King's College London, UK.
London South Bank University, UK.
Health (London). 2020 Nov;24(6):737-754. doi: 10.1177/1363459319829189. Epub 2019 Apr 2.
Informal carers are increasingly involved in supporting people with severe and enduring mental health problems, and carers' perceptions impact the wellbeing of both parties. However, there is little research on how carers actually make sense of what their loved one is experiencing. Ten carers were interviewed about how they understood a loved one's psychosis. Data were analysed using a hermeneutic-phenomenological approach. Three themes described the carers' effortful quest to understand their loved one's experiences while maintaining their relational bonds. Carers described psychosis as incomprehensible, seeing their loved one as incompatible with the shared world. To overcome this, carers developed hermeneutic 'mooring points', making sense of their loved one's unusual experiences through novel accounts that drew on material or spiritual explanations. The findings suggest that informal carers resist biomedical narratives and develop idiosyncratic understandings of psychosis, in an attempt to maintain relational closeness. We suggest that this process is effortful - it is - done in the service of maintaining the caring relationship. Findings imply that services should better acknowledge the bond between carers and care-receivers, and that more relationally oriented approaches should be used to support carers of people experiencing severe mental health problems.
非专业照料者越来越多地参与到支持有严重和持久精神健康问题的人，照料者的看法影响到双方的幸福感。然而，对于照料者如何真正理解他们所爱的人的经历，几乎没有研究。我们采访了 10 名照料者，了解他们如何理解亲人的精神病。使用解释学-现象学方法对数据进行分析。三个主题描述了照料者在保持关系纽带的同时，努力理解亲人经历的努力。照料者将精神病描述为不可理解的，认为他们的亲人与共同的世界不兼容。为了克服这一点，照料者发展了解释学的“停泊点”，通过新颖的叙述来理解亲人不寻常的经历，这些叙述借鉴了物质或精神上的解释。研究结果表明，非专业照料者抵制生物医学叙事，并对精神病形成独特的理解，试图保持关系的亲密。我们认为，这个过程是费力的——它是——为了维护照顾关系。研究结果表明，服务机构应该更好地承认照料者和被照料者之间的联系，应该使用更多以关系为导向的方法来支持有严重精神健康问题的人的照料者。
