中国全科医学Issue(23)：2684-2687,4.DOI:10.3969/j.issn.1007-9572.2014.23.005
中国西部地区农村重性精神病患者健康管理现状调查：问题及对策分析
An Investigation of Present SitUation in Health Management of Patients with Severe Psychotic Disorders in RUral Areas of the Western Region of China:Problems and CoUntermeasUres Analysis
摘要
Abstract
Objective To investigate present situation in health management of patients with severe psychotic disorders in rural areas,and to find problems and make countermeasures analysis. Methods 790 patients with severe psychotic disorders from 6 primary health care institutions were investigated from March to April,2014. 30 primary public health staff and 6 public health service accreditation inspection experts were interviewed. The status of health management of patients with severe psychotic disorders in rural areas was collected,then the existing problems were discussed and analyzed. ResUlts Among the 790 pa-tients,433 cases were male(54. 8%),357 were female(45. 2%);aged 5-96,average 47. 4. 35-64 age group accounted for the largest in different age groups(454/790,57. 5%);schizophrenia accounted for the largest in different disease types (511/790,64. 7%),followed by mental retardation comorbid mental disorders(242/790,30. 6%). The primary health care institutions carried out investigation and screening work,according to the rule that management should be managed as much as possible,and established health records for all patients diagnosed. 706 cases(89. 4%)had received follow-up at least 4 times a year;patients with risk ratings are:level 0(290 cases,36. 7%),level 1(451 cases,57. 1%),level 2(37 cases, 4. 7%),level 3(1 case,0. 1%),not rating(11 cases,1. 4%). According to the National Basic Public Health Services Specifications,the current health management problems exist in four areas:health archival records are not standardized;the classification of intervention in health management service is not standardized;the ability of mental health service in the primary health care institutions is serious insufficient,and a shortage of professional personnel;part of patients and their family members are in low degree of cooperation. ConclUsion Primary health care institutions in rural areas have carried out the health manage-ment of severe mental health,but there exists problems:the lack of management ability,nonstandard health files management,low cooperation from patients,and poor management effectiveness. The suggestions are as follows:innovate the management mechanism for the prevention and control of patients with severe psychotic disorders to improve management effectiveness;strengthen the Na-tional Standard training to further enhance the service capability of primary health care institutions;strengthen the guidance,the su-pervision of the quality control and inspection work to ensure the service for patients with severe psychotic disorders;strengthen mental health education and increase patient aid relief to improve the cooperation of patients and their family.关键词
农村地区/重性精神病/健康管理Key words
Rural area/Severe psychotic disorders/Health management分类
医药卫生引用本文复制引用
李家伟,景琳,潘宇佳,赖倩,余伟,荆媛..中国西部地区农村重性精神病患者健康管理现状调查：问题及对策分析[J].中国全科医学,2014,(23):2684-2687,4.基金项目
国家社科基金项目（12BJY092）---西部地区农村居民医疗消费现状及政策研究 （）
