Investigation On The Rehabilitation Needs Of People With Schizophrenia In Community Of Shanghai

Objectives: To understand the rehabilitation needs of registered people with schizophrenic of community in Shanghai and to analyze the relevant influencing factors,thus providing the basis for further development of community mental health service.Methods: Multi-stage cluster random sampling was performed to interview 2285 cases of registered people with schizophrenic of community(except inpatients)in 249 village committees of 18 districts of Shanghai.The survey tool: 1.Wuxi version of the Rehabilitation Needs Questionnaire for People with Schizophrenia(PRNQ-S-WX)2.General information questionnaire(self-compiled)3.Disease characteristics and treatment situation questionnaire(self-compiled).SPSS 21.0 was used to describe and analyze the data statistically.The independent sample rank sum test and post-hoc test(Bonferroni)were used to compare the rehabilitation demand factors score and the general rehabilitation needs score of patients with different demographic and related factors and disease related factors.Spearman correlation analysis and multivariate stepwise regression analysis were used to explore the relation between the overall rehabilitation needs and demographic variables and related factors,disease characteristics and treatment factors.Results:(1)The first 6 factors with the highest score of the patient's needs are social security(3.57±1.42),emotional management(3.50±1.42),treatment compliance(3.47±1.43),symptom management(3.39±1.39),mental health knowledge(3.33±1.34),psychosocial care(3.12±1.49).The first 6 factors with the lowest score of the patient's needs are occupation(2.06±1.31),education(2.12±1.38),and behavior and impulse control(2.40±1.33),Social and intimate relationship(2.54±1.30),leisure(2.56±1.42),social welfare and housing(2.71±1.31).The lowest score of single demand column was to increase the chance of promotion(1.91±1.29),and the highest was to provide adequate subsidy(3.69±1.45).The total demand score was(2.93±1.07).(2)In the general demographic characteristics,work and economic factors,the difference was statistically significant in different gender,age,type,cultural degree,suburban residence status,main caregiver identity,employment status,support conditions,disease expenses,disability certificate holders of patients between the overall rehabilitation needs score(P<0.05);no significant differences of marital status of rehabilitation needs of the patients on the overall score(P>0.05).(3)In terms of disease related factors,the overall rehabilitation needs score of patients with different course of disease,relapse times,family history,medication status,outpatient follow-up and mental symptom relief was statistically significant(P<0.05).(4)Multiple stepwise regression analysis indicated that items of received rehabilitation services,rehabilitation service satisfaction scores,recurrence times,mainly supported by their relatives,disease expenses,regular follow-up,on employment state have positive prediction on the overall PRNQ-S-WX rehabilitation needs score(?=0.029,0.328,0.021,0.271,0.152,0.183,0.153;P<0.05);age and suburban have a negative prediction on the score of overall PRNQ-S-WX rehabilitation needs(?=-0.007,-0.178;P<0.05).Conclusions: There are rehabilitation needs in many areas of community schizophrenics in Shanghai.The patients with different demographic characteristics and disease characteristics have different demands and degree of specific rehabilitation.In general,patients have the highest level of need in the field of social security,emotional management,treatment compliance,symptom management,mental health knowledge,and psychosocial care,it is necessary to pay attention to the community mental health workers,the government and the society.In addition,items of received rehabilitation services,rehabilitation service satisfaction scores,recurrence times,mainly supported by their relatives,disease expenses,regular follow-up,on employment state have positive prediction on the overall rehabilitation needs,reminding that society and government should make full use of existing mental health resources,at the same time,proceeding from the improvement of the utilization rate of rehabilitation service and the quality of rehabilitation service to enhance patients and their families' consciousness of service participation and to improve the service experience.Providing personalized and diversified rehabilitation services according to patient characteristics.