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中国农村基层医疗卫生专业人员中与精神疾病相关的耻辱感及其相关因素。

Mental illness-related stigma and its associated factors among primary health care professionals in rural China.

作者信息

Yang Yi-Yue, Wang Cong, Cai Jia, Mu Yun-Fei, Zhou Lie, Wang Yi-Zhou, Zhang Tian-Ming, Zhao Xin-Yi, Li Ming, Luo Wei, Luo Jian-Jun, IreneWong Yin-Ling, Yang Lawrence H, Ng Siu-Man, Ran Mao-Sheng

机构信息

Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Front Psychiatry. 2025 May 30;16:1519527. doi: 10.3389/fpsyt.2025.1519527. eCollection 2025.

Abstract

BACKGROUND

Primary health care professionals (PHCPs) play a key role in the workforce of community mental health services in rural China. This study aimed to explore the mental illness-related stigma and its associated factors among PHCPs in rural communities.

METHODS

This study collected the data from 247 PHCPs in 10 township health service centers in Xinjin District, Chengdu, Sichuan Province, China from November to December 2023. The Mental Illness: Clinicians' Attitudes (MICA) was used to assess the mental illness-related stigma. Demographic and stigma-related psychological scales were compared between PHCPs with and without mental illness-related stigma. Correlation and binary logistic regression analyses were performed.

RESULTS

There were 155 PHCPs (62.8%) with mental illness-related stigma, and the mean score of MICA was 50.68 ± 8.08. PHCPs with mental illness-related stigma had significantly lower mean scores of the Mental Health Knowledge Schedule (MAKS), the Reported and Intended Behavior Scale (RIBS), the 5-item Contact Scale (CQTS), and the 5-item Contact Quality Scale (CQLS) (p=0.001, p<0.001, P=0.041, P<0.001), and higher mean scores of the Social Distance Scale (SDS) (p<0.001) than those without mental illness-related stigma. Binary logistic regression analysis showed that PHCPs' work experience (β=0.080, 95%CI=1.0021.170, p=0.044) and scores of SDS (β=0.169, 95%CI=1.0561.328, p=0.004) had significantly positive impact on the mental illness-related stigma, and the scores of MAKS (β=-0.082, 95%CI=0.8500.998, p=0.045) and RIBS (β=-0.131, 95%CI=0.7830.983, p=0.024) had significantly negative impact on the mental illness-related stigma.

CONCLUSIONS

The PHCPs have severe mental illness-related stigma in rural China, and the associated factors include work experience, mental health knowledge, behavioral discrimination, and social distance towards people with mental illness. The results of this study are crucial for development of anti-stigma intervention among PHCPs in rural communities.

摘要

背景

基层医疗卫生专业人员(PHCPs)在中国农村社区精神卫生服务工作队伍中发挥着关键作用。本研究旨在探讨农村社区基层医疗卫生专业人员中与精神疾病相关的污名及其相关因素。

方法

本研究于2023年11月至12月收集了中国四川省成都市新津区10个乡镇卫生院247名基层医疗卫生专业人员的数据。采用精神疾病:临床医生态度量表(MICA)评估与精神疾病相关的污名。比较了有无与精神疾病相关污名的基层医疗卫生专业人员的人口统计学和与污名相关的心理量表。进行了相关性和二元逻辑回归分析。

结果

155名基层医疗卫生专业人员(62.8%)存在与精神疾病相关的污名,MICA量表的平均得分为50.68±8.08。与无精神疾病相关污名的基层医疗卫生专业人员相比,有精神疾病相关污名的基层医疗卫生专业人员在心理健康知识量表(MAKS)、报告与预期行为量表(RIBS)、5项接触量表(CQTS)和5项接触质量量表(CQLS)上的平均得分显著更低(p=0.001,p<0.001,P=0.041,P<0.001),而在社会距离量表(SDS)上的平均得分更高(p<0.001)。二元逻辑回归分析显示,基层医疗卫生专业人员的工作经验(β=0.080,95%CI=1.0021.170,p=0.044)和SDS得分(β=0.169,95%CI=1.0561.328,p=0.004)对与精神疾病相关的污名有显著的正向影响,而MAKS得分(β=-0.082,95%CI=0.8500.998,p=0.045)和RIBS得分(β=-0.131,95%CI=0.7830.983,p=0.024)对与精神疾病相关的污名有显著的负向影响。

结论

中国农村基层医疗卫生专业人员存在严重的与精神疾病相关的污名,其相关因素包括工作经验、心理健康知识、行为歧视以及对精神疾病患者的社会距离。本研究结果对于开展农村社区基层医疗卫生专业人员的反污名干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c349/12162690/8fa49fa55566/fpsyt-16-1519527-g001.jpg

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