黄世伟+刘峥荣++张海香+汪云芳+许曲++郑伟

[摘要]目的 探討我院强制医疗所中的精神分裂症患者家属病耻感的发生率及其相关因素。方法 选取2016年3～11月在我院符合国际疾病分类第10版（ICD-10）诊断标准的208例精神分裂症患者家属，采用自编的调查表、贬低-歧视感知量表、世界卫生组织生存质量测定量表简表对家属年龄、性别、文化程度（按年来计算）、个人收入（3000元为截点）、居住地等人口学一般资料、病耻感、生活质量、自杀企图及失眠进行评定。结果 实际收集资料198例，应答率为98.2%。62.1%的精神分裂症患者的家属存在病耻感。与病耻感组比较，非病耻感组在城市居住人口更多（χ2=10.377，P=0.001）、有更高的生活质量（t=18.883，P=0.023），差异有统计学意义。相反，病耻感组较非病耻感组，文化程度（t=7.101，P=0.0001）和收入高（χ2=13.067，P=0.0001），且存在失眠（χ2=15.647，P=0.0001）和自杀企图者（χ2=4.548，P=0.033）更多，差异有统计学意义。文化程度、月收入、存在失眠和自杀企图的家属与病耻感成正相关。结论 病耻感存在于精神分裂症患者的家庭，达半数以上。另外，受教育程度高、高收入、存在失眠和自杀企图的患者家属更易产生病耻感。

[关键词]强制医疗；精神分裂症；病耻感；家属

[中图分类号] R749.3 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0156-03

Study of stigma on family members of schizophrenic patients with compulsory medical treatment and related factors

HUANG Shi-wei1 LIU Zheng-rong1 ZHANG Hai-xiang1 WANG Yun-fang1 XU Qu1 ZHENG Wei2

1.Department of Compulsory Medical Treatment，Mental Hospital of Guangzhou Municipal Civil Affairs Bureau in Guangdong Province，Guangzhou 510430，China；2.Guangzhou Brain Hospital （Guangzhou Huiai Hospital，Affiliated Brain Hospital of Guangzhou Medical University） in Guangdong Province，Guangzhou 510370，China

[Abstract]Objective To explore the incidence rate of stigma on family members of schizophrenic patients with compulsory medical treatment and its related factors.Methods From March to November 2016，a total of 208 family members of schizophrenic patients meeting the diagnostic standard of International Classification of Diseases （ICD-10） in our hospital were selected.The demographic general information including age，gender，education level （calculated by year），personal income （3000 yuan for the cut-off），place of residence，etc.，stigma，quality of life，suicidal attempt，and insomnia were evaluated by home-made questionnaire，belittlement-discrimination scale，and World Health Organization Quality of Life Scale.Results The data were collected in 198 cases，and the response rate was 98.2%.62.1% family members of schizophrenic patients had a sense of disgrace.Compared with stigma group，participants in the non-stigma group more lived in urban areas （χ2=10.377，P=0.001），with a higher quality of life （t=18.883，P=0.023），which were displayed statistical differences.In comparison with the non-stigma group，family members in the stigma group with higher education levels （t=7.101，P=0.0001） and higher income （χ2=13.067，P=0.0001）， as well as more occurrence of insomnia （χ2=15.647，P=0.0001） and suicidal attempt （χ2=4.548，P=0.033），which were displayed statistical differences.There were positive correlations between educational level，monthly income，insomnia and suicide attempts in family members and stigma.Conclusion The stigma is existent in over half family members with schizophrenic patients.In addition，family members with high levels of education，high-income，insomnia and suicide attempts are more likely to feel disgraceful.

[Key words]Compulsory medical treatment；Schizophrenia；Stigma；Family members

精神分裂症患者家属病耻感是指患者家属因其家人患该疾病而产生的一种发自内心耻辱的体验[1]。李艳等[2]就精神分裂症对患者家庭的影响作一综述发现，精神分裂症使该家庭产生重经济负担、低生活质量、严重病耻感等现象。自2013年《中华人民共和国精神卫生法》颁布与实施后，家属病耻感日益受到精神科医护人员的普遍关注[3]。……