Yin Yi, Zhang Weijun, Hu Zhenyu, Jia Fujun, Li Yafang, Xu Huiwen, Zhao Shuliang, Guo Jing, Tian Donghua, Qu Zhiyong
School of Social Development and Public Policy, Beijing Normal University, Beijing, P. R. China.
Office of Director, Ningbo Kangning Hospital, Ningbo, Zhejiang, P. R. China.
PLoS One. 2014 Sep 26;9(9):e108527. doi: 10.1371/journal.pone.0108527. eCollection 2014.
In China, caregivers for family members with schizophrenia play an important role in treatment and recovery but may experience stigma and discrimination simply because of their family relationship. The object of this study was to measure the degrees and correlates of stigma and discrimination experiences among this group. Four hundred twenty-seven caregivers participated in this hospital-based and cross-sectional study in Ningbo and Guangzhou, China. Data were collected by trained interviewers using fixed questionnaires. Stigma and discrimination experiences were measured by the Modified Consumer Experiences of Stigma Questionnaire (MCESQ). Caregivers' social support was measured by the Social Support Rating Scale. Parametric analysis, nonparametric analysis and multivariate linear regression were used. The mean (SD) score of MCESQ was 2.44(0.45), 2.91(0.71) for stigma experiences and 1.97(0.37) for discrimination experiences on a five-point score ("1 = never" and "5 = very often"). Approximately 65% of caregivers reported that they tried to conceal their family members' illness, and 71% lacked the support of friends. The experience of stigma was significantly negatively associated with the perceived social support of caregivers (standard β = -0.2,p<0.001). Caregivers who were children of the patients experienced fewer stigmas than other (standard β = -0.18, p<0.001). Urban residence (standard β = -0.12, p<0.01) and patients did not complete primary school education (standard β = -0.13, p<0.01) were negatively related with stigmas. In addition, stigma and discrimination was more experienced in Zhejiang than in Guangdong (p<0.05). In conclusion, this study performed that caregivers of people with schizophrenia in China experienced general stigmas and rare discrimination and found the relations with social support, kinship, patient's educational level and regional differences. More interventions and supports should been given to caregivers who are lack of social support, who live in rural area and who are the patients' parents, spouses or siblings.
在中国,精神分裂症患者的家庭成员作为照料者在治疗和康复过程中发挥着重要作用,但他们可能仅仅因为与患者的亲属关系而遭受污名化和歧视。本研究的目的是衡量这一群体污名化和歧视经历的程度及其相关因素。427名照料者参与了在中国宁波和广州开展的这项基于医院的横断面研究。数据由经过培训的访谈员使用固定问卷收集。污名化和歧视经历通过改良的消费者污名经历问卷(MCESQ)进行测量。照料者的社会支持通过社会支持评定量表进行测量。采用了参数分析、非参数分析和多元线性回归。在五分制评分(“1 = 从不”,“5 = 非常频繁”)中,MCESQ的平均(标准差)得分在污名经历方面为2.44(0.45),在歧视经历方面为2.91(0.71),歧视经历方面为1.97(0.37)。约65%的照料者表示他们试图隐瞒家庭成员的病情,71%的照料者缺乏朋友的支持。污名经历与照料者感知到的社会支持显著负相关(标准β = -0.2,p<0.001)。患者的子女作为照料者所经历的污名比其他照料者少(标准β = -0.18,p<0.001)。城市居住(标准β = -0.12,p<0.01)以及患者未完成小学教育(标准β = -0.13,p<0.01)与污名呈负相关。此外,浙江的照料者比广东的照料者更多地经历污名化和歧视(p<0.05)。总之,本研究表明中国精神分裂症患者的照料者普遍经历污名化且很少遭受歧视,并发现了其与社会支持、亲属关系、患者教育水平和地区差异之间的关系。对于缺乏社会支持、居住在农村地区以及作为患者父母、配偶或兄弟姐妹的照料者,应给予更多干预和支持。