基于生物—心理—社会模式的住院患者负荷现状及多因素关联分析

Current Status and Multifactorial Association Analysis of Patient Burden in Inpatients Based on the Biopsychosocial Model

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目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象,构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分,采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分,高负荷患者约占三分之一;生物、心理、社会因素联合模型可解释68.4%的负荷变异;明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征,应建立多维评估与分层干预机制,以优化资源配置和连续照护。
Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.
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