The Research On Clinical Management Of Infectious Diseases Among Homeless Psychiatric Patients

Objective:To analyze epidemiological characteristics of infectious diseases among homeless psychiatric patients,explored the impact of behavioral style on the prevalence among this group.Put forward seamless management mode of infectious diseases among homeless psychiatric patients and provided theoretical and clinical experience on public health management of this kind of crowd for decision-makers.Methods:Based on homeless psychiatric patients rescued by Nanning Municipal Social Welfare Hospital from 2008 through 2014,combined with indicators of normal psychiatric admission patients and normal population at the same period,analyzed homeless psychiatric patients'epidemiological indicators such as morbidity.Chi-square goodness of fit test,u-test and multivariate analysis were performed in analyses using SPSS 20.0.Extracted qualitative data from data analysis results and interviews,integrated and refined the successful experience.Results:(1)Among all the patients,a total of 349 cases of infectious disease were identified and the overall prevalence rate of infectious disease was 14.7%;the prevalence rates were 10.2%(239 cases),3.3%(77),1.5%(36),and 0.4%(9)for viral hepatitis,syphilis,pulmonary tuberculosis and acquired immunodeficiency syndrome(AIDS),respectively.Significantly higher proportions of males(64.9%)than females were observed among the cases with viral hepatitis(p<0.01).The population of syphilitic between 30 and 45 was the biggest(54.5%).Non-occupational TB patients(71.4%)were more than occupational patients(P<0.01).There were many AIDS patients with malnutrition(88.9%).(2)The average annual morbidity of infectious diseases among homeless psychiatric patients is higher than that of general psychiatric inpatients and normal population at the same period.(3)Employment was a protective factor of infectious disease(OR=0.632,95.0%CI=0.466-0.857)and wandering behavior was a risk factor(OR=1.997,95.0%CI=1.608-2.479)of infectious disease.Conclusion:Wandering behavior was an important way for infectious diseases to be highly infectious and highly infectious among homeless psychiatric patients,so it was meaningful to include.homeless psychiatric patients in public health management of infectious diseases.We came up with seamless management mode including disease prevention by community,medical treatment by hospital and scientific placement by government,making contribution to domestic epidemic prevention and control system and management system of homeless psychiatric patients.