1 Department of Social Work & Social Administration, The University of Hong Kong, Pokfulam, Hong Kong.
2 Mental Health Center, Southwest Medical University, Luzhou, China.
Int J Soc Psychiatry. 2019 Nov;65(7-8):548-557. doi: 10.1177/0020764019866230. Epub 2019 Jul 30.
Improving patients' perception of social support is significant not only for their re-adaptation to life but also for alleviating caregivers' burden.
This study aims to examine an integrated model regarding social support, psychotic symptoms and caregiver burden.
Persons with schizophrenia ( = 300) and their family caregivers ( = 300) in Xinjin County, Chengdu, China, completed the survey to report their demographics, patients' perception of social support (Duke Social Support Index), psychotic symptoms (Positive and Negative Syndrome Scale) and caregiver burden (Burden Scale for Family Caregivers, Short Version). Structural equation modelling was utilised to test the proposed model.
The degree of caregiver burden differed significantly within subgroups of patients' gender and education, as well as caregivers' gender, education and employment. Caregiver burden was negatively related to patients' age and household income. Social interaction partially mediated the relationship between instrumental and subjective social support (total effect = 0.451, < .01). Subjective social support fully mediated the impact of social interaction on psychotic symptoms (total effect = -0.099, < .05). In the final model, instrumental social support was positively associated with social interaction ( < .001) and increased subjective social support ( < .05). Increased subjective social support showed correlation with a lower degree of psychotic symptoms ( < .01), which was related to a lower level of caregiver burden ( < .001).
This study shows the associations of patients' social support with psychotic symptoms and caregiver burden. Culture-specific psychosocial interventions should be provided for both patients and caregivers to enrich external support and reduce psychotic symptoms and caregivers' burden within the health care environment.
改善患者对社会支持的感知不仅对他们重新适应生活具有重要意义，而且对减轻照顾者的负担也具有重要意义。
本研究旨在检验一个关于社会支持、精神病症状和照顾者负担的综合模型。
在中国成都新津县，300 名精神分裂症患者及其家庭照顾者完成了调查，报告了他们的人口统计学资料、患者对社会支持的感知（杜克社会支持指数）、精神病症状（阳性和阴性症状量表）和照顾者负担（照顾者负担量表，简短版）。结构方程模型被用于检验所提出的模型。
患者的性别和教育程度以及照顾者的性别、教育程度和就业状况不同，照顾者负担的程度也有显著差异。照顾者负担与患者的年龄和家庭收入呈负相关。社会互动部分中介了工具性和主观社会支持之间的关系（总效应 = 0.451， < .01）。主观社会支持完全中介了社会互动对精神病症状的影响（总效应 = -0.099， < .05）。在最终模型中，工具性社会支持与社会互动呈正相关（ < .001），并增加了主观社会支持（ < .05）。主观社会支持的增加与精神病症状程度的降低呈正相关（ < .01），这与照顾者负担程度的降低有关（ < .001）。
本研究表明，患者的社会支持与精神病症状和照顾者负担有关。应针对患者和照顾者提供特定于文化的心理社会干预措施，以丰富外部支持，并在医疗保健环境中降低精神病症状和照顾者的负担。
