李清金等

[摘要] 目的 了解绵阳市农村社区人群的心理健康和精神卫生知识知晓情况。 方法 采用整群随机抽样方法，随机选取绵阳市2个乡镇总计2060人，采用由中南大学公共卫生学院编制的精神卫生与心理保健知识问卷进行调查。 结果 1984人完成有效问卷调查，其中男986人，女998人，平均得分为（9.18±3.82）分，知晓率明显偏低。问卷得分在性别、年龄、经济状况、文化程度、职业状况方面差异有高度统计学意义（P < 0.01）；多元线性逐步回归分析发现，文化程度、经济状况和年龄为精神卫生知识知晓率的独立相关因素，其标准回归系数分别为0.11、0.08、-0.09（均P < 0.01）；问卷中的20个题目整体内部信度一般（alpha=0.73，Split-Half=0.57），且问卷中4个分量表有3个的内部信度均偏低（alpha=0.27、0.47、0.68）。 结论 绵阳市农村社区人群的心理健康和精神卫生知识知晓率偏低，亟待进一步提高，尤其是关于精神卫生纪念日和精神疾病病因的认识，更需加大宣教普及力度。农村人群的人口学特征性导致知晓率的存在明显差异，因此需要针对人群特点制订相应的宣传教育方式，从而全面提高农村社区人群的知晓率。此外，调查问卷需要进一步改善设计，评估其效度，并提高其内部信度。

[关键词] 农村社区；精神卫生知识；知晓率；信度

[中图分类号] R195 [文献标识码] A [文章编号] 1673-7210（2014）12（c）-0091-05

Cross-sectional survey on awareness of mental health knowledge among the rural communities of Mianyang City

LI Qingjin1 HUANG Xuanyin2 LU Wusheng1 WEN Hong2 WANG Rongke2 LEI Lei2

1.Department of Neurology， Southeast Hospital Affiliated to Xiamen University， Fujian Province， Zhangzhou 363000， China； 2.Department of Psychiatry， Sichuan Provincial Mental Health Center， Sichuan Province， Mianyang 621000， China

[Abstract] Objective To assess the mental health and awareness of mental health knowledge in rural community of Mianyang City. Methods A cluster-sampling method identified 2060 people in two towns in Mianyang City. Everyone was asked to complete a standardized 20-item survey about mental health awareness which developed by the Public Health College of Central South University. Results 1984 valid surveys were completed by 986 males and 998 females. The mean score is （9.18±3.82） scores， which showed the level of awareness about mental health was low. The scores were statistically significant differences in the gender， age， economic status， education and occupation （P < 0.01）. Multivariate linear model regression analysis found that the cultural level， ecnomic status and age were independent factors associated with mental health knowledge awareness， its standard regression coefficient was 0.11， 0.08， -0.09 respectively （all P < 0.01）.The overall internal consistency of the 20 items in the survey was weak （alpha=0.73， Split-Half=0.57）. The internal consistency of the three subscales in the survey were also weak （alpha=0.27， 0.47， 0.68）. Conclusion The overall level of awareness about mental health issues in the rural community of Mianyang is low. Particularly regarding the cases of mental disorder and Mental Health Commemoration Day， which are in need of improvement. The level of mental health literacy varies substantially by demographic characteristics of the rural community， so cohort-specific educational interventions will be needed to effectively improve community awareness. In addition， further revision of the survey will be needed to improve its validity and internal consistency.

[Key words] The rural community； Mental health literacy； Knowledge and awareness； Validity

精神卫生问题是全球性的重大公共卫生问题，同时也是我国重要的公共问题和突出的社会问题。国内研究结果[1]提示，要较好地预防和控制精神疾病的发生，就要结合不同人群的不同健康需求，举行各种形式的精神卫生知识宣传活动和心理健康相关咨询服务，确实提高人们对精神疾病的认知水平。回顾文献[2]发现，沿海地区人群的知晓率较高，但大多数地区普通人群的知晓都较低，各地普通人群的知晓率差异较大。这可能原因有：不同研究之间所采用的问卷调查多为自制版[3-4]，问卷结构和内容各异，评估方法也各异，从而导致研究结果之间缺乏可比性；其次调查问卷的信度、效度未经系统规范的评价，也将影响调查的结果。此外，内陆中西部地区人群的相关知晓率调查较少，主要集中东部及沿海地区，调查分布不均。

国内有学者认为，精神疾病患者治疗率偏低的重要原因之一是普通民众的精神卫生知识知晓率低，社会对精神病患者存在歧视和偏见[4]，并导致精神疾病患者及其家属有较强烈的病耻感，从而影响国社区精神卫生服务的发展[6]。……