Ho T P, Chung S Y
Department of Psychiatry, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Soc Psychiatry Psychiatr Epidemiol. 1996 Sep;31(5):292-8. doi: 10.1007/BF00787923.
This study employed semi-structured interviews and questionnaires to describe the help-seeking processes and examine the determinants of help-seeking behaviours in 100 consecutive referrals to a child psychiatric clinic in Hong Kong. The help-seeking processes were characterized by (1) a sequential pattern of lay consultations starting from the families, relatives, friends and, rarely, neighbours; (2) detour via multiple professionals; (3) delay in reaching specialist services. A total of seven psychosocial variables were used to predict the help-seeking behaviours. The younger the child was, the more likely members outside the families were sought for advice. A large number of professional consultations was predicted by a high symptom score and relative old age in the referred child, less social disadvantages in the family and parental beliefs that family influences were not the cause of the child's problems. A long delay in reaching specialist services was predicted by a high symptom score in the child. Parental beliefs of outside influences being the cause of the child's problems predicted a short delay in reaching the clinic. Low awareness of services was the predominant difficulty parents encountered when they sought psychiatric care for their children. Public health education to demystify the cause of mental disturbances, close networking with teachers and general practitioners, and establishment of community child mental health clinics for easy access are recommended.
本研究采用半结构式访谈和问卷调查,以描述100例连续转诊至香港一家儿童精神科诊所的求助过程,并探讨求助行为的决定因素。求助过程的特点包括:(1) 从家庭、亲属、朋友,很少从邻居开始的一系列非专业咨询模式;(2) 经过多个专业人员的迂回过程;(3) 延迟获得专科服务。总共使用了七个社会心理变量来预测求助行为。孩子年龄越小,向家庭以外的成员寻求建议的可能性就越大。高症状评分、被转诊儿童年龄相对较大、家庭社会劣势较少以及父母认为家庭影响不是孩子问题的原因,这些因素可预测大量的专业咨询。孩子的高症状评分可预测延迟很久才获得专科服务。父母认为外部影响是孩子问题的原因,这可预测到诊所的延迟时间较短。父母在为孩子寻求精神科护理时遇到的主要困难是对服务的认知度低。建议开展公共健康教育以揭开精神障碍病因的神秘面纱,与教师和全科医生建立紧密联系,并设立社区儿童心理健康诊所以便于就诊。