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中国农村精神分裂症患者配偶和父母在照顾经历方面的横断面研究。

A cross-sectional study on spouse and parent differences in caregiving experiences of people living with schizophrenia in rural China.

机构信息

Hospital Evaluation Office, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.

Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.

出版信息

BMC Psychiatry. 2020 May 12;20(1):226. doi: 10.1186/s12888-020-02633-w.

Abstract

BACKGROUND

Conflicting evidence exists on whether parent or spouse caregivers experience better outcomes when caring for family members with schizophrenia. The current study aims to examine relative caregiving experiences and impacts of spouse and parent caregivers for people living with schizophrenia (PLS) in China.

METHODS

A cross-sectional study was conducted in a sample of 264 community-dwelling primary family caregivers of PLS. Face-to-face interviews were conducted to collect information on family caregiving activities; negative caregiving impacts including objective and subjective burden, and caregiver psychological distress such as depression and anxiety; positive caregiving impacts including caregiving rewarding feelings, and family functioning for spouse and parent caregivers.

RESULTS

Both types of caregivers report engaging in similar caregiving activities and report comparable levels of objective burden. However, parent caregivers report significantly higher subjective burden than spouse caregivers (b = 7.94, 95%CI:2.08, 13.80, P < 0.01), which is also reflected in significantly higher depression (b = 3.88, 95%CI:1.35, 6.41, P < 0.01) and anxiety (b = 2.53, 95%CI: 0.22, 4.84, P < 0.05), and lower family functioning (b = - 1.71, 95%CI: - 2.73, - 0.49, P < 0.01). Despite these differences, both groups of caregivers report comparable rewarding feelings about caregiving.

CONCLUSIONS

Our findings have implications for family caregivers globally, but especially for countries that adhere to Confucian cultural values and provide guidance for future family intervention programs. Such programs may do well to incorporate cultural values and beliefs in understanding caregiving and kinship family dynamics so as to support family caregivers, and in particular, the specific vulnerabilities of parent caregivers.

摘要

背景

关于在照顾精神分裂症患者时,父母或配偶照顾者的体验是否更好,目前的研究结果相互矛盾。本研究旨在探讨中国精神分裂症患者家属照顾者的相对照顾体验以及配偶和父母照顾者的影响。

方法

本研究采用横断面研究方法,对 264 名居住在社区的精神分裂症患者的主要家庭照顾者进行了调查。通过面对面访谈收集家庭照顾活动信息;负面照顾影响,包括客观和主观负担;以及照顾者的心理困扰,如抑郁和焦虑;对于配偶和父母照顾者,还包括积极的照顾感受和家庭功能。

结果

两种类型的照顾者都报告从事类似的照顾活动,报告的客观负担水平相当。然而,与配偶照顾者相比,父母照顾者报告的主观负担明显更高(b=7.94,95%CI:2.08,13.80,P<0.01),这也反映在抑郁(b=3.88,95%CI:1.35,6.41,P<0.01)和焦虑(b=2.53,95%CI:0.22,4.84,P<0.05)显著升高,以及家庭功能显著降低(b=-1.71,95%CI:-2.73,-0.49,P<0.01)。尽管存在这些差异,但两组照顾者都报告了类似的照顾回报感。

结论

我们的研究结果对全球家庭照顾者具有启示意义,但特别是对那些坚持儒家文化价值观并为未来家庭干预计划提供指导的国家具有启示意义。这些计划可能需要很好地将文化价值观和信仰融入到对照顾和亲属家庭动态的理解中,以支持家庭照顾者,特别是照顾者的特定脆弱性。

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