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精神分裂症患者照料者的负担及其相关因素。

Burden experienced by caregivers of schizophrenia patients and its related factors.

作者信息

Hajebi Ahmad, Naserbakht Morteza, Minoletti Alberto

机构信息

Research Center for Addiction & Risky Behaviors (ReCARB), Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran.

Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Med J Islam Repub Iran. 2019 Jun 12;33:54. doi: 10.34171/mjiri.33.54. eCollection 2019.

Abstract

Deinstitutionalization of patients with schizophrenia shifted the primary locus of care from psychiatric hospitals to family and informal caregivers. Family members often play a vital role as caregivers in the lives of individuals with schizophrenia and other serious mental illnesses. This study aimed to assess the burden experienced by the caregivers of patients with schizophrenia and to evaluate its correlation with some demographic characteristics of patients, their caregivers, and the level of expressed emotion in the family. This descriptive-analytic study was conducted on 172 schizophrenic patients and their primary caregivers, selected from the outpatient department of a psychiatric hospital in Tehran, Iran, using convenience sampling. Caregivers were evaluated with Zarit Burden Interview and Family Questionnaire to assess the burden experienced by the caregivers and the level of expressed emotion in the family, respectively. Data were analyzed using Spearman correlation coefficient and linear regression method. Data were analyzed using SPSS software (Version 21) and significance level was set at p< 0.05. The level of burden experienced by most of primary caregivers was higher than moderate. The scores obtained in the subscales of emotional over involvement and critical comments were higher than the cutoff point in 51.7% and 64.5% of caregivers, respectively, and the scores had a significant direct correlation with the burden experienced by the caregivers. The findings of multiple linear regression showed that lower family income (β= -0.33, p< 0.001), higher duration of disorder (β= 0.19, p= 0.006), and younger age at onset of the disorder (β= -0.26, p= 0.001) were predictive of higher burden of disease on caregivers. Based on the results, some demographic factors of the primary caregivers, patients, and their family significantly affected the burden experienced by the primary caregivers. Most of the caregivers had high expressed emotions and a significant direct association existed between the expressed emotions and the burden experienced.

摘要

精神分裂症患者的非机构化将护理的主要场所从精神病医院转移到了家庭和非正式护理人员。家庭成员在精神分裂症患者及其他严重精神疾病患者的生活中,常常作为护理人员发挥着至关重要的作用。本研究旨在评估精神分裂症患者护理人员所经历的负担,并评估其与患者、护理人员的一些人口统计学特征以及家庭中情感表达水平之间的相关性。 这项描述性分析研究对172名精神分裂症患者及其主要护理人员进行,这些患者和护理人员是从伊朗德黑兰一家精神病医院的门诊部通过便利抽样选取的。分别使用扎里特负担访谈量表和家庭问卷对护理人员进行评估,以评估护理人员所经历的负担以及家庭中的情感表达水平。数据采用斯皮尔曼相关系数和线性回归方法进行分析。数据使用SPSS软件(版本21)进行分析,显著性水平设定为p<0.05。 大多数主要护理人员所经历的负担水平高于中等程度。在情感过度卷入和批评性评论分量表中,分别有51.7%和64.5%的护理人员得分高于临界值,且这些得分与护理人员所经历的负担存在显著的直接相关性。多元线性回归结果显示,家庭收入较低(β = -0.33,p<0.001)、疾病持续时间较长(β = 0.19,p = 0.006)以及疾病发病年龄较小(β = -0.26,p = 0.001)预示着护理人员的疾病负担较高。 根据研究结果,主要护理人员、患者及其家庭的一些人口统计学因素显著影响了主要护理人员所经历的负担。大多数护理人员具有较高的情感表达,且情感表达与所经历的负担之间存在显著的直接关联。

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