Whitney Jenna, Haigh Rachel, Weinman John, Treasure Janet
Eating Disorders Research Unit, Institute of Psychiatry, King's College, London, UK.
Br J Clin Psychol. 2007 Nov;46(Pt 4):413-28. doi: 10.1348/014466507X173781.
Carers of people with eating disorders (ED) have high levels of distress, but little is known about the contributing factors. The aim of this study was to examine predictors of carers' distress and caregiving appraisals using a model of caregiving adapted from the previous literature.
A cross-sectional design was used.
A sample of 115 individuals currently caring for someone with an ED participated in the study. Carers completed self-report assessments of psychological distress (GHQ-12; Goldberg & Williams, 1988), experience of caregiving (Szmukler et al., 1996), illness representations (IPQ-SCV; Barrowclough, Lobban, Hatton, & Quinn, 2001) and caregiving needs (CaNAM; Haigh & Treasure, 2003). Simple and multiple hierarchical regressions were conducted.
Approximately 36% (39/109) of carers had scores on the GHQ which indicated mental health difficulties, with 17% (19/109) experiencing high psychological distress. A negative experience of caregiving was associated with carers' distress. The dependency of the individual with the ED and stigma associated with the illness were most highly predictive of carers' distress. Shorter illness duration, higher levels of needs (lower levels of support) and perceptions of high illness consequences contributed to greater negative caregiving appraisals. The belief that the illness was attributable to the sufferers' personality was related to fewer positive appraisals.
Adjusting to the impact of a family member experiencing an ED is problematic, as suggested by the relationship between shorter illness duration and greater negative appraisals of caregiving. Interventions to help reduce dependency and alleviate stigma may help to decrease carers' distress.
饮食失调症(ED)患者的照料者有高度的痛苦,但对于促成因素却知之甚少。本研究的目的是使用一个基于先前文献改编的照料模型,来检验照料者痛苦和照料评估的预测因素。
采用横断面设计。
115名目前正在照料饮食失调症患者的个体参与了本研究。照料者完成了关于心理痛苦(一般健康问卷-12;戈德堡和威廉姆斯,1988年)、照料经历(兹穆克勒等人,1996年)、疾病表征(疾病认知问卷-简短慢性病版本;巴罗克拉夫、洛班、哈顿和奎因,2001年)以及照料需求(照料需求评估量表;黑格和特雷热,2003年)的自我报告评估。进行了简单和多元分层回归分析。
约36%(39/109)的照料者在一般健康问卷上的得分表明存在心理健康问题,17%(19/109)经历高度心理痛苦。照料的负面经历与照料者的痛苦相关。饮食失调症患者的依赖性以及与该疾病相关的污名最能预测照料者的痛苦。较短的病程、较高的需求水平(较低的支持水平)以及对疾病后果严重性的认知导致了更负面的照料评估。认为疾病可归因于患者个性的信念与较少的积极评估相关。
正如较短病程与对照料的更负面评估之间的关系所表明的那样,适应家庭成员患饮食失调症的影响是个难题。帮助减少依赖性和减轻污名的干预措施可能有助于减轻照料者的痛苦。