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精神病患者照料者的感知需求:一项基于澳大利亚纵向人群的精神病性障碍患者照料者研究。

Perceived needs of carers of people with psychosis: An Australian longitudinal population-based study of caregivers of people with psychotic disorders.

作者信息

Poon Abner Weng Cheong, Joubert Lynette, Harvey Carol

机构信息

School of Social Sciences, University of New South Wales, UNSW Australia, Sydney, NSW, Australia.

Department of Social Work, Melbourne School of Health Sciences, University of Melbourne, Parkville, VIC, Australia.

出版信息

Health Soc Care Community. 2018 May;26(3):412-422. doi: 10.1111/hsc.12530. Epub 2017 Dec 15.

Abstract

Studies have documented the perceived needs of carers of people with psychosis but most recruitment has utilised convenience sampling resulting in limited understanding of carers' needs. This longitudinal study was conducted within the second Australian prevalence study of psychosis, aiming to obtain generalisable findings regarding perceived needs of carers of people with psychosis. Semi-structured interviews were conducted with 98 carers of people with psychosis recruited in the Australian prevalence study of psychosis. Seventy-eight of the carers were reinterviewed 1 year later to measure changes in their perceived needs. Correlational and paired T tests were conducted to identify relationships between perceived needs and carer's health and well-being, and changes in levels of perceived needs over time. Qualitative responses were structurally coded by segmentation according to the Carers' and Users' Expectations of Services-Carer version. Thematic analysis of common words and phrases was undertaken to identify key themes concerning carers' perceived needs. There was minimal improvement in carers' perceived needs over time and their needs were closely related to their perception of their own social connectedness, psychological health and quality of life. Five themes were identified: Greater involvement of carers in the treatment plan, provision of relevant information to carers, multiple biopsychosocial support for carers, well-being and independence interventions for people with psychosis, and choice to care and alternate caring arrangements. Although policy recognises the need to support carers, findings show that focused interventions are required to address carers' perceived needs more holistically in current mental health services. To support carers' recovery, services need to include carers in treatment planning, and consider ways to address their needs and improve their own health and well-being.

摘要

研究记录了精神病患者照料者的感知需求,但大多数招募工作采用的是便利抽样,导致对照料者需求的了解有限。这项纵向研究是在澳大利亚第二次精神病患病率研究中进行的,旨在获得关于精神病患者照料者感知需求的可推广性研究结果。对在澳大利亚精神病患病率研究中招募的98名精神病患者照料者进行了半结构化访谈。其中78名照料者在1年后接受了再次访谈,以衡量他们感知需求的变化。进行了相关性分析和配对t检验,以确定感知需求与照料者的健康和幸福感之间的关系,以及感知需求水平随时间的变化。定性回答根据《服务照料者版照料者和使用者期望》进行结构编码。对常见单词和短语进行了主题分析,以确定与照料者感知需求相关的关键主题。随着时间的推移,照料者的感知需求几乎没有改善,他们的需求与他们对自身社会联系、心理健康和生活质量的认知密切相关。确定了五个主题:照料者更多地参与治疗计划、向照料者提供相关信息、为照料者提供多方面的生物心理社会支持、对精神病患者的幸福感和独立性干预,以及照料的选择和替代照料安排。尽管政策认识到需要支持照料者,但研究结果表明,在当前的心理健康服务中,需要有针对性的干预措施,以更全面地满足照料者的感知需求。为了支持照料者的康复,服务需要让照料者参与治疗计划,并考虑满足他们需求的方法,改善他们自身的健康和幸福感。

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