Smith Gregory C
School of Family and Consumer Studies, Kent State University, 144 Nixson Hall, Kent, OH 44242, USA.
Psychiatr Serv. 2004 Jul;55(7):804-10. doi: 10.1176/appi.ps.55.7.804.
This study identified predictors of the extent of residential planning carried out by aging families of adults with severe mental illness according to the conceptual framework of the Double ABCX model of family coping and adaptation.
Mail surveys were completed by 157 mothers (mean age, 67 years) from 41 states who lived with and provided care to offspring with serious mental disorders (mean age, 38 years). Seventy-six percent of the offspring were men (N=120). Sixty percent of the offspring had been given a diagnosis of schizophrenia or schizoaffective disorder (N=94), 20 percent had multiple diagnoses (N=31), and 16 percent had bipolar disorder (N=25).
Higher stages of planning were associated with use of avoidance as a means of coping, discussion of plans with the offspring with a disability, the desire to have family members assume future care responsibilities, lower subjective burden of providing care, and more self-perceived adverse age-related change. The model accounted for 20 percent of the variance in residential planning; over half of this variance was associated with coping behaviors and appraisals of the caregiving context.
In addition to providing relevant information and alleviating feelings of intense burden that undermine residential planning, service providers can best assist older parents by encouraging them to recognize age-related changes in themselves that signal the need to plan and by helping them to involve the entire family in the planning process.
本研究根据家庭应对与适应的双ABCX模型的概念框架,确定了患有严重精神疾病的成年人的老龄家庭所进行的居住规划程度的预测因素。
来自41个州的157位母亲(平均年龄67岁)完成了邮寄调查,她们与患有严重精神障碍的子女(平均年龄38岁)生活在一起并为其提供照料。76%的子女为男性(N = 120)。60%的子女被诊断患有精神分裂症或分裂情感性障碍(N = 94),20%有多种诊断(N = 31),16%患有双相情感障碍(N = 25)。
更高阶段的规划与将回避作为一种应对方式、与残疾子女讨论规划、希望家庭成员承担未来照料责任、较低的主观照料负担以及更多的自我感知的与年龄相关的不利变化有关。该模型解释了居住规划中20%的方差变异;其中超过一半的方差变异与应对行为和对照料情境的评估有关。
除了提供相关信息和减轻那些破坏居住规划的强烈负担感之外,服务提供者若要最好地帮助老年父母,可鼓励他们认识到自身与年龄相关的变化,这些变化表明需要进行规划,并帮助他们让整个家庭参与到规划过程中。