| 摘要 |
探讨住院双相障碍及精神分裂症患者生活质量水平的保护性因素。方法 采用分层随机方法，在广州市24家精神卫生机构中抽取4家有住院部的医院，连续入组符合《国际疾病分类（第10版）》精神分裂症、双相障碍诊断标准的住院患者。采用自编人口学及临床特征问卷、世界卫生组织生活质量问卷简版 (WHOQOL-BREF) 评定患者的人口学、临床特征，以及生活质量水平。通过t检验及单因素方差分析患者的人口学、临床特征和生理领域、心理领域、社会关系领域以及环境领域间的关系；对于单因素分析结果有统计学意义的变量纳入多元方差分析。结果 共464名患者符合入组标准。患者在生理、心理及社会关系领域的生活质量均显著低于常模。多元方差结果显示，年龄(F=2.813,P=0.004)，婚姻(F=4.179,P=0.002)，运动(F=4.486,P=0.001)，自知力水平(F=10.373,P<0.001)，每日睡眠时间(F=6.013,P<0.001), 最近一周BRPS得分(F=2.724,P=0.029)和生活质量相关。其中年龄（40-60岁）、规律运动、每日睡眠超过7小时是生理领域生活质量保护性因素；曾结婚是心理领域生活质量保护因素；曾结婚、规律运动、BRPS分数低是社会关系领域生活质量保护性因素；年龄（40-60岁）、规律运动、自知力水平高、每日睡眠超过7小时、BRPS分数低是环境因素生活质量保护因素。结论 住院精神分裂症及双相障碍患者生活质量水平和多种人口学特征及临床特征相关，应根据相关特点进行有针对性干预，从而提高患者生活质量，促进全面康复。
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| Abstract |
Objective To explore the protective factors of quality of life(QOL) in hospitalized patients with bipolar disorder or schizophrenia. Methods Four hospitals with inpatient departments were selected from 24 mental health institutions in Guangzhou by stratified random method. The inpatients who met the diagnostic criteria of schizophrenia or bipolar disorder according to the International Classification of Diseases (10th edition) were enrolled in this study. Demographic and clinical characteristics and quality of life were assessed by self-designed demographic and clinical characteristics questionnaire and World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). The effect of demographic, clinical characteristics on quality of life were analyzed by using t test and one-way ANOVA. Variables with statistical significance in univariate analysis were included in multivariate ANOVA. Results A total of 464 patients met the inclusion criteria. The patients QOL in physical, psychological and social relationships domains were significantly lower than the norm. MANOVA shows that age (F = 2.813, P = 0.004), marriage (F = 4.179, P = 0.002), exercise (F = 4.486, P = 0.001), insight (F = 10.373, P < 0.001), daily sleep duration (F=6.013, P<0.001) and BRPS score in the last week (F=2.724, P=0.029) were associated with QOL. Among them, age (40-60 years old), regular exercise, sleep more than 7 hours a day were protective factors of physiological QOL; Having been married is a protective factor of psychological QOL. Previous marriage, regular exercise and low BRPS score were the protective factors of QOL in social relationship domain. Age (40-60 years old), regular exercise, high level of self-awareness, more than 7 hours of daily sleep, and low BRPS score were environmental factors to protect QOL. Conclusion The QOL of hospitalized patients with schizophrenia and bipolar disorder is correlated with a variety of demographic and clinical characteristics, so targeted intervention should be carried out according to the relevant characteristics, so as to improve the QOL of patients and promote comprehensive rehabilitation.
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