Abstract: Objective To investigate the current status of nursing burden and its influencing factors of caregivers of patients with severe mental disorders in one district in Chongqing. Methods A total of 1218 patients with severe mental disorders included in public security bank and managed by national information system of severe mental disorders were re-diagnosed and evaluated by various forms. At the same time，their educational level，family income ，guardian relationship，guardian care burden，drug compliance were investigated. Nursing burden was explored by Zarit Caregiyer Burden Interview (ZBI). The data were analyzed by multivariate stepwise regression analysis. Results The ratio of high nursing burden (score of 46.38±5.61) was 76%，and low nursing burden(score of 31.80± 5.91)was 24.0%. There were only 375 patients (30.8%) who were regularly treated with drugs. Multivariate stepwise regression analysis showed that the drug compliance， risk classification and disease category were the main factors affecting the nursing burden of patients with severe mental disorders. Conclusion The ZBI score of caregivers of patients with severe mental disorders in Chongqing is relatively high. The percentage of schizophrenia patients with high burden of care was the largest proportion. Poor drug compliance increases nursing burden. The risk burden of patients with grade 4 or above is especially obvious.

Key words: Severe Mental Disorders, Nursing Burden, Risk Assessment, Guardian, Investigation

摘要： 目的 调查分析重庆市某区部分在管严重精神障碍患者监护人照顾负担现状及相关影响因素。方法 借助该区严重精神障碍患者清查评估专项行动，对该区登记在册的1218例严重精神障碍患者进行诊断评估复核及危险分级，同时调查患者的文化程度、家庭收入、监护人关系、服药依从性等情况，并采用Zarit照顾者负担量表（Zarit Caregiver Burden Interview,ZBI)测量监护人照顾负担。采用多元线性逐步回归分析监护人照顾负担的影响因素。结果 监护人中高照顾负担占76.0%,ZBI得分（46.38±5.61)分；低照顾负担占24.0%,ZBI得分（31.80±5.91)分。正规用药治疗患者仅占30.8%。服药依从性、危险分级、疾病类别是影响严重精神障碍患者监护人照顾负担的主要因素。结论 重庆市该区严重精神障碍患者监护人照顾负担偏高，精神分裂症患者监护人高照顾负担人数占比最大，服药依从性低导致监护人负担增加，危险分级4级 以上患者监护人照顾负担增加尤为明显。

关键词: 严重精神障碍, 护理负担, 危险性评估, 监护人, 调查