佛山市社区严重精神障碍患者精康融合服务利用现状及其影响因素研究

doi:10.12183/j.scjpm.2026.0560

摘要/Abstract

摘要： 目的基于安德森模型,分析在“精康融合行动”背景下,佛山市社区严重精神障碍患者（简称重精患者）对“精康融合服务”（简称精康服务）的利用现状及影响因素,为精康服务推广提供依据。方法 2022年10—12月,采用多阶段随机抽样的方法以佛山市社区在册的重精患者为研究对象开展问卷调查,用描述分析方法分析重精患者精康服务利用现状,采用logistic回归方法分析精康服务利用的影响因素。结果纳入分析重精患者1 034例,以女性535例（51.74%）、18~<45岁407例（39.36%）居多,利用过精康服务的679例（65.67%）,以健康管理类服务（49.71%）为主,认为需要精康服务的985例（95.26%）。向前逐步logistic回归分析结果显示,重精患者年龄（18~<45岁OR=2.138;45~<60岁OR=3.317;≥60岁OR=2.501）、监护人文化程度（初中/高中/中专OR=1.838）、监护人与重精患者的关系（子女OR=1.814）、生存质量（中等OR=1.952;较高OR=1.451）、服务驻点地（村居委OR=2.773）、当地服务持续年限（>2年OR=2.293）和对精神障碍社区康复服务体系的满意度（一般OR=1.569;满意OR=2.251）是精康服务利用情况的影响因素（均P<0.05）。结论佛山市社区重精患者对精康服务利用远低于需求,镇街应根据患者、监护人以及精康服务的驻点地和持续年限等影响因素,采取适宜措施推广服务,保障较高的利用率。

关键词: 严重精神障碍, 社会工作服务, 精康融合行动, 影响因素

Abstract: Objective Grounded in the Andersen model, this study aimed to analyze the utilization of Integrated Mental Health and Rehabilitation Services (Jingkang Services) and its determinants among community-dwelling patients with severe mental disorders (SMDs) in Foshan The findings are intended to provide an evidentiary basis for the promotion and dissemination of these services. Methods A cross-sectional questionnaire-based survey was conducted between October and December 2022. A multistage random sampling methodology was employed to recruit participants from the registry of community-dwelling patients with SMDs in Foshan. Descriptive statistical analysis was used to characterize the status of service utilization, while logistic regression analysis was performed to identify the influencing factors. Results A total of 1 034 patients were included in the final analysis. The cohort was predominantly female (n=535, 51.74%) and aged between 18 and 44 years (n=407, 39.36%). Of the participants, 679 (65.67%) had utilized the services, with health management services being the most frequently accessed category (49.71%). A substantial majority of patients (n=985, 95.26%) perceived a need for these services. The logistic regression results revealed that service utilization was significantly associated with patient's age (18-<45 years OR=2.138; 45-<60 years OR=3.317; ≥60 years OR=2.501), guardian's educational attainment (junior high/high school/vocational school OR=1.838), guardian's relationship to the patient (offspring OR=1.814), quality of life (moderate OR=1.952; high OR=1.451), service delivery location (village/neighborhood committee OR=2.773), duration of local service provision (>2 years OR=2.293), and satisfaction with the community-based mental health rehabilitation system (moderate OR=1.569; satisfied OR=2.251) (all P<0.05). Conclusion The utilization of Integrated Mental Health and Rehabilitation Services among community-dwelling patients with SMDs in Foshan is substantially lower than the perceived need. It is recommended that sub-district and township authorities implement tailored strategies based on the identified determinants—including patient and guardian characteristics, service point location, and program duration—to promote service uptake and ensure higher utilization rates.

Key words: Severe mental disorders, Social work services, Integrated Mental Health and Rehabilitation Services, Influencing factors

中图分类号:

R749

康迅, 陈淑并, 伍楚琪, 胡汝为. 佛山市社区严重精神障碍患者精康融合服务利用现状及其影响因素研究[J]. 华南预防医学, 2026, 52(5): 560-566.

Kang Xun, Chen Shubing, Wu Chuqi, Hu Ruwei. Utilization and correlates of Integrated Mental Health and Rehabilitation Services among individuals with severe mental illness in Foshan[J]. South China Journal of Preventive Medicine, 2026, 52(5): 560-566.

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