The Social Function Among Schizophrenics And Its Related Factors Based On The Theory Of Social Ecosystem

Objective:To investigate the social function status of schizophrenics,and to explore the relationship between their social function status and microcosmic system,mesoscopic system and macroscopic system under the framework of social ecosystem theory,so as to provide theoretical basis for formulating effective psychological intervention measures.Methods:A total of 272 patients with schizophrenia were selected from the outpatient service of a grade a psychiatric hospital in shandong province by convenient sampling.General information questionnaire,SDSS,PANAS,PCQ,BFI-44,PSSS and APGAR were used to investigate the patients.SPSS22.0 statistical software was used for data entry,sorting and analysis.The statistical methods included descriptive statistical analysis,independent sample t test,analysis of variance,Pearson correlation analysis and multiple linear regression analysis.Results:1.Basic demographic and clinical data of patients with schizophreniaIn this study,272 patients with schizophrenia ranged in age from 18 to 60 years old,with an average age of(35.34±10.64)years.The majority of them were males(62.9%).Married(47.1%)was the same as unmarried(52.9%);The distribution of education background is middle school or below 29.8%,high school or secondary school 30.5%,college or above 39.7%.Most of them were from cities(64.3%);The household economy is dominated by those who make ends meet(65.4%).In terms of working conditions,full-time workers(44.5%)were the highest,half workers(33.4%)were in the middle,and the least unemployed,unemployed or retired(22.1%)were the lowest.Most of the disease types were paranoid schizophrenics(42.3%).The age of first onset was 18 years old or above(79.8%).Nearly half(42.6%)of patients with disease duration<5 years;The majority(81.6%)had no cause of disease.The proportion of those without a family history of mental illness was 83.8%.Occasional or sometimes active participants(62.9%);Medication compliance,good(45.6%)and poor(54.4%)about the same.2.The social function of schizophrenic patients and their differences in social demography and clinical dataThe score of social dysfunction of schizophrenic patients ranged from 1 to 20 points,with an average score of 8.17±4.25 points.According to the classification standard of social dysfunction scale,21(7.7%)patients with normal social function and 251(92.3%)patients with social dysfunction had normal social function.Independent samples t test,single factor variance analysis results showed that patients with schizophrenia social function defect score in gender,age,educational level,family economic conditions,schizophrenia,classification,first onset age,disease duration,family history of mental illness,medication adherence after discharge,working condition and to participate in social activities exist differences,differences were statistically significant(P<0.05).3.The correlation between scores of social functional deficits of schizophrenics and positive emotions,personality,positive psychological capital,family care and social supportPearson correlation analysis showed that the score of social dysfunction was positively correlated with negative emotion(r=0.256,P<0.001),positively correlated with neuroticism in personality(r=0.159,P<0.01),and negatively correlated with openness,agreeableness,extraversion,and conscientiousness(r=-0.168～-0.250,P<0.001).There was a significant negative correlation between social dysfunction score and family care(r=-0.409,P<0.001).The score of social dysfunction was negatively correlated with the family support,friends support and other support in social support(r=-0.289～-0.337,all P<0.001).4.Multiple linear regression analysis of scores of social functional deficits and related factors in patients with schizophreniaAccording to the classification criteria of each system in the theory of social ecosystem,variables were included into each system.The variables included in the micro system were gender,education level,disease classification,disease course,medication compliance,family history,negative emotion,positive psychological capital,and big five personality.The variables included family support family care and marital status.The variables included in the macro system are work situation,social activity participation,other support,and friend support.Taking the score of patients’ social functional defects as the dependent variable,the variables with statistical significance of univariate analysis were included in the regression equation as independent variables,in which the variables of the microscopic system were included in the first layer,the variables of the mesoscopic system in the second layer,and the variables of the macroscopic system in the third layer for multiple linear regression analysis.The results showed that gender(β=-1.851,P<0.001)had a negative predictive effect on the scores of patients with social dysfunction in the microsystem.Duration of disease(β=0.536,P=0.029)had a positive predictive effect on the scores of patients with social functional deficits.Toughness(β=0.199,P=0.001),hope(β=0.186,P=0.007)have negative prediction function on social function defect score,optimistic(β=0.136,P=0.023)on the patient’s social function defect score has positive prediction effect,neuroticism(β=0.139,β=0.020)for patients with social function defect score has negative prediction effect micro system explain the role of social function defect in patients with predicted quantity was 28.5%.In the mesoscopic system,family care(β=-0.356,P<0.001)had a negative predictive effect on the scores of patients’ social function deficits,and the predictive effect of mesoscopic system on patients’ social function was 6.9%.In the macro system,work participation(β=0.757,P=0.009)and social activity participation(β=1.246,P=0.001)had a positive predictive effect on patients’scores of social functional deficits,while the macro system had a positive predictive effect on patients’ social regression of 4.1%.Conclusion:1.Most patients with schizophrenia have poor or defective social functions.2.The social function of schizophrenics is correlated with emotions,positive psychological capital(resilience,hope,optimism,self-efficacy),personality,family care,social support and other factors.3.Gender,disease course,toughness,hope,optimism and neuroticism in the microsystem;In the middle system,family care;Several factors such as work status and social activity participation in the macro system can predict the social function of schizophrenics in different degrees.