Cuijpers P, Stam H
Trimbos Institute, the Netherlands Institute of Mental Health and Addiction, Utrecht.
Psychiatr Serv. 2000 Mar;51(3):375-9. doi: 10.1176/appi.ps.51.3.375.
The effectiveness of family interventions may be improved by concentrating on elements of objective burden that best predict subjective burden. The relationship between subjective burden and objective burden was investigated among caregivers of patients with serious mental illness in the Netherlands who were attending psychoeducational support groups.
The study used pretest data from an intervention study in which psychoeducational family support groups in the Netherlands were evaluated. A total of 164 participants from 19 psychoeducational groups organized by nine community mental health centers completed the Dutch translation of the Maslach Burnout Inventory and the Involvement Evaluation Questionnaire. Regression analyses were conducted, with elements of subjective burden as dependent variables and elements of objective burden, demographic characteristics, and characteristics of the patient's disorder as predictors.
Burden in general and emotional exhaustion were the aspects of subjective burden best predicted by objective burden. In two regression models, objective burden together with the other predictors explained 57 percent and 54 percent of the variance in subjective burden. Two aspects of objective burden-strain on the relationship with the patient and ability to cope with the patient's behavior-were related to almost all the investigated aspects of subjective burden.
Strong evidence was found for the relationship between objective and subjective burden and for the hypothesis that particular elements of objective burden contribute more to subjective burden than others. The findings suggest that psychoeducation should concentrate on helping relatives cope with the strain on the relationship with the patient and on improving their ability to cope with the patient's behavior.
通过关注最能预测主观负担的客观负担因素,可提高家庭干预的效果。在荷兰参加心理教育支持小组的严重精神疾病患者的照料者中,研究主观负担与客观负担之间的关系。
该研究使用了一项干预研究的预测试数据,在该干预研究中对荷兰的心理教育家庭支持小组进行了评估。来自九个社区心理健康中心组织的19个心理教育小组的164名参与者完成了马氏职业倦怠量表和参与度评估问卷的荷兰语翻译。进行了回归分析,将主观负担因素作为因变量,将客观负担因素、人口统计学特征和患者疾病特征作为预测因素。
总体负担和情感耗竭是由客观负担最能预测的主观负担方面。在两个回归模型中,客观负担与其他预测因素共同解释了主观负担方差的57%和54%。客观负担的两个方面——与患者关系中的压力以及应对患者行为的能力——与主观负担的几乎所有调查方面都相关。
发现了客观负担与主观负担之间的关系以及特定客观负担因素比其他因素对主观负担贡献更大这一假设的有力证据。研究结果表明,心理教育应集中于帮助亲属应对与患者关系中的压力,并提高他们应对患者行为的能力。