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非专业照护者在个体双相障碍自我管理支持方面的学习经历:一项现象学研究。

Informal Caregivers' Learning Experiences With Self-Management Support of Individuals Living With Bipolar Disorder: A Phenomenological Study.

机构信息

1 Silvio van den Heuvel, MA, RN, Saxion University of Applied Sciences, Deventer, Netherlands; Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands; Dimence Group, Deventer, Netherlands; KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium.

2 Peter Goossens, PhD, MANP, RN, FEANS, Dimence, Institute for Mental Healthcare, Deventer, Netherlands; Radboud Institute for Health Sciences, Nijmegen, Netherlands; Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, Netherlands; Ghent University, University Centre of Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Services, Ghent, Belgium.

出版信息

J Am Psychiatr Nurses Assoc. 2018 Nov/Dec;24(6):531-541. doi: 10.1177/1078390317752864. Epub 2018 Jan 9.

Abstract

BACKGROUND

The degree of informal caregiver involvement influences the self-management of individuals living with bipolar disorder (BD).

OBJECTIVE

This article aims to provide a description of informal caregivers' learning experiences in self-management support of BD in order to guide professionals in tailoring future psychosocial and psychoeducational interventions.

DESIGN

In-depth open interviews with 10 informal caregivers of patients with BD who followed treatment in the context of specialized outpatient bipolar care were conducted.

RESULTS

Four learning phases emerged from the phenomenological analysis describing the informal caregivers learning process: (1) understanding BD, (2) overcoming the dilemmas in self-management support for individuals living with BD, (3) dividing tasks and responsibilities, and (4) acquiring a personal definition of self-management support for individuals living with BD.

CONCLUSION

By grasping the concept of BD, informal caregivers gradually learn how to overcome dilemmas resulting from living with someone with BD, and how to control the expression of emotions. They learn to reflect on the nature of conflicts and how to share the responsibilities of illness management with individuals living with BD and professionals. Mastering these skills eventually allows them to define and delimit their supporting informal caregiver role in the self-management of BD.

PRACTICE IMPLICATIONS

Our findings provide information regarding the educational needs of informal caregivers to tailor counseling, and psychosocial and psychoeducational interventions in specialized outpatient care for individuals living with BD.

摘要

背景

非专业照护者的参与程度会影响双相情感障碍(BD)患者的自我管理。

目的

本文旨在描述非专业照护者在 BD 自我管理支持方面的学习经验,以便为专业人员量身定制未来的心理社会和心理教育干预措施提供指导。

设计

对 10 名接受专门门诊双相情感障碍治疗的 BD 患者的非专业照护者进行了深入的开放式访谈。

结果

通过对非专业照护者学习过程的现象学分析,得出四个学习阶段:(1)了解 BD;(2)克服支持 BD 患者自我管理的困境;(3)分工与责任分担;(4)对 BD 患者自我管理支持形成个人定义。

结论

通过掌握 BD 的概念,非专业照护者逐渐学会如何克服与 BD 患者共同生活所带来的困境,以及如何控制情绪表达。他们学会反思冲突的本质,以及如何与 BD 患者和专业人员共同分担疾病管理的责任。掌握这些技能最终使他们能够定义和限定他们在 BD 自我管理中的支持性非专业照护者角色。

实践意义

我们的研究结果提供了关于非专业照护者教育需求的信息,以针对专门门诊中 BD 患者量身定制咨询、心理社会和心理教育干预措施。

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