Investigation And Analysis Of Rehabilitation Needs Of Schizophrenic Patients And Their Caregivers In Community

Objectives:To understand the rehabilitation needs of schizophrenic patients and caregivers in community and its influencing factors,and to provide evidence for carrying out community mental rehabilitation services.Methods:(1)Schizophrenic patients and their caregivers in Shanghai community were selected by multi-stage stratified cluster sampling.The self-compiled questionnaire of schizophrenic patients'disease status,the questionnaire of rehabilitation needs of schizophrenic patients(Wuxi edition)and the nursing of schizophrenic patients were used.A questionnaire for rehabilitation needs(Wuxi version)was conducted for research tools.(2)Using purposeful sampling,16 caregivers who participated in the questionnaire survey and were willing to be interviewed were selected as the subjects for qualitative research.Results:(1)A total of 240 questionnaires were collected,with 221valid questionnaires and an effective response rate of 92.1%.The total rehabilitative needs of schizophrenic patients in community were 3.27±0.95,and the scores of factors from high to low were emotion management,social security and treatment compliance.By dividing the patients into high-demand group and low-demand group,we found that treatment compliance was related to age(?~2=9.85,P<0.05),marital status(?~2=7.73,P<0.05),caregiver status(?~2=15.93,P<0.05),and overall rehabilitation demand was related to age(?~2=17.81,P<0.05),employment status(?~2=7.09,P<0.05)and caregiver's identity(?~2=14.13,P<0.05).The results of logistic regression analysis showed that age was the main factor affecting the overall rehabilitation needs of the patients,and the OR value was 0.97(95%CI=0.95-0.99),indicating that the patients were younger and more likely to have high rehabilitation needs.(2)A total of 290 questionnaires were retrieved,with 276 valid questionnaires and an effective response rate of 95.2%.The total rehabilitative needs score of caregivers was 3.34±1.08,and the factors from high to low were reduced discrimination,care skills and stress management.By dividing them into high-demand group and low-demand group,we found that family support and reducing discriminatory demand were related to patients'gender(?~2=9.36,P<0.05),caregivers'gender(?~2=7.43,P<0.05);logistic regression analysis showed that the factors affecting caregivers'family support and reducing discriminatory demand were caregivers'sex.The OR values were 0.97(95%CI=0.29-0.87)and 2.052(95%CI=1.15-3.65),respectively,for male patients and female caregivers.(3)There was a significant negative correlation between the overall needs of caregivers and the overall rehabilitation needs of patients(r=0.23,P<0.01),that is,the higher the overall rehabilitation needs of patients,the higher the overall health needs of caregivers.(4)The interview transcripts were analyzed by thematic analysis and 434 codes were obtained.Seven themes were extracted from the transcripts,namely,reducing care burden,symptom management,normal life,reducing discriminatory needs,work,stress and emotional management,and medical resource needs.The main influencing factors of symptom management are patient symptoms,lack of medical resources and difficulty in managing patients;the main influencing factors of care burden are financial burden,lack of family support and fatigue;the main influencing factors of stress and emotional management are negative emotions and unwillingness to talk with people in the process of care;the shadow of work needs.The main influencing factors are the caregiver's work and the symptoms'influence on the patient's work.The main influencing factors of discrimination are the patient's discrimination because of illness,the caregiver's discrimination because of family illness and the sense of shame.Conclusions:There are many rehabilitative needs of schizophrenic patients and caregivers in the community.Patients and caregivers with different demographic characteristics have different rehabilitative needs.Rehabilitative services should be provided according to the characteristics of patients'age,patients'gender and caregivers'gender.