| Research purposes:With the rapid development of social economy and the improvement of people's standard of living, the prevalence of severe mental illness and the incidence of psychological problems have a clear upward trend. The mental health problems have become a major public health problem and outstanding social issues. The increase of mental illness cause tremendous pressure to social and family. In order to minimize and avoid recession of the patients spirit, be propitious to patients'psychological rehabilitation so as to return to society, and reduce the burden of the family and society at the same time, the community mental health services has emerged.The Community mental health service is not only a new medical treatment, but also the needs of social development. By knowing the needs of community mental health services of the community residents, the community medical staff and the community management, this project studies on the community residents'psychological health, life events, social support and coping style, creat a psychological early-warning model to analyze their mutual relations and internal mechanisms, and provide a theoretical basis to safeguard and promote the psychological health of community residents.The project is of great important guiding significance for the prevention and early intervention of the psychological health problems among the community residents, and it provides a scientific basis for the management of our community mental health services and the establishment of health policy.Methods:1. Literature search The study regarded theories of spirit analyse, cognitive, psychological stress and sociology as the theoretical foundation, through consulting professional magazines, journals, memoir and on-line information retrieval related literature, and collecting relevant research data of community mental health services, community health services, life events, mental health, social support, coping styles and other both at home and abroad, to provides the basic theoretical framework of the research.2. Experts consultationThe staff of community Health Service, relational experts, researchers and so on were consuted for the design of survey questionnaires and selecting the scale of the necessary psychological research.3. Scene investigation methodAccording to the research purposes, four communities were selected in Wuhan City, 1,167 adults who were over the age of 18 were selected randomly and were investigated in households methods. 101 medical staff and 82 community management staff were selected randomly for the investigation as well.4. Statistical analysis methodAccording to the property of the information, the statistical analysis methods were used , such as the chi-square test, multiple linear regression, Logistic regression analysis, AMOS4 structural equation model.5. Semi-structured interviewThis was based on understanding the needs of the mental health to the community residents, community managers and medical staff , in accordance to prior questions to interview community medical management so as to collect and in-depth information and data.Contents:Use the designed questionnaire about needs of community mental health service to investigate the community medical staff, the community managers and community residents, to interview community health managers, to test and survey the community residents with Life Event Scale, Coping style, social support and SCL-90; and analysis the relationship and the fuction mechanism of them, to study the prognostic factors, dangerous factors and protective factors on the psychological health; to estable psychological early-warning model of community residents, and combine the related theory to analysis it, such as sociology theory, cognitive theory, psychological stress, health education and so on; to construct the psychological health service model of community mental health services which fits our country.Results:1. The majority community medical staff, community managers and community residents thought that the community should have mental health service. There were different needs of the community mental health service in education, gender, incomes, ages, marital.2. Detective rate of psychological problem: 353 persons were detected with psychological problem according to SCL-90 results. The totle detective rate accounts for 30.2 %. Detection rates of psychological problems of male and female community residents were 10.44% and 19.56%, and there was a significant difference between men and women. Female's rate is significantly higher than the male's. By investigating the SCL-90 scor of community residents, the score difference of factors has statistical significance apart from factors of somatization and anxiety with nation-wide norm in China. The result showed that there were significant difference among different sex, cultures, ages and marital of community residents in the certain factors of SCL-90, social support and coping styles.3. There were significant interactions of certain factors with marriage, culture, gender, age in the psychological health of community residents, social support and coping style.4. The investigate of life events among community residents found that the most frequent incidents of the worse aspects of family-related problems are economic difficulties, the most frequent incidents of the worse aspects of work and study related problems are work and study pressure, and most frequent incidents of the worst aspects of sociality and other problems are misunderstandings, Cuguai, false accusations. The most frequent incidents of the best aspects of family-related problems are love or engagement. The most frequent incidents of the best aspects of work and study problems are the beginning of employment, followed by the outstanding individual achievement. With the comparison of the scores of life events'stress, there is significant difference sex in the aspects of work and study while others are not. There were significant differences among different marriage, different cultures, different ages community residents in some factors of life events.5. The bad aspects of community residents'families, work and study, sociality and other problems were positively correlative with the some factors of SCL- 90, while the good aspects of community residents'families, work and study were positively correlative with the some factors of SCL- 90. In community residents'coping styles, the solving problem was positively correlative with the objective support, subjective support and the extent of support use and totle scores of support. The assistance was positively correlative with the objective support, the extent of support use and the total scores of support. While self-accusation, fantasy and rationalization were negatively correlative with the objective support, subjective support, the extent of support use and the total scores of support; and retreat were negatively correlative with the objective support, subjective support and the total scores of support.6. The result of a multi-factor stepwise regression analysis, with the total score SCL-90 as dependent variable and factors of life events, marriage, culture, age, sex as variables, showed that education degrees, marital status, incidents of family-related bad incidents, bad incidents of work and study, bad incidents of sociality problems have significant prognostic effect on the psychological health (p <0.05).7. The results of a logistic multi-factor regression analysis by binomial classification, with psychological health as dependent variable (dichotomized variable : SCL-90 factors which has 1 item or above with scores equal or bigger than 2 are valued 1, while thoses with an average score smaller than 2 are valued 0) and all factors of coping style as independen variables, showed that solving the problem, self-accusation and fantasy were modeled, in which the OR scores of fantasy and self-accusation were high and were dangerous factors, while the solving the problem was found to be the protective factors .The results of a logistic multi-factor regression analysis by binomial classification, with psychological health as dependent variable (dichotomized variable : SCL-90 factors which has 1 item or above with scores equal or bigger than 2 are valued 1, thoses with an average score smaller than 2 are valued 0) and all factors of life events as independen variables, showed that the family-related bad incidents, bad incidents of work and study and bad incidents of sociality problems were modeled, in which three factors were dangerous factors.We can timely found the community residents of psychological problems through early warning model, and those of community residents can be early prevented and intervented and prevent them having mental diseases.8. The degree of fitting test to the structure equation model of life events, social support and psychological health of psychological health of community residents found that various of fitting indices of the integrated model were higher than those of the independent model, and the integrated model has higher degrees of fitting and stability. The social support has regulatory effects on the stress of life events to the residents'psychological health.Conclusion and Suggestion:With regard to the bad incidents of family problems, work or learning problems, sociality and other problems in life events, educational degrees and marital status have significantly prognostic effect on the psychological health of community residents. The fantasy and self-accusation are the risk factors of psychological health, and solving the problem is the protective factors of psychological health.The social support has greater regulatory effects on the stress of life events, we should guide community residents to take advantage of social support and make more use of solving the problem, which is a mature way, less self-reproach and illusions as well. The psychological situation of people with higher education and other marital status should be attended importance to. And the community residents which have the bad incidents of family problems, work and learning problems, sociality and other problems should be provided with mental health knowledge, to prevent and reduce their mental diseases.The community should carry out mental health services actively. While the government should step up investment in mental health services, expand its propaganda efforts, focus on prevention, set up an effective treatment mechanism, improve professional qualities of community mental health services, use demands as guide to meet the needs of different groups of people, reasonably allocating health resources and services, and reduce medical expenses. Community mental health services should be established the psychological health service model of "five in one", which are psychological files, psychological examination, early detecting psychological problems, the timely prevention and effective intervention. Every community residents who has participate the psychological test should be created a psychological file, and be measured off early warning mild, moderate warning, severe warning in accordance to Statistical score of the tested indexes. And psychological problems should be early detection, early prevention and early intervention.Our government should attach importance to the community mental health services, increas the investments of community mental health services,improving the professional qualities of community medical staff, the use of community people,money,goods,information resources to reach the goals of prevention of mental illness and promotion of psychological health of community residents.Innovation:Base on the research of the needs of community mental health service, psychological status of the community residents, life events, social support, coping styles and different groups of people's characteristics and relationship in our country, from the view of the establishment of psychological early-warning model of community residents which uses structural equation model, multivariate regression and Logistic regression analysis, we discuss the psychological health forecast factors, dangerous factors and protective factors, and fuction mechanism of social support, mental health and life events. Through the early warning model we can find community residents who need psychological prevention and intervention.In addition, the research attempts to regard life events as a source of stress, starts from the evaluation of the mental stress response, psychological defense mechanisms and cognitive, by researching life stress of community residents and needs of community mental health service, and combines cognitive behavioral and learning theory ,social science, health education and other disciplines'theories, and puts forward that the community mental health services is low net of the tertiary network of mental illness. The tertiary prevention is of important guiding significance to community mental health service, and health education, health promotion and health advocacy play an important role in the aspect of prevention and cure of the psychological health of community residents. Community mental health services should be established: Psychological files, psychological examination, early detection of psychological problems, the timely prevention and effective intervention, that is "five in one," the psychological health service model.
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