Professor Emerita in the Department of Psychiatry at the University of Toronto in Canada.
Psychiatry. 2013 Winter;76(4):311-22. doi: 10.1521/psyc.2013.76.4.311.
The purpose of this paper is to explore a literature gap--sibling involvement in the care and support of people with schizophrenia, and to make recommendations for filling the gap.
The method used was observation and documentation of clinical notes over a ten-year period in an outpatient clinic for women with schizophrenia. Illustrative examples were selected from approximately 200 entries dealing with sibling relationships.
Siblings constitute an important segment of the social network of persons with schizophrenia, although they do not usually take an active part in their brother or sister's care until parents are no longer able to cope alone. The role of primary caregiver appears to be a stressful one for siblings. The closest sibling bonds were those between sisters, and in most cases, the eldest girl in the family assumed the caregiver role. This depended, however, on the family's means, values, and cultural traditions, as well as on the personal attributes and life circumstances of the siblings. Financial, human, and social capital were critical determinants of sibling involvement. Sharing responsibilities and negotiating the distribution of required caretaking tasks was often the most effective way of dealing with the burden of care giving.
Although some clinical recommendations can be made, specificities that distinguish this population and the effectiveness of sibling caregiving need to be further researched.
本文旨在探讨文献中的一个空白领域——兄弟姐妹在照顾和支持精神分裂症患者方面的参与情况，并就如何填补这一空白提出建议。
采用的方法是在一家女性精神分裂症门诊诊所进行了为期十年的临床记录观察和文献记录。从大约 200 个涉及兄弟姐妹关系的条目，选择了一些有代表性的例子。
尽管兄弟姐妹通常不会在父母无法独自应对时主动参与其兄弟姐妹的照顾，但他们仍是精神分裂症患者社交网络中的重要组成部分。作为主要照顾者的角色对兄弟姐妹来说似乎是一个有压力的角色。最亲密的兄弟姐妹关系是姐妹之间的关系，在大多数情况下，家庭中的长女承担照顾者的角色。然而，这取决于家庭的经济状况、价值观和文化传统，以及兄弟姐妹的个人属性和生活环境。经济、人力和社会资本是兄弟姐妹参与的关键决定因素。分担责任和协商分配所需的照顾任务，往往是处理照顾负担的最有效方式。
尽管可以提出一些临床建议，但需要进一步研究区分这一人群的特殊性以及兄弟姐妹照顾的有效性。
