探討男性慢性精神病人的安全性行為把握度及影響因素

An Exploration of the Confidence in Conducting Safe Sexual Behavior and Related Factors in between Male Patients having Chronic Mental Illnesses

10.6847/TJPMHN.201611_11(1).0001

高凡晴(Fan-Ching Kao)；楊美賞(Mei-Sang Yang)；林健禾(Chien-Ho Lin)；高霈馨(Pei-Hsin Kao)

男性 ； 慢性精神疾病 ； 安全性行為 ； 臨床整體印象—嚴重度 ； male ； chronic mental illnesses ； safe sexual behaviors ； Clinical Global Impression- Severity (CGI-S)

精神衛生護理雜誌

11卷1期（2016 / 11 / 01）

5 - 18

繁體中文

背景：不安全性行為每年導致數百萬人感染性傳播疾病甚至死亡。相較於一般族群，精神疾病病人感染性傳播疾病的比率較高，而在男性病人性相關的危險行為則較多，為提供醫療照護，了解病人對安全性行為的把握程度，以及各項因素與安全性行為的相關性是有必要的。目的：瞭解男性慢性精神病人執行安全性行為的把握程度，探討個人屬性因素、疾病及藥物治療因素和執行安全性行為把握度的相關性。方法：採橫斷式研究，以一對一的訪談方式完成自填式結構量表。共95名病人參與研究，包含日間病房和居家照護單位，採用描述性與推論性統計分析數據。結果：病人執行安全性行為把握度的標準化得分是59.7分，病人最有把握的安全性行為是確實執行不要性交時能拒絕對方，而最無把握的則是在有「性」困擾時能尋求正確資源。個人屬性、疾病及藥物與安全性行為把握度得分皆無顯著差異，僅疾病因素中精神疾病嚴重度指標（臨床整體評估－嚴重度）與安全性行為把握度得分有顯著負相關性，尤其是具有非固定性伴侶的病人，精神症狀嚴重度分數越高在安全性行為把握度得分顯著越低。

Millions of people have been infected with sexual transmission disease (STD) and even resulted in death due to unsafe sexual behaviors. Comparing to general population, patients with chronic mental illnesses had higher risk for getting STD and male patients had more risky sexual behaviors. To providing medical care, it is necessary to understand the patients’ confidence of conducting safe sexual behaviors and their related factors in between. The aim of this study is to investigate the confidence of carrying out safe sexual behaviors among male patients with chronic mental illnesses. Moreover, we have explored the difference between personal characteristic and disease history in confidence of conducting safe sexual behaviors. A cross-sectional study with a self-administered structured questionnaire was given and conducted in a one-to-one interview. A total of 95 patients were recruited in this study who were from psychiatric day care units and home care units. The study data were analyzed by descriptive and inferential statistics. In the study, the standard score of all patients’ confidence to conduct safe sexual behavior was 59.7. Patients had great confidence in refusing sexual invitation while they didn’t want to have sex with others. However, patients had the lowest confidence in searching accurate resources or information when they have sexual disturbing problems. There was no significant association among personal characteristics, type of mental illness, drugs and confidence of conducting safety sexual behaviors. The confidence of conducting safety sexual behaviors had a significant negative association with Clinical Global Impression - Severity (CGI-S) scale, especially those with non-fixed sexual partners. The higher the score of CGI-S is, the lower the score of confidence of conducting safety sexual behaviors would be.

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