Hou Ming-Ru, Wang Jun, Xue Jian-Hua, Pei Jian-Qin, Shi Yan, Li Xian-Wen
Department of General Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, 156 Qianrong Road, Wuxi, Jiangsu 214151, China.
School of Nursing, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
Heliyon. 2023 Apr 22;9(5):e15719. doi: 10.1016/j.heliyon.2023.e15719. eCollection 2023 May.
We sought to examine the independent correlates of long-term hospitalization in a sample of Chinese inpatients with schizophrenia (SCZ) from a gender-based perspective.
This was a cross-sectional study that was carried out in a tertiary psychiatric hospital. All adult inpatients in this hospital were screened from January to March 2020, 251 of whom were identified as long-stay inpatients with SCZ (LSIS) and 224 as short-stay inpatients with SCZ (SSIS). Demographic and clinical information of the two groups was collected through medical records, scale assessments and interviews. Gender differences were analyzed, and independent correlates of long-stay between genders were explored by logistic regression analyses.
Compared to SSIS, greater proportions of LSIS patients were male (64.1%), single (82.1%), unemployed (81.7%) and had no family caregivers (54.2%). For LSIS per se, proportionally more males were single (88.8%), had no family caregiver (65.8%), had concomitant physical disease (65.2%) and had a history of hazardous behavior (27.3%) than their female counterparts. For females, the top independent risk factors for a long stay included poor functioning ( = 5.9, 95% : 2.9-12.0), older age ( = 4.3, 95% : 2.1-9.1) and being single ( = 3.9, 95% : 1.8-8.4). Similar to women, both older age ( = 5.3, 95% : 2.5-11.2) and poor functioning ( = 4.0, 95% : 2.1-7.9) were also independent factors for long-term hospitalization of male patients; however, having no family caregiver ( = 10.2, 95% : 4.6-22.6) was the primary risk factor for men.
Both clinical and nonclinical factors play important roles in long-term hospitalization in Chinese patients with schizophrenia. There are overlaps and distinctions across genders with respect to the independent factors of long stays. These findings provide clues for developing better service strategies for this population, and highlight the importance of paying attention to gender differences in further research in this field.
我们试图从性别角度研究中国精神分裂症住院患者样本中长期住院的独立相关因素。
这是一项在三级精神病医院开展的横断面研究。2020年1月至3月对该医院所有成年住院患者进行筛查,其中251例被确定为精神分裂症长期住院患者(LSIS),224例为精神分裂症短期住院患者(SSIS)。通过病历、量表评估和访谈收集两组的人口统计学和临床信息。分析性别差异,并通过逻辑回归分析探索性别间长期住院的独立相关因素。
与SSIS相比,LSIS患者中男性(64.1%)、单身(82.1%)、失业(81.7%)且无家庭照顾者(54.2%)的比例更高。就LSIS本身而言,男性中单身(88.8%)、无家庭照顾者(65.8%)以及患有躯体疾病(65.2%)和有危险行为史(27.3%)的比例高于女性。对于女性,长期住院的首要独立危险因素包括功能差(β = 5.9,95%CI:2.9 - 12.0)、年龄较大(β = 4.3,95%CI:2.1 - 9.1)和单身(β = 3.9,95%CI:1.8 - 8.4)。与女性类似,年龄较大(β = 5.3,95%CI:2.5 - 11.2)和功能差(β = 4.0,95%CI:~2.1 - 7.9)也是男性患者长期住院的独立因素;然而,无家庭照顾者(β = 10.2,95%CI:4.6 - 22.6)是男性的主要危险因素。
临床和非临床因素在中国精神分裂症患者长期住院中均起重要作用。长期住院的独立因素在性别间存在重叠和差异。这些发现为针对该人群制定更好的服务策略提供了线索,并突出了在该领域进一步研究中关注性别差异的重要性。