Roick C, Heider D, Toumi M, Angermeyer M C
Department of Psychiatry, University of Leipzig, Leipzig, Germany.
Acta Psychiatr Scand. 2006 Nov;114(5):363-74. doi: 10.1111/j.1600-0447.2006.00797.x.
Impact of caregiver characteristics, patient variables, and regional differences on family burden.
Two hundred and eighteen schizophrenia patients and key-relatives of an urban and a rural area were examined five times over 30 months. Patients' psychopathology, service utilization; relatives' burden, coping abilities and contact duration with the patients were recorded. Effects of interpersonal differences and intrapersonal changes over time were analyzed with regression models.
Interpersonal differences (patients' positive and negative symptoms, relatives' coping abilities, and patient contact) and intrapersonal changes (relatives' coping abilities, patients' negative symptoms and utilization of community care) predicted family burden.
Family education programs should help caregivers to improve their coping strategies. Therapy solutions must address negative symptoms just as much as positive symptoms, as these especially impact caregivers. Intensified community-based care can reduce burden, but provision alone is not sufficient. Psychiatrists and caregivers should motivate patients to take advantage of such offers.
照顾者特征、患者变量及地区差异对家庭负担的影响。
对城乡地区的218名精神分裂症患者及其主要亲属在30个月内进行了5次检查。记录患者的精神病理学、服务利用情况；亲属的负担、应对能力以及与患者的接触时长。采用回归模型分析人际差异和个体随时间的变化的影响。
人际差异（患者的阳性和阴性症状、亲属的应对能力以及与患者的接触）和个体随时间的变化（亲属的应对能力、患者的阴性症状以及社区护理的利用）可预测家庭负担。
家庭教育项目应帮助照顾者改善其应对策略。治疗方案必须同样关注阴性症状和阳性症状，因为阴性症状对照顾者影响尤其大。强化社区护理可减轻负担，但仅提供护理是不够的。精神科医生和照顾者应激励患者利用此类服务。
