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针对患有精神病的中国移民照顾者的简短反耻辱干预:改编与初步结果。

A brief anti-stigma intervention for Chinese immigrant caregivers of individuals with psychosis: adaptation and initial findings.

作者信息

Yang Lawrence H, Lai Grace Y, Tu Ming, Luo Maggie, Wonpat-Borja Ahtoy, Jackson Valerie W, Lewis-Fernández Roberto, Dixon Lisa

机构信息

Columbia University.

出版信息

Transcult Psychiatry. 2014 Apr;51(2):139-57. doi: 10.1177/1363461513512015. Epub 2013 Dec 6.

Abstract

Mental illness stigma has adverse effects on both the caregivers' psychological well-being and the effectiveness of care that consumers receive. While anti-stigma interventions for family caregivers from Western settings have recently shown efficacy, these interventions may not be equally applicable across culturally diverse groups. Specifically, Chinese immigrant caregivers experience heightened internalized stigma, which predisposes the adoption of harmful coping strategies and reduced quality of social networks. We present an anti-stigma intervention based on a peer-family group format, co-led by a clinician and a trained family caregiver, to counter stigma among Chinese immigrants. Data are presented from a brief intervention administered to a pilot sample of 11 Chinese immigrant caregivers that provides: psychoeducation, strategies to counter experienced discrimination, and techniques to resist internalized stigma. Case vignettes illustrate implementation of this intervention, and how the peer-family format via interactive contact counteracts internalized stereotypes, encourages adaptive coping strategies, and reinvigorates social networks. Quantitative results further suggest preliminary efficacy in reducing internalized stigma for caregivers who evidenced at least some prior internalized stigma. This study constitutes an initial but important step towards reducing mental illness stigma among Asian Americans, for whom stigma has played a powerful role in the delay and underuse of treatment.

摘要

精神疾病污名化对照顾者的心理健康和消费者所接受护理的有效性都有不利影响。虽然针对西方背景家庭照顾者的反污名化干预措施最近已显示出成效,但这些干预措施可能并不适用于所有文化背景不同的群体。具体而言,中国移民照顾者经历了更强烈的内化污名,这使得他们更容易采取有害的应对策略,并降低社交网络的质量。我们提出了一种基于同伴-家庭小组形式的反污名化干预措施,由一名临床医生和一名经过培训的家庭照顾者共同领导,以对抗中国移民中的污名化现象。本文展示了对11名中国移民照顾者的试点样本进行简短干预后的数据,该干预提供了:心理教育、应对所经历歧视的策略以及抵制内化污名的技巧。案例 vignettes 说明了这种干预措施的实施情况,以及同伴-家庭形式如何通过互动接触抵消内化的刻板印象、鼓励适应性应对策略并重振社交网络。定量结果进一步表明,对于那些至少有一些先前内化污名的照顾者,在减少内化污名方面初步具有成效。这项研究是朝着减少亚裔美国人精神疾病污名化迈出的重要第一步,污名化在亚裔美国人治疗的延迟和利用不足方面起到了很大作用。

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