ABSTRACT
Objective:To investigate the evaluation of disease perception, treatment compliance and community follow-up services of community schizophrenia patients, family members and personnel in Shantou City, and to provide a reference basis for improving the quality of management treatment.Methods:With the method of stratified sampling qualitative research, a community sample of 17 198 patients with schizophrenia in seven districts or county in Shantou City were sampled from February to August 2019, with 2 towns being drawn from each district or county, and 10 patients, 10 family members and 3 personnel were selected in each town. The evaluation of disease perception, treatment compliance and community follow-up services were investigated and analyzed. Respondents were eventually included in 137 patients, 138 family members and 41 personnel.The interviewees were conducted with semi-structured interviews, the data were collected according to traditional methods, and the descriptive statistical analysis was carried out with SPSS 12.0.Results:(1)34.3% of patients and 32.6% of the family members were not fully aware of the disease.22.6% of the patients and 23.2% of the family members had a sense of ill shame. (2)26.3% of patients did not comply with treatment, 29.9% of patients had not insight, 53.3% of patients and 24.6% of family members on the side effects of drugs and addiction understood improperly, and, 35.0% of patients and 13.0% of the family had a misunderstanding of illness and using drugs. (3)29.2% of patients and 31.2% of their families were tired of taking long-term medication, 24.8% of patients and 21.0% of their families felt socially isolated, and, 17.5% felt unsupported and 18.8% of their families admitted that they did not care enough about patients. (4)31.4% of patients did not actively receive follow-up services, 37.2% of patients and 20.3% of family members did not cooperate with follow-up doctors, and, 21.2% of patients and 10.1% of family members were not satisfied with follow-up services. (5)The personnel of psychiatric care could basically grasp the conditions of patients in the jurisdiction and carried out follow-up services on a regular basis (90.2%), master emergency disposal methods (92.7%), and have carried out training (97.6%). However, the psychiatric practice of the personnel were lower than (58.5%) and most lying part-time (78.0%), the average length of service was 5.7±1.4 years. The personnel satisfaction with the community follow-up service was higher (95.1%), but most of them thought that the psychiatric care was more difficult (36.6%), and were dissatisfied with the multi-functional staff to undertake a number of public services (31.7%).Conclusion:The management treatment project of mental disorders services in Shantou City show initial results.The patients were satisfied with the community follow-up service, but the patients and their families still have low level of cognition, poor compliance, obvious negative emotions, and have concerns about drug treatment.It is necessary to strengthen the professionalization of personnel, to carry out early mental health education and rational emotional behavior training for patients and their families.
ABSTRACT
Objective:To understand the characteristics of brucellosis in adults and the abnormality of blood lipid profile, and to analyze the related factors of dyslipidemia in brucellosis patients, so as to provide reference for preventing and controlling the potential risk of dyslipidemia in brucellosis patients.Methods:The clinical data of all hospitalized patients with brucellosis diagnosed in Liaoning Provincial Hospital of Infectious Diseases from January 1, 2015 to December 31, 2016 were collected. Patients' general demographic characteristics, exposure history, clinical stage and course of disease, concomitant chronic diseases and other basic conditions and dyslipidemia were analyzed; single factor and multivariate unconditional logistic regression models were used to analyze the related factors of dyslipidemia in patients with brucellosis.Results:A total of 562 cases with brucellosis were collected, aged (48.59 ± 12.26) years old, ranging from 18 to 76 years old, and the male to female ratio was 2.5∶1.0 (402∶160); among them, 193 cases (34.3%) had a history of contact with cattle and 331 cases (58.9%) had a history of contact with sheep. Among the 562 cases of brucellosis, 314 cases (55.9%) were accompanied with dyslipidemia, 48 (8.5%), 152 (27.0%), 60 (10.7%) and 217 (38.6%) with abnormal total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C), respectively. The results of logistic regression analysis showed that diabetes [odds ratio ( OR) = 4.201, 95% confidence interval ( CI): 1.361-12.971], elevated neutrophils ( OR = 2.314, 95% CI: 1.981-5.462), elevated alanine transferase ( OR = 2.188, 95% CI: 1.379-3.473), increased procalcitonin ( OR = 1.707, 95% CI: 1.515-2.532), history of contact with cattle ( OR = 2.170, 95% CI: 1.464-3.125) were risk factors of dyslipidemia in patients with brucellosis; and neutropenia ( OR = 0.458, 95% CI: 0.232-0.904) was a protective factor. Conclusions:The incidence of dyslipidemia in brucellosis patients is high. Diabetes, inflammation, abnormal liver function, and history contact with cattle are related factors for dyslipidemia in patients with brucellosis. Targeted measures should be taken to intervene and control the potential risk of dyslipidemia in patients with brucellosis, so as to reduce the burden of brucellosis and non-infectious chronic diseases.