Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
Soc Sci Med. 2013 Dec;98:135-40. doi: 10.1016/j.socscimed.2013.09.005. Epub 2013 Sep 14.
This study evaluated caregiving experience in the caregivers of patients with schizophrenia within the framework of the stress-appraisal-coping model. By purposive random sampling, 100 Indian patients with schizophrenia and their primary caregivers were assessed. The patients were assessed on Positive and Negative Symptom Scale (PANSS). Caregivers completed the Scale for Positive Aspects of Caregiving Experience (SPACE), Involvement Evaluation Questionnaire (IEQ), Family Burden Interview (FBI) Schedule, Coping Checklist, Social Support Questionnaire, and General Health Questionnaire (GHQ-12). Path analysis showed that psychological morbidity is mainly determined by subjective experience of burden, which in turn is significantly influenced by severity of psychopathology, time spent per day (in hours) in caregiving and the coping strategies used. Although coping strategies and PANSS do influence objective burden, objective burden itself has no influence on the level of psychological morbidity. Total PANSS score has no direct influence on subjective burden, but acts indirectly through total time spent in caregiving and coping. Caregiver's gain in positive experiences on SPACE scale positively influences subjective burden. The present findings suggest that better control of patients' symptoms would lead to less demand on the caregivers in the form of time and strain on coping abilities and would thus reduce subjective burden and psychological morbidity in the caregivers.
本研究在应激-评估-应对模型的框架下评估了精神分裂症患者照顾者的照顾体验。通过目的随机抽样,评估了 100 名印度精神分裂症患者及其主要照顾者。患者使用阳性和阴性症状量表 (PANSS) 进行评估。照顾者完成了照顾体验积极方面量表 (SPACE)、参与评估问卷 (IEQ)、家庭负担访谈 (FBI) 量表、应对清单、社会支持问卷和一般健康问卷 (GHQ-12)。路径分析表明,心理发病率主要由负担的主观体验决定,而负担的主观体验又受到精神病理学严重程度、每天(小时)照顾时间和使用的应对策略的显著影响。虽然应对策略和 PANSS 确实会影响客观负担,但客观负担本身对心理发病率没有影响。总 PANSS 评分对主观负担没有直接影响,但通过总照顾时间和应对方式间接影响。照顾者在 SPACE 量表上获得的积极体验会对主观负担产生积极影响。这些发现表明,更好地控制患者的症状会减少照顾者在时间和应对能力方面的需求,从而降低照顾者的主观负担和心理发病率。