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经历精神病的父母:一项定性探索。

Parents who experience psychosis: A qualitative exploration.

机构信息

Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK.

Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.

出版信息

Psychol Psychother. 2023 Sep;96(3):590-607. doi: 10.1111/papt.12458. Epub 2023 Mar 13.

Abstract

OBJECTIVES

Psychosis can present parents with complex parenting challenges and significant adverse outcomes for parents and their children have been reported. However, remarkably little is known about how parenting is experienced by these parents. Therefore, this qualitative study aimed to understand the lived experiences of parents with psychosis, including how parenting support was experienced.

DESIGN AND METHODS

Using interpretative phenomenological analysis (IPA), eight biological parents (five mothers and three fathers) with psychosis were recruited and interviewed from early intervention in psychosis services in the Northwest of England.

RESULTS

Three superordinate themes and seven subordinate themes were identified. Theme 1 'Living with the Struggle: Painfully Disconnected' captured a persistent parenting struggle that distanced parents from their children and support due to all-consuming experiences of psychosis, fear and risk-focused service support. Theme 2 'Desired and Vulnerable Position: Comfortably Connected' captured parental experiences of symptom relief through connection with their children, alongside parental need to be integrated with the systems around them. Theme 3 'Exposed: Parenting Under a Spotlight' represented parental experiences of inescapable observation and judgement from the systems around them.

CONCLUSIONS

Novel insights into the role of misaligned parent and service priorities in parental perceptions of powerlessness, shame and disconnection from their children, valued parenting identities, and system supports are presented. Systemic interventions that target stigma, provide system-wide psychoeducation and promote person-centred, compassionate and meaningful connections between parents and the systems they live within are needed to promote better parenting outcomes.

摘要

目的

精神疾病可能会给父母带来复杂的育儿挑战,并且已经报道了对父母及其子女的严重不良后果。然而,人们对这些父母的育儿体验知之甚少。因此,本定性研究旨在了解精神疾病父母的生活体验,包括他们对育儿支持的体验。

设计和方法

使用解释现象学分析(IPA),从英格兰西北部的早期精神病干预服务中招募并采访了 8 位有精神疾病的亲生父母(5 位母亲和 3 位父亲)。

结果

确定了三个上级主题和七个下属主题。主题 1“与挣扎共存:痛苦的脱节”捕捉到了父母与子女和支持之间持续存在的育儿挣扎,这种挣扎是由于精神病、恐惧和以风险为中心的服务支持所带来的无法承受的经历而产生的。主题 2“渴望和脆弱的地位:舒适的联系”捕捉到了父母通过与孩子的联系缓解症状的经历,以及父母需要与周围的系统整合的需求。主题 3“暴露:处于聚光灯下的育儿”代表了父母不可避免地受到周围系统的观察和评判的经历。

结论

提出了在父母对无力感、羞耻感和与子女脱节的看法中,父母与服务重点之间错位的作用的新见解,以及父母对有价值的育儿身份和系统支持的看法。需要进行系统性干预,以消除耻辱感,提供全系统的心理教育,并促进父母与他们所在系统之间以人为本、富有同情心和有意义的联系,以促进更好的育儿结果。

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