| Objectives:Through the epidemiological investigation of patients with schizophrenia in 13 counties in Honghe,Yunnan province,to describe the epidemiological characteristics of activities of daily living in patients with schizophrenia in Honghe and to analyze the related influencing factors;To explore the attributable risk factors of the influencing factors of daily life activities in schizophrenic patients and to provide scientific basis for evaluation of community rehabilitation effect in schizophrenic patients.Methods:Using the two-stage simple random sampling method,1310 patients with schizophrenia were randomly selected from 65 investigation sites in 13 counties in Honghe.A face-to-face survey of patients was conducted using a uniformly designed questionnaire and the Barthel Index.Using Epidata 3.1 to establish a database and data entry.SPSS 18.0 was used for statistical analysis of the data.Measured data were presented by mean ± standard deviation;Enumeration data was presented by rate or proportion;single factor analysis was used Kruska-wallis H test,the influence factors were analyzed with ordinal Logistic regression;The population attributable risk analysis was calculated by the corresponding formula.Results:(1)Basic information:This study investigated a total of 1,310 cases,7 non-conformance questionnaires were eliminated,and 1,303 valid questionnaires were collected.The effective rate was 99.5%.The age distribution of 1303 patients was 3?88 years old,and the average age was 44.67(± 13.73).The patients' age was mainly concentrated in the 20?60 years old,accounting for 82.12%;among them,there were 759 males with the average age of 43.68(±13.13),544 females with the average age of 46.06(± 14.42);277 patients with schizophrenia in the city,1026 cases in rural areas;ethnic Han-based accounted for 46.82%,Yi Followed by(21.49%).Marital status is given priority to married with 734 cases,accounting for 56.33%,followed by unmarried(30.16%).The level of education is mainly below the middle school level,accounting for 91.87%.The patient of 10.21%had a family history of inheritance.Patients of 91.86%had clinical treatment;and patients of 52.88%participated in rehabilitation.Patients of 39.52%were taken care of by a spouse;and 27.40%were taken care of by parents.(2)In the Barthel Index,the patients of 86.49%and 89.33%were able to complete bathing and retouching independently.All of the six items of eating,dressing,urine control,toilet use,and up and down stairs accounted for 89.72%,81.50%,93.40%,92.17%,81.89%,88.87%respectively;bed chair and floor walking accounted for 65.08%and 79.12%respectively.(3)Spearman's rank correlation analysis of patients' ADL scores with age,delay time,and course of illness showed negative correlations between results.(4)Patients ADL grade:Patients with normal ADL in schizophrenia accounted for 35.15%,60.02%with mild functional impairment,and 4,83%with moderate-severe dysfunction in Honghe,so the incidence of ADL disorder in schizophrenia was 64.85%.Among them,males of 20.72%could take care of themselves in their daily lives,and 14.43%were women.Males of 35.07%and females of 24.94%were mild functional impairment.Urban residents accounted for 7,6%of their daily life,while rural groups accounted for 27.55%.The dysfunctional of city group accounted for 12.43%,and the rural group accounted for 47.58%;the age group of self-care 20 groups(13.2%)were higher than the 0-year group(0.77%).(5)Influencing factors of ADL:The results of univariate analysis showed that the age,nationality,marital status,education level,and family genetic history had statistically significant effects on ADL in different grades of schizophrenia among the population's social characteristics(P<0.05).There were statistically significant between different family types,whether to participate in rehabilitation treatment,whether the delay in the treatment,the course of disease,stigma and schizophrenia patients with different grades of the difference(P<0.05).The ordinal Logistic regression analysis found that the age group of 20-(OR=1.530,95%CI=1.032-2.267)and 40?(OR=1.750,95%CI=1.222?2.506),educational level were illiterate(OR=0.179,95%CI=0.062?0.513),whether there is a genetic histories(OR=0.642,95%CI=0.438?0.941),if you feel mental illness is a disgrace(OR=1.408,95%CI=1.043?1.902)and family type for the nuclear family(OR=1.684,95%CI=1.120?2.531)were related with the patient ADL grade(P<0.05).The ADL attribution risk analysis of patients showed that PARc of the three main risk factors(family type,disease grouping,and whether mental illness is a shameful thing)were 0.2527,0.2008,0.1646,and sPAR was 0.4979.Other factors such as marital status,participation in rehabilitation treatment,etc.will not exceed 50.21%of the combined effects of ADL disorders in patients.Conclusions:(1)The incidence of ADL disorder in the survey population was 64.85%.There was no influence on the occurrence of ADL disorder between men and women and different places of residence.The incidence of ADL disorders is higher in patients with aged 20-60 years and in elementary school and below.Patients with the longer the course disease and the higher the age are more likely to develop ADL disorders.(2)There is a significant correlation between the self-care ability of schizophrenia patients at home management in Honghe and age,education level,family type,delay in attendance,clinical treatment,disease duration and stigma.Old age,delays in treatment,and stigma are risk factors for ADL in patients,and.high education and rehabilitation are the protective factors for ADL.(3)The analysis of risk of attribution of family types,course of disease,and whether or not they think that mental illness is disgraceful showed that sPAR of the three factors is 0.4979.In addition to the above three factors,other factors such as age,marital status,etc,the effect on the disorder of ADL will not exceed 50.21%.It is necessary to carry out interventions based on the above aspects,to carry out propaganda and education,to pay attention to and improve health education,to enhance the health awareness of patients focused on special schizophrenia patients and their families,in order to improve patients and guardians of schizophrenia in Honghe.Early medical treatment could reduce the burden of disease on patients,their families,and society. |
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