照顾患有精神疾病亲属的家庭的心理社会问题及其应对策略：坦桑尼亚达累斯萨拉姆市基于城市的定性研究
The psychosocial problems of families caring for relatives with mental illnesses and their coping strategies: a qualitative urban based study in Dar es Salaam, Tanzania.
作者信息
Iseselo Masunga K, Kajula Lusajo, Yahya-Malima Khadija I
机构信息
Department of Clinical Nursing, Muhimbili University of Health & Allied Sciences (MUHAS), P.O.Box 65004, Dar es Salaam, Tanzania.
Department of Psychiatry and Mental Health, Muhimbili University of Health & Allied Sciences (MUHAS), P.O.Box 65001, Dar es Salaam, Tanzania.
出版信息
BMC Psychiatry. 2016 May 14;16:146. doi: 10.1186/s12888-016-0857-y.
BACKGROUND
Mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient's family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family as a whole. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons. The aim of the study was to determine the psychosocial problems of mental illness on the family including the coping strategies utilized by family members caring for a person with mental illness.
METHOD
A qualitative study was conducted, involving four focus group discussions and 2 in-depth interviews of family members who were caring for patient with mental illness at Temeke Municipality, Dar es Salaam. Purposive sampling procedure was used to select participants for the study. Audio-recorded interviews in Swahili were conducted with all study participants. The recorded interview was transcribed and qualitative content thematic analysis was used to analyse the data.
RESULTS
Financial constraints, lack of social support, disruption of family functioning, stigma, discrimination, and patients' disruptive behaviour emerged as the main themes in this study. Acceptance and religious practice emerged as the major coping strategies used by family members.
CONCLUSION
Familial care for a person with mental illness has its advantages, yet it has multiple social and psychological challenges. Coping strategies and skills are important for the well-being of the caregiver and the patient. Addressing these psychosocial challenges requires a collaborative approach between the health care providers and government so that the needs of the family caregivers and those of the patients can be addressed accordingly.
背景
精神疾病可能会引发各种社会心理问题，比如患者家庭成员的生活质量下降，以及患者及其照顾家庭与社会的距离增大。与精神疾病相关的污名加剧了社会心理挑战，这一问题不仅影响患者，也影响整个家庭。由于多种原因，不同家庭应对精神病患者的机制各不相同。本研究的目的是确定精神疾病给家庭带来的社会心理问题，包括照顾精神病患者的家庭成员所采用的应对策略。
方法
开展了一项定性研究，包括在达累斯萨拉姆的特梅克市对照顾精神病患者的家庭成员进行四次焦点小组讨论和两次深入访谈。采用立意抽样程序选择研究参与者。对所有研究参与者进行斯瓦希里语的录音访谈。对录音访谈进行转录，并采用定性内容主题分析来分析数据。
结果
经济困难、缺乏社会支持、家庭功能紊乱、污名、歧视以及患者的破坏性行为成为本研究的主要主题。接纳和宗教活动成为家庭成员采用的主要应对策略。
结论
对精神病患者的家庭护理有其优势，但也面临多重社会和心理挑战。应对策略和技能对照顾者和患者的幸福至关重要。应对这些社会心理挑战需要医疗服务提供者和政府采取协作方法，以便相应地满足家庭照顾者和患者的需求。
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