McCann Terence V, Bamberg John, McCann Flora
Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Mental Health Nursing), Victoria University, Melbourne, Victoria, Australia.
Int J Ment Health Nurs. 2015 Jun;24(3):203-12. doi: 10.1111/inm.12135. Epub 2015 May 11.
While the burden of caring for older people with chronic medical illness and dementia has been well documented, considerably less is known about how carers develop the strength and resilience to sustain this important role with older family members with mental illness. The aim of the study was to understand the lived experience of primary caregivers of older people with severe and persistent mental illness, and to explore what, if anything, helps to sustain them in their caring role. An interpretative phenomenological analysis approach was adopted, and qualitative interviews were used with 30 primary caregivers. Two overarching themes, and related subthemes, were abstracted from the data. First, caring is a difficult and demanding responsibility. It affects carers adversely, emotionally, physically, socially, and financially, and their lifestyle in general. This is reflected in three subthemes: (i) physically and emotionally draining; (ii) grieving about the loss; (iii) and adverse effects on lifestyle and social relationships. Second, carers develop resilience in caring, which helps sustain them in their role, as illustrated in three subthemes: (i) caring as purposeful and satisfying; (ii) harnessing social support from others; and (iii) purposefully maintaining their own well-being. Community mental health nurses have a key role in assessing carers' needs and supporting them in their caring role.
虽然照顾患有慢性疾病和痴呆症的老年人的负担已有详细记录，但对于照顾者如何培养力量和适应能力，以便持续照顾患有精神疾病的老年家庭成员这一重要角色，我们了解得要少得多。本研究的目的是了解患有严重且持续性精神疾病的老年人的主要照顾者的生活经历，并探讨是什么（如果有的话）有助于他们维持照顾者的角色。本研究采用了解释现象学分析方法，并对30名主要照顾者进行了定性访谈。从数据中提炼出了两个总体主题及相关子主题。首先，照顾是一项艰难且要求很高的责任。它会对照顾者在情感、身体、社交和经济方面以及总体生活方式上产生不利影响。这体现在三个子主题中：（i）身心俱疲；（ii）对失去感到悲痛；（iii）对生活方式和社会关系产生不利影响。其次，照顾者在照顾过程中培养了适应能力，这有助于他们维持自己的角色，这体现在三个子主题中：（i）照顾是有目的且令人满足的；（ii）利用他人的社会支持；（iii）有目的地维持自身幸福。社区精神卫生护士在评估照顾者的需求并支持他们履行照顾职责方面发挥着关键作用。
