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护理经历量表:进一步的证据。

The Experience of Caregiving Inventory: further evidence.

作者信息

Joyce J, Leese M, Szmukler G

机构信息

Department of Community Psychiatry, Institute of Psychiatry, London, UK.

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2000 Apr;35(4):185-9. doi: 10.1007/s001270050202.

Abstract

BACKGROUND

The aim of this study was to reexamine the construct validity of the Experience of Caregiving Inventory (ECI) using new, independent data from a population of patients and their carers. This involved re-testing the ECI within the stress-coping model, but adding new variables which included independently rated (rather than carer-rated) assessments of the patient's symptoms and disabilities, a rating of social support (this time for the patient rather than the carer) and a measure of a range of service inputs.

METHOD

Data were available on 69 patients and their carers from the PRiSM Psychosis Study. Two regression analyses were performed; the first to establish the extent to which the ECI predicted GHQ scores and the second to examine predictors of the ECI selected from the wider dataset on the basis of their likely relationship to carer appraisal. The second regression analysis was performed in two stages, allowing the effect of service factors to be assessed after controlling for the impact of patient personal characteristics such as illness-related or environmental factors.

RESULTS

ECI scores accounted for 27% of the variance of GHQ scores. Over one-third of the ECI negative appraisal can be explained by a combination of patient disability (the Social Behaviour Score Total), extent of patients' social network (Social Network Schedule: Number of Friends) and involvement of a Community Psychiatric Nurse (CPN). At the same level of patient morbidity and informal social network, CPN contact reduced ECI scores.

CONCLUSION

As hypothesised, ECI scores correlated significantly with the other measures in the directions predicted by the stress-coping model; that is, negative caregiving as measured by the ECI predicted carer morbidity, while it in turn was predicted by a combination of stressor variables (patient symptoms and disability) acting to increase it, and mediating variables (social support, service inputs) acting to reduce it. Implications for services are discussed.

摘要

背景

本研究的目的是使用来自患者及其照顾者群体的新的独立数据,重新审视照顾体验量表(ECI)的结构效度。这涉及在压力应对模型中对ECI进行重新测试,但增加了新的变量,包括对患者症状和残疾的独立评分(而非照顾者评分)、社会支持评分(这次是针对患者而非照顾者)以及一系列服务投入的测量。

方法

从PRiSM精神病研究中获取了69名患者及其照顾者的数据。进行了两项回归分析;第一项分析确定ECI预测一般健康问卷(GHQ)得分的程度,第二项分析检查从更广泛的数据集中根据其与照顾者评估的可能关系选择的ECI预测因素。第二项回归分析分两个阶段进行,以便在控制患者个人特征(如疾病相关或环境因素)的影响后评估服务因素的作用。

结果

ECI得分占GHQ得分方差的27%。超过三分之一的ECI负面评估可以通过患者残疾(社会行为总分)、患者社交网络范围(社交网络量表:朋友数量)和社区精神科护士(CPN)的参与来解释。在患者发病率和非正式社交网络水平相同的情况下,CPN接触降低了ECI得分。

结论

如假设的那样,ECI得分与压力应对模型预测的方向上的其他测量指标显著相关;也就是说,ECI测量的负面照顾预测照顾者发病率,而反过来,它又由增加发病率的应激源变量(患者症状和残疾)以及减少发病率的中介变量(社会支持、服务投入)共同作用所预测。讨论了对服务的影响。

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