Orygen Youth Health Research Centre, Centre for Youth Mental Health Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
Bipolar Disord. 2011 Aug-Sep;13(5-6):556-70. doi: 10.1111/j.1399-5618.2011.00942.x.
Close family and friends are often a primary source of support for a person with bipolar disorder. However, there is a lack of information for caregivers about ways to provide helpful support and take care of themselves. Rates of caregiver burden are high and increase the risk of caregiver depression and health problems. This study aimed to develop guidelines to assist caregivers of adults with bipolar disorder to be informed about bipolar disorder and to support the person without neglecting their own wellbeing.
The Delphi method was used to assess consensus between international expert panels of 45 caregivers, 47 consumers, and 51 clinicians about what information to include in the caregiver guidelines. Initial online survey items were based on the existing literature. Subsequent surveys included new or reworded items suggested by panel members and items that needed re-rating. Items endorsed by at least 80% of all three panels formed the content of the guidelines.
Nearly 86% of the 626 survey items were endorsed. The items covered information on the illness, treatment, and suggestions on ways caregivers can provide support and take care of themselves in the different phases of illness and wellness, and information on dealing with specific real-life challenges. Although consensus rates were high, meaningful areas of difference between panels were found (e.g., collaboration issues).
The guidelines provide comprehensive introductory information, suggestions, and resources for caregivers. Access to relevant information may help caregivers to cope constructively with the person's bipolar disorder and their caregiving situation. The content of the guidelines could be used to help formulate a stepped-care approach to supporting caregivers, ranging from basic information and pamphlets to brief training courses and specialized family or caregiver interventions based on need and accessibility.
亲密的家人和朋友通常是双相情感障碍患者的主要支持来源。然而，对于照顾者来说，缺乏关于如何提供有益支持和照顾自己的信息。照顾者负担过重的比率很高，这增加了照顾者抑郁和健康问题的风险。本研究旨在制定指南，帮助双相情感障碍患者的照顾者了解双相情感障碍，并在不忽视自身福祉的情况下支持患者。
采用德尔菲法，评估了由 45 名照顾者、47 名消费者和 51 名临床医生组成的国际专家小组对纳入照顾者指南的信息的共识。最初的在线调查项目基于现有文献。随后的调查包括小组成员提出的新的或重新措辞的项目，以及需要重新评估的项目。至少有三个小组的 80%以上都赞成的项目构成了指南的内容。
近 86%的 626 项调查项目得到了认可。这些项目涵盖了关于疾病、治疗以及如何在疾病和健康的不同阶段为照顾者提供支持和照顾自己的建议的信息，以及处理特定现实生活挑战的信息。尽管共识率很高，但在小组之间还是发现了有意义的差异领域（例如，合作问题）。
该指南为照顾者提供了全面的介绍性信息、建议和资源。获得相关信息可能有助于照顾者建设性地应对患者的双相情感障碍及其照顾情况。指南的内容可用于帮助制定支持照顾者的分级护理方法，范围从基本信息和小册子到根据需要和可及性提供的简短培训课程和专门的家庭或照顾者干预措施。
