Shi Ying, Shao Yanping, Li Huanhuan, Wang Shouqi, Ying Jie, Zhang Meiling, Li Yuan, Xing Zhuangjie, Sun Jiao
School of Nursing, Jilin University, Changchun, China.
School of Nursing, Hubei University of Medicine, Shiyan, Hubei, China.
J Psychiatr Ment Health Nurs. 2019 Feb;26(1-2):49-61. doi: 10.1111/jpm.12505. Epub 2018 Dec 17.
WHAT IS KNOWN ON THE SUBJECT?: A growing body of qualitative and quantitative research has investigated the experiences of affiliated stigma for family members of PWMI. Some findings are contradictory and have not been considered systematically. WHAT DOES THE PAPER ADDS TO EXISTING KNOWLEDGE?: Family caregivers of PWMI may encounter affiliate stigma, but no systematic review or meta-analysis has been conducted to evaluate affiliate stigma among them. We identified eight variables significantly related to affiliate stigma among caregivers of PWMI. The findings can be used to help clinical practice to develop health promotion and prevention strategies. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Affiliate stigma was prevalent among the family caregivers of PWMI and is important for clinicians to consider. Health-focused interventions for family caregivers can mediate the impact of affiliated stigma through provision of social support by practitioners, such as respite care based on the "Senses Framework," self-help groups and online support program. And the caregivers of PWMI might benefit from further support (e.g., psychoeducation) to improve their knowledge about mental illness. ABSTRACT: Introduction Many studies have investigated the correlates of affiliate stigma among family caregivers of people with mental illness (PWMI). Thus far, no systematic review or meta-analysis has been conducted to synthesize these results. Aims/Question This review aims to identify the correlates of affiliate stigma among family caregivers of PWMI. Method We searched four databases including PubMed, PsycINFO, EMBASE and Web of Science for studies that investigated the association of affiliate sigma with socio-demographic, psychosocial and disease-related factors. Results Twenty-two studies including 3,381 participants met the inclusion criteria. Eighteen variables were included for the meta-analysis. For disease-related characteristics, only "disease attribution" and "care time/day" were associated with affiliate stigma. For psychosocial characteristics, "support from others," "burden," "depression," "stress," "distress" and "face concern" were related to affiliate stigma. Discussion This review is the first to assess the association of affiliate stigma with other characteristics of interest. However, the findings are limited due to a very small number of studies. Researchers should conduct in-depth study in this area and improve the quality of the literature. Implications for practice Health-focused interventions for family caregivers such as respite care, self-help groups, online support program and psychosocial education can mediate the impact of affiliated stigma.
关于该主题已知的内容有哪些？：越来越多的定性和定量研究调查了患有精神疾病的人的家庭成员所经历的关联污名。一些研究结果相互矛盾，且未得到系统的考量。
本文对现有知识有何补充？：患有精神疾病的人的家庭照料者可能会遭遇关联污名，但尚未进行系统评价或荟萃分析来评估他们当中的关联污名情况。我们确定了与患有精神疾病的人的照料者的关联污名显著相关的八个变量。这些研究结果可用于帮助临床实践制定健康促进和预防策略。
对实践有何启示？：关联污名在患有精神疾病的人的家庭照料者中普遍存在，临床医生对此加以考量很重要。针对家庭照料者的以健康为重点的干预措施可以通过从业者提供社会支持来调节关联污名的影响，例如基于“感官框架”的喘息服务、自助小组和在线支持项目。而且，患有精神疾病的人的照料者可能会从进一步的支持（如心理教育）中受益，以提高他们对精神疾病的认识。
引言 许多研究调查了患有精神疾病的人的家庭照料者中关联污名的相关因素。到目前为止，尚未进行系统评价或荟萃分析来综合这些结果。
目的/问题 本综述旨在确定患有精神疾病的人的家庭照料者中关联污名的相关因素。
方法 我们在四个数据库中进行检索，包括PubMed、PsycINFO、EMBASE和Web of Science，以查找研究关联污名与社会人口学、心理社会和疾病相关因素之间关联的研究。
结果 22项研究（包括3381名参与者）符合纳入标准。18个变量被纳入荟萃分析。对于疾病相关特征，只有“疾病归因”和“每日照料时间”与关联污名相关。对于心理社会特征，“他人支持”、“负担”、“抑郁”、“压力”、“痛苦”和“面子顾虑”与关联污名有关。
讨论 本综述首次评估了关联污名与其他相关特征之间的关联。然而，由于研究数量非常少，研究结果有限。研究人员应在该领域进行深入研究并提高文献质量。
对实践的启示 针对家庭照料者的以健康为重点的干预措施，如喘息服务、自助小组、在线支持项目和心理社会教育，可以调节关联污名的影响。
