Dr. Lerner, Dr. Chang, Dr. Rogers, and Dr. Lyson are with the Program on Health, Work and Productivity, Tufts Medical Center, and with the Sackler School of Graduate Biomedical Sciences, Tufts University, Boston. Ms. Benson is with Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Titusville, New Jersey. Dr. Dixon is with the Center for Practice Innovations at Columbia University and the Division of Behavioral Services and Policy Research, New York State Psychiatric Institute, New York.
Psychiatr Serv. 2018 Feb 1;69(2):169-178. doi: 10.1176/appi.ps.201600422. Epub 2017 Oct 2.
The aim was to quantify caregiver distress among informal caregivers of individuals with schizophrenia or schizoaffective disorder and identify its correlates.
From December 2014 through April 2015, ads posted with mental health advocates and the media recruited informal caregivers, age ≥21 years, to complete an online questionnaire. It included the ten-item Perceived Stress Scale (PSS) (0, no distress; 39, highest) and hypothesized distress correlates in four groups: caregiver and care recipient characteristics; caregiver role demands; caregiver social supports; and caregiver cognitive appraisals of caregiving. Three hypotheses were tested: first, distress is significantly related to variables from each group; second, social supports moderate the effects of role demands on distress; and third, cognitive appraisals mediate the effects of role demands on distress. Hypotheses were tested with multiple linear regression equations and structural equation models (SEMs).
Of 2,338 Web site "hits," 1,708 individuals consented, 1,398 were eligible, and 1,142 had complete data. Most caregivers were women (83%), white (89%), and college educated (59%), with a mean±SD age of 55.6±13.0. Compared with U.S. norms on the PSS (13.4±6.5), mean caregiver distress was high (18.9±7.1). According to SEMs, variables from each group were associated with distress. Contributing most to greater distress were caregiver health problems, providing frequent caregiving assistance, monitoring medication, having limited social support, and appraising caregiving negatively. Cognitive appraisals mediated the effects of demands on distress. Social support had a significant direct effect only.
Caregiver distress was relatively high and related to multiple variables, some of which are potentially modifiable.
量化精神分裂症或分裂情感障碍患者的非正式照顾者的照顾者困扰，并确定其相关因素。
2014 年 12 月至 2015 年 4 月，通过心理健康倡导者和媒体发布广告招募年龄≥21 岁的非正式照顾者完成在线问卷。问卷包括 10 项感知压力量表（PSS）（0，无压力；39，最高）和四个组别的假设压力相关因素：照顾者和照顾对象的特征；照顾者角色需求；照顾者社会支持；以及照顾者对照顾的认知评估。测试了三个假设：首先，压力与来自每个组别的变量显著相关；其次，社会支持缓和了角色需求对压力的影响；第三，认知评估介导了角色需求对压力的影响。通过多元线性回归方程和结构方程模型（SEM）测试了假设。
在 2338 个网站“点击”中，有 1708 人同意，1398 人符合条件，1142 人有完整的数据。大多数照顾者是女性（83％），白人（89％）和大学学历（59％），平均年龄为 55.6±13.0。与 PSS（13.4±6.5）的美国标准相比，照顾者的平均压力较高（18.9±7.1）。根据 SEM，每个组别的变量都与压力相关。造成压力更大的因素是照顾者的健康问题、经常提供照顾帮助、监测药物、社会支持有限以及负面评价照顾。认知评估中介了需求对压力的影响。社会支持仅具有显著的直接影响。
照顾者的困扰相对较高，与多个变量有关，其中一些是潜在可改变的。
