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Quality of Life and Its Influencing Factors Among Schizophrenia Patients Living in Urban and Rural Areas
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摘要:
目的 调查四川省某市精神分裂症患者生活质量现状，进一步探讨生活质量影响因素的城乡差异。 方法 采用多阶段分层整群随机抽样法选取已纳入“四川省严重精神障碍综合管理信息系统”管理的824例精神分裂症患者为调查对象。采用精神分裂症患者生活质量量表（Schizophrenia Quality of Life Scale, SQLS）、社会支持评定量表(Social Support Rating Scale, SSRS)、一般情况调查表和生活行为方式调查表等对其进行问卷调查，并采用单因素和多重线性回归模型分析城市和农村精神分裂症患者生活质量的影响因素。 结果 农村患者各个测评领域的生活质量均比城市患者更差（P<0.05）。婚姻状况、职业技能、体育锻炼和社会支持是城市患者生活质量的影响因素（P<0.05）；而年龄、婚姻状况、家庭年收入、职业技能、社区康复活动、步行至最近的医疗机构所需时间是农村患者生活质量的影响因素（P<0.05）。 结论 应根据城乡特点，从经济扶持、职业技能训练、精神卫生投入、社区康复和社会支持等多方面，有针对性地制定提升精神分裂症患者的生活质量的措施。 Abstract:Objective To investigate the status quo of the quality of life of schizophrenia patients in a city in Sichuan Province and to explore, thereof, the urban-rural differences in the factors influencing their quality of life. Methods A total of 824 schizophrenia patients were selected for the study through multistage stratified cluster random sampling method. All the subjects were selected from a pool of patients covered by the Sichuan Provincial Information System for the Comprehensive Management of Severe Mental Disorders. Questionnaire surveys were conducted with the Schizophrenia Quality of Life Scale (SQLS), the Social Support Rating Scale (SSRS), the general circumstance questionnaire, and the lifestyle questionnaire. In addition, univariate and multiple linear regression models were used to analyze the influencing factors of quality of life among schizophrenia patients living in urban areas and those in rural areas. Results Rural patients had poorer quality of life than urban patients did in all measurement domains (P<0.05). Marital status, vocational skills, physical exercise, and social support were influencing factors of the quality of life among urban patients (P<0.05). Age, marital status, annual household income, vocational skills, participation in community rehabilitation activities, and the time required to walk to the nearest medical institution were influencing factors of the quality of life among rural patients (P<0.05). Conclusion Targeted measures for the enhancement of the quality of life of schizophrenia patients should be formulated on the basis of urban and rural characteristics in terms of economic support, vocational skills training, input in mental health services, community rehabilitation services, and social support. -
Key words:
- Schizophrenia /
- Urban and rural areas /
- Quality of life /
- Influencing factors
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表 1 城乡间精神分裂症患者生活质量量表（SQLS）评分对比
Table 1. Comparison of SQLS scores of schizophrenia patients from urban areas and those from rural areas
Measurement field Urban areas ( n=105) Rural areas (n=719) t P Psychosocial ($\bar x\pm s $) 13.38±12.77 18.74±18.31 −2.90 0.0039 Motivation and Energy ($\bar x\pm s $) 47.11±13.50 51.79±18.31 −2.52 0.0119 Symptoms and Side-effects ($\bar x\pm s $) 9.19±10.29 16.33±16.66 −4.27 <.0001 Total score ($\bar x\pm s $) 20.13±9.66 25.81±14.59 −3.86 0.0001 
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表 2 精神分裂症患者生活质量影响因素的单因素分析
Table 2. Univariate analysis of factors influencing the quality of life of schizophrenia patients
Variable Number of cases (n=824) SQLS score ($\bar x\pm s $) t/F P Sex −1.44 0.1493 Male 344 24.24±13.77 Female 480 25.69±14.45 Age 13.14 <0.0001 ≤30 yr. 58 23.27±13.11 31-59 yr. 502 23.38±14.02 ≥60 yr. 264 28.72±14.06 Highest education achieved 4.13 0.0025 Primary school and below 217 27.19±13.63 Junior high school 308 26.03±14.48 High school or junior college 192 22.47±14.05 College and above 80 22.27±12.22 Annual family income 4.61 <0.0011 <10000 RMB 262 27.09±14.85 10000 -30000 RMB 331 25.69±14.86 30001 -50000 RMB 132 22.16±11.42 >50000 RMB 77 20.99±11.20 Marital status 1.93 0.1230 Married 512 24.91±14.16 Divorced 45 22.55±11.80 Widowed 47 29.30±13.44 Never married 200 25.32±14.49 Smoking 2.01 0.0450 Yes 99 22.41±11.46 No 725 25.45±14.48 Drinking −0.14 0.8850 Yes 66 25.32±15.04 No 758 25.06±14.11 Physical exercise 2.07 0.0387 Yes 182 23.16±13.31 No 642 25.62±14.37 Poor living conditions −3.69 0.0002 Yes 48 32.36±15.15 No 776 24.63±14.01 Lack of vocational skills −9.73 <0.0001 Yes 176 33.82±12.72 No 648 22.71±13.62 Experiencing social discrimination −8.12 <0.0001 Yes 121 34.39±12.58 No 703 23.48±13.82 Participation in community rehabilitation activities 3.79 0.0002 Yes 330 22.81±12.47 No 494 26.60±15.03 Walking time to the nearest medical facility 7.30 0.0007 ≤15 min 161 21.51±10.31 16-30 min 245 26.87±15.81 >30 min 418 25.41±14.24 Suffering from chronic diseases 4.87 0.0079 Yes 145 27.71±12.67 No 664 24.36±14.36
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表 3 城乡精神分裂症患者生活质量影响因素的多重线性回归分析
Table 3. Multiple linear regression analysis of factors influencing the quality of life in urban and rural schizophrenia patients
Factor Variable Reference Urban Rural β P β P Sex Male Female −2.50 0.2059 −1.24 0.3546 Age 31-59 yr. ≤30 yr. −1.21 0.7171 1.44 0.5115 ≥60 yr. 5.82 0.1681 6.74 0.0076 Marital status Divorced Married −0.04 0.9900 2.01 0.4092 Widowed 10.89 0.0200 3.84 0.0868 Never married 3.22 0.1798 4.28 0.0091 Annual family income 10000-30000 RMB <10000 RMB −1.79 0.5588 −0.71 0.5476 30001-50000 RMB 2.21 0.5199 −2.98 0.0658 >50000 RMB −2.49 0.4802 −4.81 0.0476 Highest education achieved Junior high school Primary school and below −3.81 0.2139 0.82 0.5255 High school or junior college −4.60 0.1684 −0.92 0.5563 College and above −5.27 0.1139 0.78 0.7633 Suffering from chronic diseases No Yes −1.14 0.6690 −2.26 0.1020 Lack of vocational skills No Yes −6.27 0.0137 −10.46 <0.0001 Poor living conditions No Yes −2.31 0.7996 −0.75 0.7155 Experiencing social discrimination No Yes −2.29 0.5152 −3.48 0.0930 Smoking No Yes −2.10 0.4404 0.19 0.9140 Drinking No Yes −2.01 0.5737 −0.39 0.8379 Physical exercise No Yes 4.39 0.0221 1.53 0.2260 Participation in community rehabilitation activities No Yes 3.62 0.2281 4.66 <0.0001 Walking time to the nearest medical facility ≤15 min >30 min 1.46 0.7463 −3.56 0.0265 16-30 min 1.12 0.8064 1.21 0.2871 SSRS score −0.35 0.0144 0.41 <0.0001
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