Chang Kam Hock, Horrocks Stephen
Lecturer, Faculty of Medicine and Health Sciences, University Malaysia Sarawak, Sarawak, Malaysia.
J Adv Nurs. 2006 Feb;53(4):435-43. doi: 10.1111/j.1365-2648.2006.03732.x.
The aim of this paper is to report a study conducted to explore the meanings of the lived experiences that Chinese family caregivers in Malaysia ascribed to the care they provided to relatives with severe and persistent mental illness.
In the past, many researchers have used quantitative approaches to explore the experiences of family caregivers of relatives with severe and persistent mental illness. However, the results of these studies have been far from conclusive because of serious methodological flaws. In addition, a large majority of these studies were conducted in western cultures, and it has been difficult to transfer the results to family caregivers in oriental cultures.
The philosophy of Martin Heidegger underpinned the study. Qualitative data were collected mainly through in-depth interviews with 19 criterion-selected Chinese family caregivers of relatives with severe and persistent mental illness in 2002.
We present the emergent themes reflecting the meaning structures of managing, enduring, and surviving the day-to-day experiences of the Chinese family caregivers. The impact of the stigma of the relatives' mental illness on family caregivers and families is pervasive and strong. As a result, family caregivers tried to avoid talking about their relative's mental illness with extended family or friends in order to protect their families from 'losing face'. In addition, most family caregivers believed that adopting positive behaviours and attitudes helped them cope with caregiving.
Mental health nurses need to help Chinese family caregivers to cope with the stresses and stigmas of their relatives' mental illnesses through psychosocial education or family intervention, and to provide them with culturally-congruent care. They should also educate the public about mental health and ill health through health promotion and education.
本文旨在报告一项研究,该研究旨在探索马来西亚华裔家庭照顾者对其为患有严重及持续性精神疾病的亲属提供照顾的生活经历所赋予的意义。
过去,许多研究人员采用定量方法来探索患有严重及持续性精神疾病亲属的家庭照顾者的经历。然而,由于严重的方法学缺陷,这些研究的结果远非定论。此外,这些研究大多在西方文化中进行,很难将结果应用于东方文化中的家庭照顾者。
该研究以马丁·海德格尔的哲学为基础。2002年,主要通过对19名经过标准筛选的患有严重及持续性精神疾病亲属的华裔家庭照顾者进行深入访谈收集定性数据。
我们呈现了反映华裔家庭照顾者日常经历的管理、忍耐和生存意义结构的新出现主题。亲属精神疾病的污名对家庭照顾者和家庭的影响广泛而强烈。因此,家庭照顾者试图避免与大家庭或朋友谈论其亲属的精神疾病,以保护家人“不失面子”。此外,大多数家庭照顾者认为采取积极的行为和态度有助于他们应对照顾工作。
精神科护士需要通过心理社会教育或家庭干预帮助华裔家庭照顾者应对其亲属精神疾病带来的压力和污名,并为他们提供符合文化的护理。他们还应通过健康促进和教育向公众宣传心理健康和疾病知识。