Provencher H L, Mueser K T
Centre de recherche, Université Laval-Robert Giffard, School of Nursing, Laval University, Québec, Canada.
Schizophr Res. 1997 Jul 25;26(1):71-80. doi: 10.1016/S0920-9964(97)00043-1.
The relationships of perceived severity and responsibility attribution for positive and negative symptom behaviors to caregiver burden were investigated. Two types of burden were studied: objective burden (i.e., negative consequences such as physical problems, financial difficulties, and household tension), and subjective burden (i.e., emotional distress about disturbing behaviors).
Self-report measures were completed by 70 primary caregivers of persons with schizophrenia.
Subjective burden was related to both the severity of positive and negative symptom behaviors, whereas objective burden was related only to the severity of negative symptom behaviors. Responsibility attribution for negative symptom behaviors was related only to objective burden. Caregivers who perceived patients as being less responsible for their negative symptom behaviors reported higher levels of objective burden. The relationship between responsibility attribution for negative symptom behaviors and objective burden remained significant, even after controlling for the severity of negative symptom behaviors. Caregivers' perceptions of patients' responsibility for positive symptom behaviors were not related to objective burden.
As expected, perceived severity of negative symptom behaviors was related to objective caregiver burden, whereas severity of positive symptom behaviors was not. These findings suggest that negative symptoms may have a greater impact on role functioning that positive symptoms, leading to greater burden. However, contrary to expectations, less responsibility attribution for negative symptom behaviors was related to higher levels of objective caregiver burden. Caregivers who perceive patients as incapable of altering their negative symptom behaviors and meeting certain role obligations may assume extra responsibilities, leading to higher levels of objective burden. The results indicate that there may be disadvantages for caregivers associated with assuming that patients have no control over their negative symptom behaviors.
研究对阳性和阴性症状行为的感知严重程度及责任归因与照料者负担之间的关系。研究了两种类型的负担：客观负担（即身体问题、经济困难和家庭关系紧张等负面后果）和主观负担（即对干扰行为的情绪困扰）。
70名精神分裂症患者的主要照料者完成了自我报告测量。
主观负担与阳性和阴性症状行为的严重程度均相关，而客观负担仅与阴性症状行为的严重程度相关。对阴性症状行为的责任归因仅与客观负担相关。认为患者对其阴性症状行为责任较小的照料者报告的客观负担水平较高。即使在控制了阴性症状行为的严重程度之后，对阴性症状行为的责任归因与客观负担之间的关系仍然显著。照料者对患者阳性症状行为责任的认知与客观负担无关。
正如预期的那样，阴性症状行为的感知严重程度与照料者的客观负担相关，而阳性症状行为的严重程度则不然。这些发现表明，阴性症状可能比阳性症状对角色功能的影响更大，从而导致更大的负担。然而，与预期相反，对阴性症状行为较少的责任归因与照料者较高水平的客观负担相关。认为患者无法改变其阴性症状行为并履行某些角色义务的照料者可能会承担额外的责任，从而导致更高水平的客观负担。结果表明，假设患者无法控制其阴性症状行为可能会给照料者带来不利影响。
