Lambda Beta-At-Large, Professor, School of Nursing, College of Medicine, Chang Gung University, Department of Psychiatry, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
Nurse director, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan, Republic of China.
J Nurs Scholarsh. 2019 Nov;51(6):680-688. doi: 10.1111/jnu.12526.
This study aimed to examine the quality of family-centered care perceived by primary family caregivers and its influencing factors in mental healthcare practice.
A cross-sectional, correlational study.
A convenience sample of 121 mental health nurses and 164 primary family caregivers of patients with schizophrenia was recruited from acute psychiatric wards and chronic psychiatric rehabilitation wards in three psychiatric hospitals in Taiwan. Structured questionnaires for mental health nurses were designed to examine nurses' attitudes toward schizophrenia and the importance of families in nursing care. Primary family caregivers were assessed to determine their perceptions of quality of family-centered care. At least one primary family caregiver of patients was matched to a nurse who took major responsibility for the patient during the hospitalization. Data were analyzed with descriptive statistics, Pearson's product-moment correlations, independent t-test, one-way analysis of variance, and stepwise regression analyses.
Quality of family-centered care perceived by primary family caregivers regarding the provision of general and specific information, as compared to enabling and partnership, coordinated and comprehensive care, and respectful and supportive care, was relatively inadequate. Younger and more educated primary family caregivers, having relatives with schizophrenia in acute wards, less supportive nurses' attitudes toward schizophrenia, and the importance of family in nursing care were correlated with poor primary family caregivers' perceptions of quality of family-centered care. Nurses' supportive attitudes toward schizophrenia and chronic psychiatric rehabilitation wards where patients received care were key factors in determining better quality of family-centered care.
Findings provide a platform for the development of effective continuing education and training programs to equip mental health nurses with supportive attitudes toward mental illness and an integration of the family in nursing care, which will ultimately improve mental health care for families experiencing mental health problems.
Efforts in professional training to address stigma and encourage a family-centered approach into recovery-oriented practice for practicing mental healthcare providers, including mental health nurses, are recommended.
本研究旨在探讨精神科医护实务中，主要照顾者对以家庭为中心之照顾品质的认知及其影响因素。
横断式相关性研究。
本研究以方便取样方式，于台湾三间精神科医院之急性精神病房及慢性精神复健病房，选取 121 位精神科护理师及 164 位照顾精神分裂症患者之主要家属。针对精神科护理师设计结构式问卷以评估其对精神分裂症之态度及家庭在护理照顾上的重要性，而主要家属则用以评估其对以家庭为中心之照顾品质的认知。每位患者至少有一位主要家属被配对至一位在住院期间主要负责该患者的护理师。资料以描述性统计、皮尔逊积差相关、独立样本 t 检定、单因子变异数分析及逐步迴归分析进行分析。
相较于促进合作与伙伴关系、协调与全面性照顾及尊重与支持性照顾，主要照顾者认为在提供一般性与特定性资讯方面，以家庭为中心之照顾品质的提供相对不足。年轻、教育程度较高、急性病房有家属罹患精神分裂症、护理师对精神分裂症支持态度较差，以及家庭在护理照顾上较重要的主要照顾者，其对以家庭为中心之照顾品质的认知较差。护理师对精神疾病的支持态度以及患者接受照顾的慢性精神复健病房，是决定以家庭为中心之照顾品质的关键因素。
研究结果提供一个发展有效继续教育与训练方案的平台，以培养精神科护理师对精神疾病的支持态度，并将家庭纳入护理照顾，进而改善有精神健康问题之家庭的精神健康照护。
建议努力于专业训练以处理污名化，并鼓励以家庭为中心的方法应用于以复元为导向的精神科医护实务，包括精神科护理师。
