Analysis On The Status Quo And Related Factors Of Social Welfare And Work For Patients With Schizophrenia In Ningxia

Objectives 1.Analyze the status quo of Ningxia schizophrenia’s access to social welfare and work from the perspective of social welfare and work roles.2.Understand the factors related to different types of social welfare and work status for schizophrenic patients.3.Analyze the relationship between schizophrenic patients’social welfare and work status,explore whether the patient has the problem of relying on welfare and not engaging in paid work,and make suggestions for patients to obtain social welfare and participate in work.Methods 1.Research objects and sampling methods:using cross-sectional research and convenient sampling methods to select 4 counties in Ningxia,Zhongning,Longde,Tongxin,and Jingyuan.the community under the“686”registration system was in charge of 3,060 severe mental disorders in 2017.The patient is a potential research object.From July 2017 to September 2019,telephone interviews or household surveys were used to collect patient information,and patients with depression,mental retardation,epilepsy,and severe head disease were excluded,and they were finally included in compliance with the criteria of 895 patients with schizophrenia.2.Research contents and tools:（1）General demographic characteristics,including gender,age,education level,whether living alone,place of residence,type of guardian and other general information.（2）Patient social welfare status,combined with the social welfare status of patients with schizophrenia in China,it mainly includes four dimensions of social welfare including free drug treatment,subsistence allowances,disability subsidies,and home care subsidies.（3）The patient’s working status,includes the patient’s work status and personal labor income.The patient’s work status includes working as a farmer,Physical labor,mental labor,students,housewives,etc.,and the inability to do any work.Among them,the work that has income for the past year is paid work,and the work that does not earn economic income is unpaid work.（4）Suffering Condition,including the untreated time of psychotic symptoms,hospitalization,duration of illness,age at first onset,degree of risky behavior,and self-compiled questionnaires for past positive symptoms and quality of life scores.3.Statistical analysis:Using SPSS 22.0 and Arcgis10.5（Arc Map）software,descriptive analysis uses median,interquartile range,composition ratio to describe the general situation of patients,and the cluster analysis of Arc Map is used to describe the economic development level and welfare situation of the county where the patient is located.Single factor analysis of differences between groups uses independent samples or one-way ordered cross-tabulation of rank sum test,χ² test,multi-factor logistic regression analysis to explore independent related factors of social welfare and work status,and classification tree model The results of logistic regression analysis were used to verify and analyze the interrelationships of multilevel variables.the log-linear model was used to analyze the interaction effect between patients’social welfare and whether they were engaged in paid work.Results 1.54.9%of the schizophrenic patients surveyed received free drug treatment,and the proportion of patients receiving disability subsidies,subsistence allowances,and home care subsidies ranged from 30.7%to 59.6%.49.8%of patients were unable to engage in any work,and 50.2%of patients were employed as farmers,Manual labor,housewives and other jobs,of which 9.7%of patients are engaged in paid work,and 40.4%of patients are engaged in unpaid work.2.The logistic regression analysis of the patients’social welfare shows that the gender,single residence,guardian type,and residence of the social demographic structure are independent factors related to the patient’s social welfare.the number of female patients who received social welfare is even smaller（OR=0.645,95%CI:0.461～0.901）,Living alone（OR=1.906,95%CI:1.122～3.238）,the guardian is someone other than the parents and children（OR=2.173,95%CI:1.309～3.608）,it is highly likely to receive the subsistence allowance.The guardian is more likely to get free medicines and social welfare for the parents（OR₁=2.815,95%CI₁:1.337～5.926,OR₂=1.961,95%CI₂:1.180～3.258）,place of residence Urban patients are more likely to receive disability subsidies（OR=2.854,95%CI:1.406～5.793）,and urban patients are less likely to receive home care subsidies（OR=0.544,95%CI:0.314～0.941）.3.The logistic regression analysis of the patients’social welfare shows that the age of onset of disease factors,the number of hospitalizations,and the duration of untreated psychiatric symptoms are independent relevant factors for patients to receive social welfare.Patients with the younger age of first onset receive disability subsidies,family care subsidies,The greater the number of combined social welfare benefits（OR₁=0.971,95%CI₁:0.950～0.992,OR₂=0.982,95%CI₂:0.967～0.997,OR₃=0.954,95%CI₃:0.935～0.974）,the number of hospitalizations Patients with more than 3 times are more likely to receive disability subsidies and social welfare combined（OR₁=3.254,95%CI₁:1.784～5.933,OR₂=2.802,95%CI₂:1.702～4.614）,those who have not been treated for a short time and the greater number of patients receiving social welfare combined（OR=0.969,95%CI:0.949～0.990）.4.The logistic regression analysis of factors related to the patient’s work status shows that the guardian is the children are less likely to be able to work（OR=0.493,95%CI:0.336～0.722）,Patients with a longer illness are less likely to be able to work（OR=0.968,95%CI:0.954～0.983）.Patients with"moderate"or"severe"mental and psychological problems are less likely to be able to work in the past year（OR₁=0.227,95%CI₁:0.099～0.522,OR₂=0.086,95%CI₂:0.037～0.198）,and patients with free drugs are more likely to be able to work（OR=1.607,95%CI:1.173～2.202）.5.The analysis of the classification tree model shows that receiving disability subsidies and free drugs are the independent variables with the greatest improvement in predictive effect.The group receiving disability subsidies,guardians as parents,and age is no more than 45.5 years old have a higher rate of obtaining free drugs,obtaining free medicines,having no treatment time is no more than 19.75 years,quality of life is no more than 56.25 points,subsistence allowances,and the age of onset is no more than 34.5 years of age,the disability subsidy rate is higher.the degree of influence of mental and psychological problems is the variable that predicts the greatest improvement in the patient’s ability to work,mental and psychological problems,groups whose mental and psychological problems are"mild"or below,with a disease course of no more than 31.167 years,and with a lower degree of risky behavior,are more likely to be able to work.6.The log-linear model analysis shows that there is an interactive effect in receiving free drugs,disability subsidies,subsistence allowances,and home care subsidies（P<0.05）.There are no statistics on the interaction items of receiving free medicines,disability subsidies,and being able to engage in paid work Academic significance（P>0.05）,The interaction items of receiving disability subsidies,subsistence allowances,and being able to engage in paid work were not statistically significant（P>0.05）.Conclusions 1.The rate of obtaining social welfare for schizophrenia patients is lower.Female patients receive less social welfare than male patients.Rural patients are more likely to receive home care subsidies than urban ones.However,urban patients are more likely to receive disability subsidies due to their geographic location and other advantages.the number of patients whose guardians are parents,the younger the age of onset,and the shorter the untreated period of psychotic symptoms,will receive more welfare,the hospitalized patients are more likely to receive social benefits.2.Patients with schizophrenia have repeated illnesses,which can easily cause the patients to lose their ability to work.Some patients can engage in basic tasks such as physical strength and housewives,but most patients engage in unpaid work.The shorter the illness,the guardian is a spouse,and the mental and psychological problems in the past year Patients whose impact is"slightly below"are more likely to engage in unpaid or paid work.3.Whether patients with schizophrenia receive free drugs,disability subsidies,subsistence allowances,and home care subsidies,there is an interactive effect.Obtaining disability subsidies and free drugs are important predictors of each other’s effects.Free drug treatment and there is a positive correlation between being able to engage in paid or unpaid work,but there is no interaction effect between obtaining social welfare and being able to engage in paid work.4.There are urban-rural differences or individual in the social welfare access and participation of patients with schizophrenia.The state and the government need to pay attention to the patients’social welfare and practical problems of work,and provide patients with more comprehensive welfare and employment policy support.