Chakraborty Satabdi, Bhatia Triptish, Anderson Carol, Nimgaonkar Vishwajit L, Deshpande Smita N
Assistant professor at the Department of Psychiatry, PGIMER, Dr RML Hospital, New Delhi, India.
Principal investigator at the Department of Psychiatry, PGIMER, Dr RML Hospital, New Delhi, India.
Int J Ment Health. 2013;15(5):288-298. doi: 10.1080/14623730.2013.856633. Epub 2013 Nov 21.
There is considerable evidence that family psycho-education combined with pharmacological intervention for patients with schizophrenia increases family understanding of the illness, reduces the familial burden of care, and improves patient outcomes. However, no studies have determined whether the burden of care is greater for those families with more than one ill member (multiplex) than for families with a single-affected individual (simplex), and whether psycho-educational programs should be adapted to meet the specific needs of multiplex families. This study was conducted at a tertiary care postgraduate teaching hospital in New Delhi, India. Caregivers in simplex [n = 50] and multiplex families [n = 30] were compared with regard to levels of burden, coping, and the impact of psycho-education on family functioning. All the caregiver participants attended eight bimonthly, psycho-educational intervention sessions. They were assessed on the Burden Assessment Schedule (BAS) and the Coping Check List (CCL) before and after psycho-education. Caregivers from the multiplex families reported significantly more burden on two domains of the BAS, but there were no significant differences between the groups with regard to coping on the CCL. Following psycho-education, significant improvement occurred in the majority of domains of the BAS and the CCL; the effect sizes varied by domain and family type. Multiplex families face a greater burden of care compared with simplex families. Currently, available psycho-education programs are moderately effective for such families.
有大量证据表明,对精神分裂症患者而言,家庭心理教育与药物干预相结合可增进家庭对该疾病的了解,减轻家庭护理负担,并改善患者预后。然而,尚无研究确定有不止一名患病成员的家庭(多重家庭)的护理负担是否比仅有一名患病成员的家庭(单一家庭)更重,以及心理教育项目是否应进行调整以满足多重家庭的特殊需求。本研究在印度新德里的一家三级护理研究生教学医院开展。对单一家庭[ n = 50 ]和多重家庭[ n = 30 ]的照料者在负担水平、应对方式以及心理教育对家庭功能的影响方面进行了比较。所有照料者参与者均参加了为期八个月的双月心理教育干预课程。在心理教育前后,他们接受了负担评估量表(BAS)和应对检查表(CCL)的评估。多重家庭的照料者在BAS的两个维度上报告的负担明显更重,但两组在CCL的应对方式方面没有显著差异。经过心理教育后,BAS和CCL的大多数维度都有显著改善;效应大小因维度和家庭类型而异。与单一家庭相比,多重家庭面临更大的护理负担。目前,现有的心理教育项目对此类家庭有一定效果。