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躯体共病背景下精神分裂症患者的社会功能障碍特征、社会挫折感水平评估及对医疗质量的满意度。

FEATURES OF SOCIAL DYSFUNCTION, ASSESSMENT OF LEVELS OF SOCIAL FRUSTRATION AND SATISFACTION WITH THE QUALITY OF MEDICAL CARE IN PATIENTS WITH SCHIZOPHRENIA ON THE BACKGROUND OF SOMATIC COMORBIDITY.

机构信息

IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY, IVANO-FRANKIVSK, UKRAINE.

出版信息

Wiad Lek. 2022;75(8 pt 1):1876-1881. doi: 10.36740/WLek202208110.

Abstract

OBJECTIVE

The aim: To study the features of social dysfunction, assess the levels of social frustration and satisfaction with the quality of medical care in patients with schizophrenia on the background of somatic comorbidity.

PATIENTS AND METHODS

Materials and methods: The study included 105 patients (55 women - 52.38% and 50 men - 47.61%) with a verified diagnosis of schizophrenia (F20.0-F20.3). The psychopathological condition of patients was assessed according to the "Positive and Negative Syndrome Scale" (PANSS). A special psychodiagnostic technique by L. I. Wasserman in the modification of V.V. Boiko was used to assess the level of social frustration. Peculiarities of social dysfunction were assessed based on the "Personal and Social Performance scale" (PSP). "The Health Resource Use Questionnaire" was used to obtain the information about the coverage of this patient with primary or specialized somatic care during the last three months. General and systematic examination of the patient was also performed, physical methods of diagnosis (palpation, percussion, auscultation) were applied, body mass index was calculated. Consultations of specialists, instrumental (ECG, ultrasound, Echo-CS, etc.) and laboratory diagnostic methods were prescribed depending on the detection or suspicion of concomitant somatic pathology.

RESULTS

Results: The results showed significant social isolation of the respondents, their contacts were limited to communication with relatives and friends. This was confirmed by the data of social functioning on the PSP scale, according to which the most pronounced violations in the examined patients were found in the areas of "personal and social relationships", "socially useful activities, including work and study". It should be noted that the higher the rates of social dysfunction, the stronger the level of frustration (p<0.05). In particular, the low level of satisfaction with the field of medical services due to its inaccessibility, according to respondents, attracts attention. According to the relatives, the main reason for this restriction was the patients' lack of awareness of their condition, neglect and indifference.

CONCLUSION

Conclusions: Further attention is required to develop strategies to improve comorbid treatment in the patients with schizophrenia regardless of whether this situation is the result of negative attitude of health professionals towards patients with mental illness, or the result of the patients' ignorance of their physical condition, or other factors.

摘要

目的

研究躯体共病背景下精神分裂症患者社会功能障碍的特征,评估其社会挫折感和对医疗质量的满意度水平。

患者与方法

本研究纳入了 105 名(55 名女性,占 52.38%;50 名男性,占 47.61%)确诊为精神分裂症的患者(F20.0-F20.3)。根据“阳性与阴性症状量表”(PANSS)评估患者的精神病理状况。采用 L.I. Wasserman 在 V.V. Boiko 改良版中的特殊心理诊断技术评估社会挫折感水平。根据“个人和社会表现量表”(PSP)评估社会功能障碍的特点。使用“卫生资源使用问卷”获取患者在过去三个月内接受初级或专门躯体护理的覆盖信息。对患者进行了全面和系统的检查,应用了物理诊断方法(触诊、叩诊、听诊),计算了体重指数。根据共病躯体病理的发现或怀疑,为患者安排了专科会诊、仪器检查(心电图、超声、回声 CT 等)和实验室诊断方法。

结果

结果显示,受访者存在明显的社会孤立,他们的接触仅限于与亲戚和朋友的交流。这一点得到了 PSP 量表上社会功能数据的证实,根据该数据,在接受检查的患者中,最明显的异常出现在“个人和社会关系”和“包括工作和学习在内的社会有益活动”领域。需要指出的是,社会功能障碍程度越高,挫折感水平越强(p<0.05)。特别是,受访者对医疗服务领域的低满意度(认为其难以获得)引起了注意。据亲属反映,这种限制的主要原因是患者对自身病情缺乏认识、忽视和冷漠。

结论

进一步需要关注制定策略,改善精神分裂症患者的共病治疗,无论这种情况是卫生专业人员对精神疾病患者的消极态度的结果,还是患者对自身身体状况的忽视或其他因素的结果。

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