Health education; Medication compliance; Telephone return visit
With the progress of society and the development of science and technology, the pace of life is accelerating, people are facing increasingly fierce competition and challenges, and social psychological factors and lifestyle-related diseases are obviously increasing. Mental illness is not only a public health problem, but also a social problem. Many mental diseases can only be controlled by long-term medication because the etiology is unknown and there is no specific treatment. Because of the prolonged course of disease, easy recurrence and high disability rate, patients and their families often lose confidence in treatment, and a vicious circle of drug withdrawal, recurrence, retreatment and drug withdrawal is formed after discharge, which has caused huge economic burden to individuals, families and society. Therefore, strengthening health education, improving the compliance of patients with mental disorders after discharge and maintaining treatment are effective methods to prevent recurrence, prevent disability and promote rehabilitation. In this paper, patients discharged from mental health center in Jinshan District of Shanghai from June 5438+00, 2008 to June 5438+00, 2009 were paid a telephone call back, and the results are reported as follows.
1 objects and methods
1. 1 The subjects were registered patients in this city who were discharged from June 2008 to June 2009 124 people, including 59 males and 65 females. The age ranged from 65438 04 to 86, with an average of (37.28 65438 04.36) years. According to CCMD-3 diagnostic criteria, there were 89 cases of schizophrenia, 9 cases of mood disorder, 5 cases of mental retardation with mental disorder, and 2/kloc-0 cases of other mental disorders. After treatment, 18 cases were cured, 59 cases were markedly effective, 4 cases were improved, and 6 cases remained unchanged. Education level: 5 cases in university, 0/4 cases in junior high school/KLOC-0, 48 cases in junior high school, 39 cases in primary school and below, and 28 cases in illiteracy. Number of hospitalizations: first time 14 cases, second time 38 cases, third time 34 cases, fourth time and above 38 cases.
1.2 methods Health education on mental illness was given to patients during hospitalization, including the name, function, adverse reactions and treatment of antipsychotic drugs, and the purpose and methods of maintenance treatment. At the time of discharge, the family members were given intensive education on the importance and necessity of drug abuse. At the end of discharge 1, call back the subjects to understand the medication situation.
Two results
2. 1 The proportion of patients taking medicine after discharge for the first time and four or more times was significantly lower than that for the second and third time. See table 1. Table 1 Number of inpatients with mental disorders after discharge and drug use
2.2 The different education levels of patients have no obvious influence on the drug use. See Table 2. Table 2 Education level and drug use
2.3 Compared with other diseases, the withdrawal rate of schizophrenic patients in the last month after discharge is not high, as shown in Table 3. Table 3 Diseases and Drugs
3 discussion
3. 1 The importance and necessity of taking medicine is the main content of health education to improve compliance. Due to the lack of understanding of the seriousness of mental illness, this survey shows that the proportion of first-time inpatients who stop taking drugs after discharge is high. First-time patients are generally younger, have a shorter course of disease and have a relatively mild degree of social dysfunction. Maintenance treatment has a far-reaching impact on the prognosis of patients. During hospitalization, patients and their families will be introduced to the role of antipsychotic drugs, adverse reactions and their treatment, and the purpose and methods of maintenance treatment, so that they can fully realize its importance and necessity and insist on maintenance treatment. Patiently answer questions from patients and their families, and provide psychological support when calling back. Medication compliance has always been a thorny issue in the treatment of mental illness. With the increase of hospitalization times and the extension of illness time, many patients and their families gradually lose confidence. This survey shows that the proportion of patients who have been hospitalized for four times or more in the past month is high. It is consistent with Zhang Shushen's survey in 2005 [1]. Objective most patient have family management when they leave hospital, and that quality of family management will directly affect the effectiveness of patients' compliance. In addition to calling on the society to pay more attention to these vulnerable groups, we should also regularly impart mental health knowledge to patients and their families during hospitalization, carry out mental health education, create a suitable environment for patients' rehabilitation, help family members face reality, correct their attitude towards diseases, eliminate bad factors affecting rehabilitation, increase communication among patients, family members and medical staff, improve family relations and doctor-patient relations, and promote the recovery and reconstruction of patients' family and social functions.
3.2 Health education can promote compliance after discharge, but it is necessary to strengthen continuing health education after discharge. The compliance rate of newly discharged patients was 15.32%, which was significantly higher than that of 43.85% registered mental patients in Minhang District of Shanghai in June 2005 [2]. It shows that health education during hospitalization can make patients and their families realize the importance of taking medicine when they leave the hospital. However, with the extension of discharge time, the compliance of patients with antipsychotic drugs gradually declined. At the same time, the patient's condition and the identity of the guardian may affect the drug compliance, resulting in poor compliance when discharged. According to statistics, 82% of patients relapsed within 5 years, while the recurrence rate of patients who insisted on treatment was only 16%[3]. Therefore, it is helpful to actively carry out various health education for continuing treatment after discharge, promote patients' maintenance treatment and reduce the recurrence rate.
Through health education, patients and their families can get scientific guidance, humanistic understanding, care and respect, especially for patients' families, reduce sense of shame, increase knowledge of disease prevention and treatment, and improve the safety and effectiveness of patients' maintenance treatment during discharge.