中国全科医学 ›› 2024, Vol. 27 ›› Issue (09): 1088-1094.DOI: 10.12114/j.issn.1007-9572.2023.0416

• 论著 • 上一篇    下一篇

中青年缓解期精神分裂症患者社会疏离体验的质性研究

徐亚南1, 栗文娟2, 赵淑芹2, 汤语忌3, 原富强1, 赵昆朋1,*()   

  1. 1.453002 河南省新乡市,新乡医学院第二附属医院老年精神科
    2.453002 河南省新乡市,新乡医学院第二附属医院护理部
    3.453002 河南省新乡市,新乡医学院第二附属医院早期干预二科
  • 收稿日期:2023-07-14 修回日期:2023-08-19 出版日期:2024-03-20 发布日期:2023-12-19
  • 通讯作者: 赵昆朋

  • 作者贡献:徐亚南负责研究整体设计、访谈资料整理与归纳、论文撰写和修订;栗文娟负责协调研究的实施、文献查阅;赵淑芹负责组织访谈、访谈资料整理与归纳;汤语忌负责文献查阅、组织访谈;原富强访谈资料整理与归纳;赵昆朋负责访谈资料整理与归纳,论文的撰写和修订。
  • 基金资助:
    河南省科技厅科技攻关项目(212102310588)

A Qualitative Study on the Social Isolation Experience of Young and Middle-aged Patients with Schizophrenia in Remission

XU Yanan1, LI Wenjuan2, ZHAO Shuqin2, TANG Yuji3, YUAN Fuqiang1, ZHAO Kunpeng1,*()   

  1. 1. Department of Geriatric Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
    2. Nursing Department, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
    3. Early Intervention Department 2, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China
  • Received:2023-07-14 Revised:2023-08-19 Published:2024-03-20 Online:2023-12-19
  • Contact: ZHAO Kunpeng

摘要: 背景 精神分裂症患者在整个生存期常感知到的较为严重的社会歧视,出现自我疏离或者社会性疏离。目前针对中青年缓解期精神分裂症患者社会疏离方面的研究较少。 目的 描述中青年缓解期精神分裂症患者社会疏离的体验,旨在为缓解该人群社会疏离体验制订支持干预方案提供一定的借鉴和参考。 方法 采用目的抽样法选取18~59岁,曾在新乡医学院第二附属医院住院且出院后愿意继续接受随访的中青年缓解期精神分裂症患者为研究对象,于2022年5—12月通过对受访者进行面对面半结构式深入访谈,并以内容分析法归纳和提炼主题。 结果 共纳入18名中青年缓解期精神分裂症患者。通过对访谈资料进行分析,共提炼出3个主题和8个亚主题:中青年缓解期精神分裂症患者社会疏离的表现(包括2个亚主题:负性情感体验、期待与行为之间的退缩);中青年缓解期精神分裂症患者社会疏离的主观原因(包括2个亚主题:自我疏离、自我歧视)、中青年缓解期精神分裂症患者社会疏离的客观原因(包括4个亚主题:社会歧视和被动疏离、药物不良反应的影响、精神疾病引起的生活和照护负担加重、缺乏社会支持)。 结论 中青年缓解期精神分裂症患者由于生理健康受损、心理状况不良、社会支持不足等存在社会疏离,医护人员应加强对该人群的症状管理和心理疏导,政府及社会各界应积极引导对精神疾病的正向认知并给予一定的社会支持;同时强化家庭内部支持,以帮助其重返和适应社会。

关键词: 精神分裂症, 社会疏离, 缓解期, 中青年, 半结构式访谈, 质性研究

Abstract:

Background

Schizophrenia often experience severe social discrimination throughout their entire survival period, resulting in self isolation or social isolation. Limited studies have been conducted on social isolation in young and middle-aged patients with schizophrenia in remission.

Objective

To describe the social isolation experience of young and middle-aged patients with schizophrenia in remission, aiming to provide reference for developing supportive intervention plans to alleviate the social isolation experience of this population.

Methods

A purposive sampling method was used to select young and middle-aged schizophrenia patients aged 18-59 who had been hospitalized at the Second Affiliated Hospital of Xinxiang Medical University and were willing to continue follow-up after discharge as the research subjects. From May to December 2022, a semi-structured in-depth interview was conducted face-to-face with the respondents, and the themes were summarized and extracted using content analysis method.

Results

A total of 18 young and middle-aged patients with schizophrenia in remission were included. By analyzing the interview data, a total of 3 themes and 8 sub themes were extracted, including the performance of social isolation in young and middle-aged patients with schizophrenia in remission (containing 2 subthemes of negative emotional experience and withdrawal between expectation and behavior) ; subjective reasons for social isolation in young and middle-aged patients with schizophrenia in remission (containing 2 subthemes of self isolation and self discrimination) , and the objective reasons for social isolation in young and middle-aged patients with schizophrenia in remission (containing 4 subthemes of social discrimination and passive containing, effects of adverse drug reactions, increased burden of living and care caused by mental illness, and the lack of social support) .

Conclusion

Young and middle-aged patients with schizophrenia in remission may experience social isolation due to impaired physical health, poor psychological status, and insufficient social support. Healthcare professionals should strengthen symptom management and psychological counseling for this population. The government and all sectors of society should actively guide positive perception of mental illness and provide certain social support; family support should be strengthened to help young and middle-aged patients with schizophrenia in remission reintegrate and adapt to society.

Key words: Schizophrenia, Social isolation, Relief period, Middle-aged and young people, Semi-structured interviews, Qualitative research