Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
J Psychiatr Ment Health Nurs. 2020 Dec;27(6):763-788. doi: 10.1111/jpm.12617. Epub 2020 Apr 13.
WHAT IS KNOWN ON THE SUBJECT?: Adults who support an adult family member with a severe and enduring mental health problem often experience carer burden. Over time, this often negatively affects their mental and physical health and social well-being. Understanding and communicating about mental health problems in families can help to improve resilience and coping among both adults and children. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: We conducted a review of studies looking at how adult relatives understand and communicate about an adult family member's mental health problem. The findings highlight that how relatives make sense of MHP is related to historical family relationships, their mental health literacy and whether they see themselves as a "carer" or not. The findings also show that little research to date has explored how adult relatives talk with children about their parent's difficulties, and how the adults' understanding might affect what children learn about the MHP. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: There is a research gap to be addressed regarding family communication with children about parental mental health problems. This knowledge gap likely impacts family-focused mental health nursing and therapy provision. Mental health nursing, therapeutic and support workers and advocates are ideally positioned to assist relatives with improving their mental health literacy and confidence communicating about mental health, and to promote inclusion of relatives and children in interventions. ABSTRACT: Introduction Relatives are profoundly affected by an adult family member's severe and enduring mental health problem (MHP). The burdens of caring impact on adult relatives' emotional, physical and social well-being. How relatives make meaning and communicate about the MHP is thought to affect family talk about mental health, and this can impact family coping and well-being. Aim No review has yet drawn together research about how adult relatives of people with severe and enduring MHP make meaning and communicate about their relatives' difficulties. We aimed to address this gap. Method We conducted a systematic review of peer-reviewed primary research. SCOPUS, PubMed, Psychnet, SCIE, Cochrane and CINAHL+ databases were searched. Results Nineteen papers qualified for inclusion. Findings are organized under four themes: making meaning about the MHP and affected individual; conceptualizing the self in the presence of the MHP; meaning-making processes underlying relatives' well-being outcomes; and relatives' perspectives on family talk about the MHP. Discussion Historical relationships, caregiver identity and mental health literacy moderate relatives' understanding and talk about the MHP. Implications for practice Psychoeducation and communication support for relatives should be provided by mental health practitioners. Future research should address familial communication about MHP, including with children.
照顾有严重和持久精神健康问题的成年家庭成员的成年人通常会承受照顾者负担。随着时间的推移，这通常会对他们的身心健康和社会福利产生负面影响。了解和交流家庭中的精神健康问题有助于提高成年人和儿童的适应能力和应对能力。本文增加了哪些新的知识：我们对研究进行了综述，探讨了成年亲属如何理解和交流成年家庭成员的精神健康问题。研究结果表明，亲属对心理健康问题的理解与历史家庭关系、他们的心理健康素养以及他们是否认为自己是“照顾者”有关。研究结果还表明，迄今为止，很少有研究探讨成年亲属如何与孩子谈论父母的困难，以及成年人的理解如何影响孩子对心理健康问题的了解。这对实践有什么影响：在家庭与孩子就父母的精神健康问题进行沟通方面，存在一个需要解决的研究空白。这一知识空白可能会影响以家庭为中心的精神健康护理和治疗服务的提供。精神健康护理、治疗和支持工作者以及倡导者最适合帮助亲属提高他们的心理健康素养和信心，以促进家庭沟通，促进亲属和儿童参与干预措施。摘要：引言成年亲属会受到成年家庭成员严重和持久的精神健康问题（MHP）的深远影响。照顾的负担会影响成年亲属的情感、身体和社会福祉。亲属对 MHP 的意义和交流方式被认为会影响家庭对精神健康的讨论，这可能会影响家庭的应对能力和幸福感。目的迄今为止，还没有对成年亲属如何理解和交流严重和持久的精神健康问题亲属的困难进行综述。我们旨在解决这一差距。方法我们对同行评议的原始研究进行了系统综述。SCOPUS、PubMed、PsycINFO、SCIE、Cochrane 和 CINAHL+数据库进行了检索。结果有 19 篇论文符合纳入标准。研究结果组织在以下四个主题下：对 MHP 和受影响个体的意义理解；在 MHP 存在的情况下对自我的概念化；影响亲属幸福感结果的意义形成过程；以及亲属对家庭谈论 MHP 的看法。讨论历史关系、照顾者身份和心理健康素养调节着亲属对 MHP 的理解和交流。对实践的影响心理健康从业者应为亲属提供心理健康教育和沟通支持。未来的研究应该解决关于 MHP 的家庭沟通问题，包括与儿童的沟通。
