青少年心境障碍患者心理求助体验的质性研究

doi:10.3761/j.issn.0254-1769.2025.08.008

摘要/Abstract

摘要：

目的探讨青少年心境障碍患者心理求助过程中的体验，为医护人员制订针对性干预措施，促进青少年及早获取心理卫生健康服务提供参考。方法采用目的抽样法，于2023年12月—2024年3月，选取兰州市某三级甲等医院心理卫生科收治的14例青少年心境障碍患者进行半结构式访谈，并采用Colaizzi 7步分析法对资料进行分析。结果共提炼漫长而曲折的求助过程（对于不良情绪的自我适应、不断探索的非正式求助、危机触发或需求引导的正式求助）、挣扎与期待交织的心理体验（不被重视的失望、不被认同的无助、期待更多的理解与支持）、心理求助行为的阻碍因素（疾病知识不足、自我披露困难、缺乏信任的关系、非正式求助对象的负面态度、消极的正式求助经历）3个主题。结论青少年心境障碍患者往往经历着漫长且曲折的心理求助过程，求助过程中面临多重阻碍，渴望被理解与支持。医护人员应联合家庭、学校等多方资源，提高青少年心理健康素养，构建良好的社会支持体系，为青少年心境障碍患者获取专业心理健康服务提供可靠支持。

关键词: 心境障碍, 青少年, 心理求助, 质性研究, 体验, 心理护理

Abstract:

Objective The study explored the psychological help-seeking experiences of adolescents with mood disorder，so as to provide references for healthcare professionals to carry out relevant interventions to facilitate adolescents’ early access to mental health services. Methods A qualitative research was adopted，and 14 adolescents with mood disorder admitted to a tertiary hospital in Lanzhou City from December 2023 to March 2024 were interviewed by semi-structured interviews. The data was analyzed by Colaizzi seven-step method. Results 3 themes were extracted，including long and tortuous help-seeking journey（maladaptive coping，continuous exploration of informal help-seeking behavior，formal help-seeking for crisis-triggered or needs-driven），the psychological experience intertwining struggles and expectations（disappointment at not being taken seriously，helplessness at not being understood，expectation of more understanding and support），barriers to help-seeking（lack of knowledge，difficulties with self-disclosure，lack of trust，negative attitudes encountered when seeking informal help，negative experiences during formal help-seeking）. Conclusion Adolescents with mood disorder experienced a long and tortuous journey while seeking help，faced with numerous barriers along the process，and desired to be understood and supported. Healthcare professionals should collaborate with families，schools，and other resources，to improve adolescents’ mental health literacy and establish a robust social support system，so as to provide reliable support for adolescents with mood disorder in accessing professional mental health services.

Key words: Mood Disorder, Adolescents, Psychological Help-Seeking, Qualitative Research, Experience, Psychological Nursing

章子怡, 杜冰, 张荩之, 尹敏. 青少年心境障碍患者心理求助体验的质性研究[J]. 中华护理杂志, 2025, 60(8): 947-952.

ZHANG Ziyi, DU Bing, ZHANG Jinzhi, YIN Min. The psychological help-seeking experience of adolescents with mood disorders：a qualitative study[J]. Chinese Journal of Nursing, 2025, 60(8): 947-952.

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参考文献 22

[1]	黄顺森, 罗玉晗, 来枭雄, 等. 中国青少年抑郁的核心症状及性别、抑郁程度间的比较:基于网络分析方法[J]. 心理科学, 2022, 45(5):1115-1122.
	Huang SS, Luo YH, Lai XX, et al. Core symptoms of depression in Chinese adolescents and comparisons between gender and depression level:a network analysis approach[J]. Psychol Sci, 2022, 45(5):1115-1122.
[2]	Van Meter A, Moreira ALR, Youngstrom E. Updated meta-analysis of epidemiologic studies of pediatric bipolar disorder[J]. J Clin Psychiatry, 2019, 80(3):18r12180.
[3]	Pedrini L, Sisti D, Tiberti A, et al. Reasons and pathways of first-time consultations at child and adolescent mental health services in Italy:an observational study[J]. Child Adolesc Psychi-atry Ment Health, 2015,9:29.
[4]	Sadler K, Vizard T, Ford T, et al. Mental health of children and young people in England,2017:trends and characteristics[R]. Leeds,UK: NHS Digital, 2018.
[5]	Neufeld SAS, Dunn VJ, Jones PB, et al. Reduction in adolescent depression after contact with mental health services:a longitudinal cohort study in the UK[J]. Lancet Psychiatry, 2017, 4(2):120-127. DOI PMID
[6]	Rickwood D, Deane F, Wilson C, et al. Young people’s help-seeking for mental health problems[J]. Aust E J Adv Ment Health, 2005,4:218-251.
[7]	Slotte S, Ramsøy-Halle H, Melby L, et al. Facilitating factors for seeking help for mental health problems among Norwegian adolescent males:a focus group interview study[J]. Front Psychiatry, 2022,13:1049336.
[8]	Eigenhuis E, Waumans RC, Muntingh ADT, et al. Facilitating factors and barriers in help-seeking behaviour in adolescents and young adults with depressive symptoms:a qualitative study[J]. PLoS One, 2021, 16(3):e0247516.
[9]	Radez J, Reardon T, Creswell C, et al. Adolescents’ perceived barriers and facilitators to seeking and accessing professional help for anxiety and depressive disorders:a qualitative interview study[J]. Eur Child Adolesc Psychiatry, 2022, 31(6):891-907.
[10]	世界卫生组织. ICD-10精神与行为障碍分类:临床描述与诊断要点[M]. 北京: 人民卫生出版社,1993.
	World Health Organization. The ICD-10 classification of mental and behavioral disorders:clinical description and key points of diagnosis[M]. Beijing: People’s Medical Publishing House,1993.
[11]	苏林雁. 儿童精神医学[M]. 长沙: 湖南科学技术出版社,2014:52.
	Su LY. Child psychiatry[M]. Changsha: Hunan Science & Technology Press,2014:52.
[12]	Stunden C, Zasada J, VanHeerwaarden N, et al. Help-seeking behaviors of transition-aged youth for mental health concerns:qualitative study[J]. J Med Internet Res, 2020, 22(10):e18514.
[13]	Englander M. The phenomenological method in qualitative psychology and psychiatry[J]. Int J Qual Stud Health Well-being, 2016,11:30682.
[14]	Doblyte S, Jiménez-Mejías E. Understanding help-seeking behavior in depression:a qualitative synthesis of patients’ experiences[J]. Qual Health Res, 2017, 27(1):100-113. PMID
[15]	尚超娜, 王剑英, 宋涛, 等. 伴非自杀性自伤行为心境障碍青少年患者心理体验的质性研究[J]. 中华护理杂志, 2022, 57(7):827-834. DOI URL
	Shang CN, Wang JY, Song T, et al. The psychological experience of adolescent patients with mood disorder accompanied by non-suicidal self-injury:a qualitative study[J]. Chin J Nurs, 2022, 57(7):827-834.
[16]	占金苹, 邹莉梅, 廖婧诗, 等. 青少年非自杀性自伤体验质性研究的Meta整合[J]. 护理学杂志, 2024, 39(1):11-16.
	Zhan JP, Zou LM, Liao JS, et al. The lived experience of adolescents who engage in non-suicidal self-injury:a meta-synthesis[J]. J Nurs Sci, 2024, 39(1):11-16.
[17]	Cornally N, McCarthy G. Help-seeking behaviour:a concept analysis[J]. Int J Nurs Pract, 2011, 17(3):280-288. DOI PMID
[18]	Tharaldsen KB, Stallard P, Cuijpers P, et al. ‘It’s a bit taboo’:a qualitative study of Norwegian adolescents’ perceptions of mental healthcare services[J]. Emot Behav Difficulties, 2017, 22(2):111-126.
[19]	Aguirre Velasco A, Cruz ISS, Billings J, et al. What are the barriers,facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review[J]. BMC Psychiatry, 2020, 20(1):293.
[20]	郜志远, 尚超娜, 严芳, 等. 心境障碍伴非自杀性自伤青少年照顾者不同阶段照顾困境的质性研究[J]. 中华护理杂志, 2023, 58(24):3011-3017. DOI URL
	Gao ZY, Shang CN, Yan F, et al. Caring dilemma of adolescent caregivers with mood disorder with non-suicidal self-injury behavior at different stages:a qualitative study[J]. Chin J Nurs, 2023, 58(24):3011-3017.
[21]	Platell M, Cook A, Martin K. How parents can help or hinder access to mental health services for young people[J]. Child Youth Serv Rev, 2023,145:106760.
[22]	Logan DE, King CA. Parental facilitation of adolescent mental health service utilization:a conceptual and empirical review[J]. Clin Psychol Sci Pract, 2001, 8(3):319-333.