School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia.
Xiangya School of Nursing, Central South University, Changsha, China.
Health Soc Care Community. 2022 Nov;30(6):2300-2310. doi: 10.1111/hsc.13780. Epub 2022 Mar 30.
Care-giving burden and internalised stigma are prevalent among family caregivers of people diagnosed with schizophrenia. Internalised stigma has been regarded as a source of care-giving burden. But it remains unclear if high levels of internalised stigma directly contribute to an increased risk of care-giving burden or if the effects could be buffered by psychological factors. This cross-sectional study was to investigate the relationship between internalised stigma and care-giving burden, and to determine the mediating effects of coping styles and social support. Data were collected from 344 Chinese family caregivers of adults diagnosed with schizophrenia in a psychiatric outpatient department of a tertiary hospital in Changsha, Hunan between April and August 2018. A self-reported questionnaire was used to collect data anonymously. Instruments included the Simplified Coping Style Questionnaire, the Multidimensional Scale of Perceived Social Support, the Internalized Stigma of Mental Illness Scale and the Caregiver Burden Inventory. Data analysis was conducted using descriptive statistics, the Spearman correlation and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results showed that internalised stigma, social support and passive coping were significant correlates of care-giving burden; social support partially mediated the relationship between internalised stigma and care-giving burden; active coping did not show impacts on internalised stigma and care-giving burden. This study provided social workers and healthcare providers with a better understanding of the development of care-giving burden. Comprehensive interventions should be designed to provide supportive resources and reduce the possibilities of internalisation of stigma and passive coping, to alleviate care-giving burden.
照顾负担和内化污名在精神分裂症患者的家庭照顾者中普遍存在。内化污名被认为是照顾负担的一个来源。但目前尚不清楚高水平的内化污名是否直接导致照顾负担增加，或者心理因素是否可以缓冲这种影响。本横断面研究旨在调查内化污名与照顾负担之间的关系，并确定应对方式和社会支持的中介作用。数据来自 2018 年 4 月至 8 月期间在湖南省长沙市一家三级医院精神病门诊接受诊断的精神分裂症成年患者的 344 名中国家庭照顾者。使用自报问卷匿名收集数据。工具包括简化应对方式问卷、多维感知社会支持量表、内化精神疾病污名量表和照顾者负担量表。使用描述性统计、Spearman 相关和回归分析来估计直接和间接效应，使用自举分析进行估计。结果表明，内化污名、社会支持和消极应对是照顾负担的显著相关因素；社会支持部分中介了内化污名和照顾负担之间的关系；积极应对对内化污名和照顾负担没有影响。这项研究为社会工作者和医疗保健提供者提供了更好地了解照顾负担发展的机会。应设计综合干预措施，提供支持性资源，减少污名内化和消极应对的可能性，以减轻照顾负担。
