| Objective:To well understand the state of mental health of the outpatients in a hospital and to analyze and study the factors influencing their mental health, so as to provide scientific information for clinical decision-making in treating the diseases and meanwhile developing mental interventions for the outpatients in the hospital.Methods:From May to July in 2009,900 persons were randomly selected from Jiaozhou Central Hospital of Qingdao using random sampling, and were evenly divided into three groups:the group of the surgical outpatient departments including 300 patients from the departments of Orthopedics, General Surgery, Neurosurgery, Urinary Surgery, Ophthalmology and Stomatology, the group of outpatient departments of the Internal Medicine including 300 patients from the departments of Cardiology, Neurology, Gastroenterology, Pneumology, Endocrinology and Nephrology, and the control group including 300 healthy persons for physical examination at the same period. They were all required to respond to the questionnaires and were interviewed by face to face.The Questionnaires in this research included the questionnaires for the outpatients in the hospital, Kessler 10 Scale, Hospital Anxiety and Depression Scale (HADS) and Symptom Check List-90 (SCL-90). All the data collected were checked without any error, then were inputted into the FOXPRO 6.0 in the computer, and finally were collated and analyzed with the SPSS 16.0 statistic software. The states of mental health of the outpatients and the relevant influencing factors were analyzed and evaluated comprehensively combining the relevant factors of the objective physical health, psychology, injury, etc. in the investigated population with the general basic factors using the statistic method of Chi-squared analysis and t-test. Results:All 900 patients were interviewed with questionnaires,892 questionnaires were finally got, with the effective rate of 99.11%, including 876 valid questionnaires and the response rate was 97.33%. The main results were as follow.1. The scores of K10 were not more than 21 among 88.4%persons in the investigated population with the average scores of K10 in the three groups of 15.8±3.4. The states of mental health of the persons in the three groups were good in 63.2%, moderate in 25.2%and bad in 10.9%persons.2. The positive symptom rate of HAD was 48.9%, with the score of HAD anxiety≥8 in 428 cases including 383 dubious cases (43.7%) and 45 definitive cases (5.2%) among 876 persons. The average scores of anxiety were 3.26±2.38. The average scores of depression were 2.64±2.25.3. There were significant differences in the scores of such factors as the symptoms of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, paranoid ideation and psychoticism (P<0.05), compared the group of surgical outpatients departments and the group of outpatients departments of internal medicine with the control group, according to the scores of SCL-90, which showed that the states of mental health of the outpatients were worse than those of the healthy persons for physical examination.4. The results of single factor analysis indicated that gender, age, marriage status, educational background, the mode of medical insurance, economic income in the family, physical states, psychological factors, etc. were all the factors influencing the mental states of the of outpatients. The scores of K10 were higher in the outpatients of female, old group, having lost spouse or divorced, poorly educational background and people with low insurance. The states of self-assessment were worse in the cases with bad mental states such as those with introverted nature, without any intimate friend, with dull and inactive life, with high pressure in the life and suffered setbacks or unexpected misfortunes.5. The results of multiple factors analysis indicated that the dangerous factors leading to the bad states of mental health for the outpatients were the factors of female, old group, bad marriage status, poorly educational background, lack of medical insurance, low level of economic income in the family, bad physical and psychological states, etc..Conclusions:The measuring results of the three psychological scales in this study indicated that the states of mental health of the outpatients were bad, which was resulted from the multiple influencing factors including the general social factors, the economic factors, the physical health factors, the factors of the mental states, etc.. The appropriate clinical psychological intervention should be carried out according to the different characteristics of the outpatients, so as to comprehensively improve the health level of the outpatients.Policy Suggestions:The following policy suggestions were put forward according to the results of this study:1. Strengthen the community features and expand community support;2. Increase health care and reimbursement in appropriate level3. Improve capacity of social assistance to patients and social assistance4. Enhance health education and psychological intervention timely;5. Reinforce the training of psychological knowledge to grassroots medical staff to improve the capacity of intervening psychological problems.
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