Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
Department of Psychology, University of Hertfordshire, UK.
Compr Psychiatry. 2018 May;83:19-24. doi: 10.1016/j.comppsych.2018.02.003. Epub 2018 Feb 12.
The first onset of psychosis can exert a significant negative impact on the functioning and positive wellbeing of family carers. Carer reports of "burnout" have recently been recorded in early psychosis carers, though the literature is scarce detailing our understanding of how burnout relates to the primary experience of caregiving. The current study investigated reports of burnout and its relationship with beliefs about caregiving and wellbeing in a large group of early psychosis carers who were routinely assessed within an early intervention team.
Using a cross-sectional design, 169 early psychosis carers completed the Maslach Burnout Inventory alongside measures of caregiving experiences, affect and wellbeing.
The mean illness length for patients with psychosis was 18 months. Their mean age was 24.4 years and most was male (65%). The majority of carer participants were parental caregivers and living with their relative with psychosis. Across the three key burnout dimensions, 58% of the sample reported high levels of emotional exhaustion; 31% endorsed high levels of depersonalization; and 43% reported low levels personal accomplishment. The most severe level of burnout, reflecting elevated rates across all three dimensions, was observed in 16% of the sample. Carer burnout was positively associated with negative caregiving experiences (i.e. burden), poor affect, and reduced levels of positive wellbeing and perception of being in good health.
Reports by early psychosis carers of exhaustion, feeling inadequate and expressing negativity towards the relative they care for is not uncommon and are closely associated with their overall negative appraisals of caregiving. The results underscore the importance of developing targeted interventions during the early phase, which are designed to reduce the development and entrenchment of burnout responses in carers, but to also mitigate its negative sequelae.
精神病首次发作会对照顾者的功能和积极幸福感产生重大负面影响。最近，在早期精神病照顾者中记录了“倦怠”的照顾者报告，尽管文献很少详细说明我们对倦怠与主要照顾体验的关系的理解。本研究调查了在早期干预团队中常规评估的一大群早期精神病照顾者中倦怠的报告及其与照顾信念和幸福感的关系。
使用横断面设计，169 名早期精神病照顾者完成了 Maslach 倦怠量表，以及照顾体验、情感和幸福感的测量。
精神病患者的平均发病时间为 18 个月。他们的平均年龄为 24.4 岁，大多数是男性（65%）。大多数照顾者是父母照顾者，与患有精神病的亲属同住。在三个关键的倦怠维度中，58%的样本报告了高水平的情绪衰竭；31%的样本报告了高水平的去人性化；43%的样本报告了低水平的个人成就感。在 16%的样本中观察到最严重的倦怠程度，反映了所有三个维度的发生率较高。照顾者倦怠与负面照顾体验（即负担）、不良情绪以及积极幸福感和健康感知水平降低呈正相关。
早期精神病照顾者报告的疲惫、感到不足和对他们所照顾的亲属表示消极的情况并不罕见，并且与他们对照顾的整体负面评价密切相关。研究结果强调了在早期阶段制定有针对性的干预措施的重要性，这些干预措施旨在减少照顾者倦怠反应的发展和根深蒂固，并减轻其负面影响。
