关键词: 精神分裂症, 康复, 卫生服务需求, 社区卫生服务, 影响因素分析

Abstract: Background　Most patients with schizophrenia return to the community to continue to recover when the symptoms during an acute schizophrenic episode being relieved or improved.However，in China，the utilization rate of community mental health resources is not high，community-based rehabilitation services can not meet the growing rehabilitation needs of patients，and patients are dissatisfied with such services.Objective　To investigate the rehabilitation needs and influencing factors among community-dwelling schizophrenic patients in Shanghai，providing a basis for theoretical research and implementation of mental health rehabilitation.Methods　From December 2016 to July 2017，a survey was conducted in a multi-stage stratified cluster random sample of 2 285 registered schizophrenic patients receiving community-based mental health management from 249 residential（village）committees in 18 districts of Shanghai.Survey tools include self-developed General Personal Information Questionnaire，and Disease Characteristics and Treatment Questionnaire，and Wuxi version of the Rehabilitation Needs Questionnaire for People with Schizophrenia（PRNQ-S-WX）．The total score of rehabilitation needs was compared by personal characteristics.Influencing factors of rehabilitation needs were analyzed by stepwise multiple linear regression.Results　The mean total score of rehabilitation needs assessed by all the participants was（2.93±1.07）．The top-ranked six factors in terms of mean evaluation score were 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 total score of rehabilitation needs varied significantly by gender，place of residence（urban or suburban area），education level，living status（independent or not），main caregivers，employment status，financial support from family，mean monthly expenditure on schizophrenia，prevalence of having disability certificate，family history，schizophrenia，medication status，outpatient follow-up and psychiatric symptoms relief（P<0.05）．The total score of rehabilitation needs was negatively correlated with age and duration of schizophrenia（r valuces were -0.230，0.139；P<0.05），but was positively correlated with the number of schizophrenia relapses，the number of rehabilitation services received and the score of service satisfaction（r valuces were 0.113，0.469，0.330；P<0.05）．Stepwise multiple linear regression analysis showed that place of residence，employment status，financial support from family，mean monthly expenditure on schizophrenia，outpatient follow-up，age，number of schizophrenia relapses，number of rehabilitation services received，and satisfaction with rehabilitation services were associated with the rehabilitation needs in schizophrenia patients（P<0.05）．Conclusion　Schizophrenic patients in the community in Shanghai have many various domains of rehabilitation needs.Their rehabilitation needs are influenced by place of residence，employment status，financial support from family，monthly expenditure on schizophrenia，outpatient follow-up status，age，number of schizophrenia relapses，number of rehabilitation services received，and satisfaction level with rehabilitation services.In view of this，social and government departments should make full use of the existing resources to provide personalized and diversified services according to the patient's situation.

Key words: Schizophrenia, Rehabilitation , Health services needs and demand, Community health services, Root cause analysis