Construction Of Hierarchical Psychological Management Model For Non-psychiatric Patients In General Hospital

Objective:1.To investigate the mental health status of non-psychiatric inpatients in general hospitals and analyze its influencing factors,so as to provide a basis for the establishment of a hierarchical psychological management model for non-psychiatric patients in general hospitals.2.To investigate the willingness of non-psychiatric medical staff in general hospitals to provide psychological services,the current situation of psychological services and obstacles,so as to provide references for the establishment of a hierarchical psychological management model for non-psychiatric patients in general hospitals.3.The construction of general hospital of psychiatric patients psychological classification management mode,to general hospital to improve the mental patients'psychological problem high prevalence rate,low recognition rate,psychological care ability is insufficient medical staff to provide a set of scientific,operational management mode,innovation in general hospital in psychological assessment,dynamic warning,hierarchical intervention of psychological service.Methods:1.A random sampling method was used to select 523 patients who were hospitalized in the non-psychiatric department of a general hospital from November 2017to January 2018.Questionnaires were used to investigate and analyze the mental health status of 523 patients.2.Using the convenience sampling method,222 non-psychiatric medical staff in a third-grade a general hospital were selected for a questionnaire survey.The questionnaire on the status of mental health services of non-psychiatric medical staff in general hospital was used as the survey tool to evaluate the willingness of medical staff to provide psychological services,the status of psychological services and obstacles.3.On the basis of current situation investigation,literature analysis and expert consultation,the hierarchical psychological management model for non-psychiatric patients in general hospitals was established,and the feasibility of the hierarchical psychological management model was preliminarily verified through the pilot work of a third-level first-class general hospital in Shan xi Province.SPSS23.0 software was used for statistical processing of data,statistical indicators such as mean,standard deviation,quartile,composition ratio and rate were used for data description,and statistical methods such as chi-square test and T test were used for data analysis,P(27).005indicating statistical significance(?(28)0.05).Results:1.Among the 523 non-psychiatric patients,108 had psychological problems,accounting for 20.65%of the total number.From high to low,the positive rate of self-rating scale for patients in different departments was neurosurgery(11,34.38%),plastic surgery(9,32.14%),general surgery(8,32.00%),geriatrics(4,26.67%),endocrinology(6,25.00%),etc.Among them,90 cases(17.21%)of all kinds of psychological symptoms were compulsive symptoms from high to low,78 cases(14.91%)of dietary and sleep symptoms,and 60 cases(11.47%)of somatic symptoms.Whether to receive surgery or not is the main influencing factor of psychological problems in patients(x ~2=9.975,P<0.05).2.Non-psychiatric medical staff in general hospitals have a higher willingness to provide psychological services.There are statistically significant differences in the willingness to provide psychological services among medical staff of different genders,professional titles,educational backgrounds,working years and occupations in general data.77%of respondents can correct understanding of the psychological service,73.0%said they would delay patients suffering from psychological problems by illness to function defect,49.1%consider themselves almost accepts the proportion of patients need psychological services in January was 10%~20%,58.1%believe they have knowledge can not cope with clinical work.The deficiency are mainly reflected in the unfamiliarity of psychiatric drugs(104,80.6%)and Inadequate identification of mental disorders(103,79.8%).3.After two rounds of expert consultation,the results of the two rounds of expert consultation were analyzed,and the hierarchical management model of non-mental patients in general hospitals was finally completed.The response rates of the two rounds of expert consultation were respectively 85.71%and 100.00%,with a high degree of expert positivity.The authority coefficients of the two rounds of expert consultation were0.85 and 0.89 respectively,and the opinions put forward by the experts were relatively credible.In the first round,the Kendall'W values of the first-level,second-level and third-level items were 0.335,0.209 and 0.374,respectively.In the second round,the Kendall'W values of the first-level,second-level and third-level items were 0.340,0.233and 0.315,all values are between 0 and 1,P<0.001,and the expert opinions are relatively consistent.Conclusion:1.The level of mental health of non-psychiatric patients in general hospitals is low,and the severity of mental problems varies.Psychological problems are common in patients in all clinical departments.The incidence of psychological problems is not related to patients'age,gender,disease course and other factors,but related to whether patients receive surgery.General hospitals can guide nurses to pay attention to the psychological state of patients,pay more attention to the psychological state of patients during the operation,and adopt scientific psychological evaluation,effective intervention means,implement psychological hierarchical management,improve the identification and intervention of patients with psychological problems,to achieve the psychological and physical health of patients.2.It is necessary for general hospitals to carry out psychological services.Hospitals can use psychological assessment to conduct preliminary screening of patients and give early warning to patients with serious psychological problems,so as to attract the attention of medical staff.3.Two rounds of expert consultation eventually formed a hierarchical management model for non-psychiatric patients in general hospitals with 5 first-level items,17second-level items and 48 third-level items.The research process was scientific and highly feasible.For the hospital to carry out psychological evaluation-dynamic early warning-hierarchical intervention psychological services to form a standard and feasible psychological management long-term operation mechanism.