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中国农村不同类型精神分裂症患者家庭照顾者的照顾负担与疾病相关的压力源。

Disease-related stressors of caregiving burden among different types of family caregivers of persons with schizophrenia in rural China.

机构信息

1 Department of Social Work & Social Administration, University of Hong Kong, Hong Kong.

2 Department of Social Work, Fudan University, Shanghai, China.

出版信息

Int J Soc Psychiatry. 2019 Nov;65(7-8):603-614. doi: 10.1177/0020764019866224. Epub 2019 Aug 7.

Abstract

BACKGROUND

Little is known about the impacts of schizophrenia on different types of caregiving burden.

AIM

This study aims to examine how the severity of schizophrenia, social functioning and aggressive behavior are associated with caregiving burden across different kinship types.

METHOD

The analytic sample included 300 dyads of persons with schizophrenia and their family caregivers in Xinjin, Chengdu, China. The 10th edition of the International Classification of Diseases (ICD-10) was utilized to identify the patients, whose symptom severity, social functioning and aggressive behavior were measured. Caregiving burden was estimated using the Burden Scale for Family Caregivers-short (BSFC-s).

RESULTS

A higher level of burden was significantly associated with female caregivers, larger family size, lower income, worse symptoms, poorer functional status and more aggressive behaviors. Parent caregivers showed greater burden if the patients had better functioning of social interest and concern or more aggression toward property. Mother caregivers showed greater burden than fathers. Spouses tended to perceive greater burden if the patients had better marital functioning, poorer occupational functioning or more aggressive behaviors toward property. Patients attacking others or a father with schizophrenia was related to a higher burden of child caregivers. A heavier burden of other relatives was correlated with patients' more verbal aggression and self-harm.

CONCLUSION

This study shows the distinct impacts of disease-related factors on the caregiving burden across different kinship types. Our findings have implications for health-care professionals and practitioners in terms of developing more targeted family-based or individualized intervention to ameliorate burden according to kinship types and deal with behavioral and functional problems in schizophrenia.

摘要

背景

关于精神分裂症对不同类型的照料负担的影响知之甚少。

目的

本研究旨在探讨精神分裂症的严重程度、社会功能和攻击行为如何与不同亲属类型的照料负担相关。

方法

分析样本包括来自中国成都新津的 300 对精神分裂症患者及其家庭照顾者。使用第十版《国际疾病分类》(ICD-10)来识别患者,评估其症状严重程度、社会功能和攻击行为。使用家庭照顾者负担量表-短版(BSFC-s)来评估照料负担。

结果

较高的负担水平与女性照顾者、家庭规模较大、收入较低、症状更严重、社会功能和职业功能更差以及更多的攻击行为显著相关。如果患者的社会兴趣和关注功能更好或对财产的攻击性更强,父母照顾者的负担更大。如果患者的婚姻功能更好、职业功能更差或对财产的攻击行为更多,配偶照顾者则更容易感到负担更重。如果患者攻击他人或父亲患有精神分裂症,则子女照顾者的负担更高。其他亲属的负担更重与患者的言语攻击和自残行为有关。

结论

本研究表明,疾病相关因素对不同亲属类型的照料负担有不同的影响。我们的研究结果为医疗保健专业人员和从业者提供了启示,即根据亲属类型制定更有针对性的家庭或个体化干预措施,以减轻负担,并解决精神分裂症中的行为和功能问题。

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