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目的评定长沙市公众精神卫生和精神疾病预防知识的知晓情况。方法采用多阶段整群随机抽样方法,选取长沙市辖区随机抽取的2个城市社区和2个农村社区的1660户家庭。从15岁及以上的家庭成员中随机抽取1人进行访谈,完成卫生部推荐的精神卫生知晓率标准问卷(20项)调查。结果 1563人完成有效问卷调查,其中男性676人,女性887人,平均年龄(标准差)为41.9(15.9)岁。平均(标准差)应答正确率为68.5%(46.4%),城市社区平均(标准差)应答正确率[70.5%(13.6%)]高于农村社区应答正确率[66.2%13.5%)](t=6.18,p<0.001)。正确应答率与年龄负相关(r=-0.21,p<0.001),与文化程度正相关(r=0.28,p<0.001),与职业和婚姻状态的差异呈多样相关性。采用逐步回归分析发现文化程度、年龄和职业(农民或工人与其他职业比较)为精神卫生知晓率的独立相关因素。问卷20个条目总体内部一致性及4个分量表的内部一致性偏低(alpha=0.27～0.57)。结论长沙市普通居民精神卫生知识总体知晓率相对较高,但有些方面仍需提高,特别是对于精神疾病病因的认识。公众精神卫生知识的知晓能力随人口学特征不同而有较大差异,因此对不同人群进行特定的精神卫生教育可有效地提高社区居民的精神卫生知识知晓率。今后需修订调查问卷,提高信、效度和内部一致性。
Objective To assess the public awareness of public mental health and mental illness prevention in Changsha. Methods A multistage cluster random sampling method was used to select 1660 households from 2 urban communities and 2 rural communities randomly selected from Changsha area. A random sample of 1 family members aged 15 years and over interviewed and completed a questionnaire (20 items) on the standard of awareness of mental health recommended by the Ministry of Health. Results 1563 people completed an effective questionnaire survey, of which 676 males and 887 females, with an average age (standard deviation) of 41.9 (15.9) years. The mean (standard deviation) response accuracy was 68.5% (46.4%), and the mean (standard deviation) response accuracy of urban communities was 70.5% (13.6%) higher than that of rural communities (66.2% 13.5%) = 6.18, p <0.001). Correct response rate was negatively correlated with age (r = -0.21, p <0.001), positively correlated with educational attainment (r = 0.28, p <0.001) and varied with occupational and marital status. A stepwise regression analysis found that education, age, and occupation (peasant or worker versus other occupations) were independently correlated with awareness of mental health. The overall internal consistency of the 20 items in the questionnaire and the low internal consistency of the four subscales (alpha = 0.27-0.57). Conclusion The general awareness rate of mental health among ordinary residents in Changsha is relatively high, but some aspects still need to be improved, especially for understanding the etiology of mental illness. Public awareness of mental health knowledge varies greatly with demographic characteristics, so specific mental health education for different groups of people can effectively improve the awareness of mental health of community residents. In the future, it is necessary to revise the questionnaire to improve the letter, validity and internal consistency.