深圳市某区严重精神障碍患者健康体检率调查及其影响因素研究

目的 了解深圳市某区严重精神障碍患者的免费健康体检率及其影响因素，为制定社区健康体检干预措施提供依据。方法 选取2020年度某区登记在管的严重精神障碍患者为研究对象，采用多因素logistic回归模型分析患者健康体检的影响因素。结果 共收集6188例患者资料，参加免费体检患者2 652例，体检率为42.86%。多因素logistic回归分析结果显示，年龄18~44岁（OR=1.619，95%CI:1.213~2.161）、年龄45~59岁（OR=2.194，95%CI:1.589~3.029）、年龄≥60岁（OR=2.122，95%CI:1.444~3.118）、非户籍（OR=1.570，95%CI:1.362~1.809）、医疗费用支付方式为医保（OR=1.195，95%CI:1.023~1.396）、医疗费用支付方式为补贴救助(OR=1.877，95%CI:1.628~2.164)或其他（OR=2.178，95%CI:1.583~2.997）、分裂情感性障碍（OR=1.353，95%CI:1.015~1.803）或癫痫所致精神障碍（OR=2.220，95%CI:1.511~3.261）是患者参加免费体检的积极因素，监护人为亲戚（OR=0.735，95%CI:0.591~0.914）、监护人为朋友及其他（OR=0.429，95%CI:0.314~0.586）、无监护人（OR=0.635，95%CI:0.457~0.884）、服药依从性为间断服药（OR=0.628，95%CI:0.476~0.829）、不服药（OR=0.378，95%CI:0.311~0.460）、初发病年龄≥40岁（OR=0.705，95%CI:0.551~0.904）是患者参加免费体检的消极因素。结论 深圳市某区严重精神障碍患者的免费健康体检率有待提高，应通过加强健康宣教、督促规律服药、适当增加体检项目等措施提高患者体检率。

Physical examination rate of patients with severe mental disorders and its influencing factors in one district of Shenzhen

Objective To explore the free physical examination rate and its influencing factors of patients with severe mental disorders (SMD) in one district of Shenzhen, and to provide evidence for developing community physical examination intervention. Methods Patients with SMD in one district of Shenzhen were selected as subjects, in 2020. The influencing factors of physical examination were analyzed by multivariate logistic regression. Results The total number of patients with SMD and that of free physical examination were 6 188 and 2 652, respectively. The physical examination rate was 42.86%. Multivariate logistic regression analysis showed that age 18 to 44 years (OR=1.619, 95%CI:1.213-2.161)，age 45 to 59 years (OR=2.194, 95%CI:1.589-3.029)，age ≥60 years (OR=2.122, 95%CI:1.444-3.118), non-registered permanent residence (OR=1.570, 95%CI:1.362-1.809), the payment method on medical expenses was medical care (OR=1.195, 95%CI:1.023-1.396), the payment method on medical expenses was government subsidy (OR=1.877, 95%CI:1.628-2.164) or others (OR=2.178, 95%CI:1.583-2.997), Schizoaffective disorder (OR=1.353, 95%CI:1.015-1.803) or Mental disorder due to epilepsy (OR=2.220, 95%CI:1.511-3.261) were positive factors for patients to participate in free physical examination, while guardians were relatives (OR=0.735, 95%CI:0.591-0.914), guardians were friends or others (OR=0.429, 95%CI:0.314-0.586), no guardian (OR=0.635, 95%CI:0.457-0.884), taking medicine was intermittent (OR=0.628, 95%CI:0.476-0.829), no drugs (OR=0.378, 95%CI: 0.311-0.460) and the age of onset ≥40 years (OR=0.705, 95%CI:0.551-0.904) were negative factors for patients to participate in free physical examination. Conclusion Free physical examination rate of patients with SMD in one district of Shenzhen needs to be improved. It is necessary to strengthen health education, urge regular medication, and increase physical examination items appropriately to develop the physical examination rate.