就诊的精神障碍患者中这两种行为之间的关联。

方法

总共通过分层抽样和系统抽样技术招募了 223 名研究参与者。2018 年 4 月至 5 月进行了一项基于机构的横断面研究。使用预先测试的基于访谈的问卷收集数据。采用来自行为监测调查和不同文献来源的四项目问卷。采用多变量逻辑回归模型来评估风险性行为与独立变量之间的关联强度以及方向。基于调整后的优势比和 95%置信区间(CI)内的 p 值进行解释。

结果

将近一半的研究参与者(49.8%,95%CI;43.9-56.5%)表现出高风险性行为。研究发现,男性(2.98;调整后的优势比[OR] = 2.98;95%CI;1.49-5.95)、读写能力差(3.99;OR = 3.99;95%CI:1.53-10.4)、住院史(3.95;OR = 3.95;95%CI:1.87-8.32)、感知内部耻辱感(2.45,OR = 2.45;95%CI:1.18-5.11)和较差的社会支持(3.07,OR = 3.07;95%CI:1.29-7.30)是严重精神障碍患者高风险性行为的显著预测因素。

结论

患有严重精神障碍的患者中,高风险性行为(49.8%)很普遍。应特别关注男性患者,将严重精神障碍患者纳入成人教育计划,持续进行有关高风险性行为和使用避孕套的健康教育,建立自尊心,并鼓励他人提供良好的社会支持系统,以减轻该人群的这种行为。

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