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台湾精神分裂症患者家庭照顾者的照顾负担与家庭功能因素

Factors of caregiver burden and family functioning among Taiwanese family caregivers living with schizophrenia.

作者信息

Hsiao Chiu-Yueh, Tsai Yun-Fang

机构信息

School of Nursing, College of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China.

Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.

出版信息

J Clin Nurs. 2015 Jun;24(11-12):1546-56. doi: 10.1111/jocn.12745. Epub 2014 Dec 8.

Abstract

AIMS AND OBJECTIVES

To assess the degree of caregiver burden and family functioning among Taiwanese primary family caregivers of people with schizophrenia and to test its association with demographic characteristics, family demands, sense of coherence and family hardiness.

BACKGROUND

Family caregiving is a great concern in mental illness. Yet, the correlates of caregiver burden and family functioning in primary family caregivers of individuals with schizophrenia still remain unclear.

DESIGN

A cross-sectional descriptive study.

METHODS

A convenience sample of 137 primary family caregivers was recruited from two psychiatric outpatient clinics in Taiwan. Measures included a demographic information sheet and the Chinese versions of the Family Stressors Index, Family Strains Index, 13-item Sense of Coherence Scale, 18-item Caregiver Burden Scale, Family Hardiness Index and Family Adaptability, Partnership, Growth, Affection, and Resolve Index. Data analysis included descriptive statistics, Pearson's product-moment correlation coefficients, t-test, one-way analysis of variance and a stepwise multiple linear regression.

3 RESULTS: Female caregivers, additional dependent relatives, increased family demands and decreased sense of coherence significantly increased caregiver burden, whereas siblings as caregivers reported lower degrees of burden than parental caregivers. Family caregivers with lower family demands, increased family hardiness and higher educational level had significantly enhanced family functioning. Sense of coherence was significantly correlated with family hardiness.

CONCLUSIONS

Our findings highlighted the importance of sense of coherence and family hardiness in individual and family adaptation. Special attention needs to focus on therapeutic interventions that enhance sense of coherence and family hardiness, thereby improving the perception of burden of care and family functioning.

RELEVANCE TO CLINICAL PRACTICE

Given the nature of family caregiving in schizophrenia, understanding of correlates of caregiver burden and family functioning would help provide useful avenues for the development of family-focused intervention in psychiatric mental health nursing practice.

摘要

目的与目标

评估台湾精神分裂症患者的主要家庭照顾者的照顾负担程度及家庭功能,并检验其与人口统计学特征、家庭需求、连贯感和家庭坚韧性的关联。

背景

家庭照顾是精神疾病领域备受关注的问题。然而,精神分裂症患者的主要家庭照顾者的照顾负担及家庭功能的相关因素仍不明确。

设计

横断面描述性研究。

方法

从台湾两家精神科门诊招募了137名主要家庭照顾者作为便利样本。测量工具包括一份人口统计学信息表以及中文版的家庭压力源指数、家庭紧张指数、13项连贯感量表、18项照顾者负担量表、家庭坚韧性指数和家庭适应性、伙伴关系、成长、情感及决心指数。数据分析包括描述性统计、Pearson积差相关系数、t检验、单因素方差分析和逐步多元线性回归。

结果

女性照顾者、有其他受抚养亲属、家庭需求增加以及连贯感降低会显著增加照顾者负担,而作为照顾者的兄弟姐妹所报告的负担程度低于父母照顾者。家庭需求较低、家庭坚韧性增强且教育水平较高的家庭照顾者的家庭功能显著增强。连贯感与家庭坚韧性显著相关。

结论

我们的研究结果凸显了连贯感和家庭坚韧性在个体及家庭适应中的重要性。需要特别关注增强连贯感和家庭坚韧性的治疗性干预措施,从而改善对照顾负担的认知及家庭功能。

与临床实践的相关性

鉴于精神分裂症家庭照顾的性质,了解照顾者负担及家庭功能的相关因素将有助于为精神科心理健康护理实践中以家庭为中心的干预措施的发展提供有用途径。

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