Hsu Mei-Chi, Tu Chun-Hsien
Department of Nursing, I-Shou University, Kaohsiung City, Taiwan.
J Adv Nurs. 2014 Feb;70(2):336-49. doi: 10.1111/jan.12194. Epub 2013 Jul 16.
To describe the lived experiences of aggression and violence among patients with schizophrenia and their victimized biological parent as the major caregiver being aggressed by their child (parent-adult-child dyads), and to gain an understanding of the precipitating factors influencing violence.
Child-to-parent violence, particularly in the mentally ill adult child, is arguably the most stressful and under-researched issue of family violence. Violence in patients with mental illness is most frequently targeted at family members, and most often takes place at home. Both patients and their parents' experiences of violence are relatively unexplored.
Qualitative study design.
Data were collected using individual in-depth interviews between August 2010-August 2011 in Taiwan. Purposive sample of 14 hospitalized patients with schizophrenia who had aggression and violence in the past year directed towards their biological parent of either gender.
Five main themes were identified: violence occurring beyond control in a particular situation translated into parent and patient's possible endangerment, the repetitive nature of violence, distress, ineffective communication, and management of violence and help-seeking. Repetitive violent episodes and tension made both the parent and patient feel uncontrollable. Parents had a perceived fear of adverse consequences such as being punished by receiving more retribution and they also had concerns related to their parental responsibility.
Health professionals should be aware of the complexity of phenomena and the interplay of factors inducing violence. A comprehensive dyadic parent-child intervention is suggested for violence prevention.
描述精神分裂症患者及其作为主要照顾者而遭受子女攻击的亲生父母(亲子二元组)的攻击和暴力经历,并了解影响暴力行为的诱发因素。
子女对父母的暴力行为,尤其是成年精神疾病子女对父母的暴力行为,可谓是家庭暴力中压力最大且研究最少的问题。精神疾病患者的暴力行为最常针对家庭成员,且大多发生在家中。患者及其父母的暴力经历相对而言未得到充分探索。
定性研究设计。
2010年8月至2011年8月期间在台湾通过个体深度访谈收集数据。选取了14名过去一年曾对其亲生父母有攻击和暴力行为的住院精神分裂症患者作为有目的的样本,其父母性别不限。
确定了五个主要主题:特定情境下失控发生的暴力行为转化为对父母和患者的潜在危害、暴力行为的重复性、痛苦、无效沟通以及暴力行为的管理和求助。暴力事件的反复发生和紧张局势让父母和患者都感到无法控制。父母担心会有不良后果,比如受到更多报复性惩罚,他们也担心自己作为父母的责任。
卫生专业人员应意识到现象的复杂性以及诱发暴力行为的因素之间的相互作用。建议采取全面的亲子二元干预措施来预防暴力行为。