精神分裂症患者照料者心理应激状况调查

Investigation of the psychological stress status of schizophrenia caregivers

目的探讨精神分裂症照料者的心理应激状况并提出对策，为精神分裂症患者康复提供良好家庭环境。方法采用症状自评量表（SCL-90）、应对方式问卷（CSQ）和社会支持评定量表（SSRS）对300名精神分裂症患者照料者进行心理应激状况调查，并分析三者的相关性。结果精神分裂症患者照料者检出心理问题者检出率为63．0％；心理问题者SCL-90总分为（157．79±29．52）分，明显高于国内常模的（129．96±38．76）分，差异具有统计学意义（t=9．50，P〈0．01）；心理问题者CSQ中解决问题和求助因子评分分别为（6．16±2．18）分和（4．19±1．77）分，明显低于非心理问题者（8．19±2．37），（5．71±1．92）分，差异均有统计学意义（t分别为7．54，6．96；P〈0．01），而心理问题者自责、幻想、退避以及合理化因子评分分别为（5．86±2．59），（5．44±2．57），（5．88±2．75），（4．71±2．80）分，明显高于非心理问题者的（4．25±1．49），（3．63±2．03），（4．18±1．82），（3．23±1．42）分，差异均具有统计学意义（t分别为5．99，6．35，5．81，5．19；P〈0．01）；心理问题者SSRS总分为（35．67±5．34）分，明显低于非心理问题者（41．81±6．52）分，差异具有统计学意义（t=8．85，P〈0．01）；除客观支持维度外，SCL-90与SSRS和CSQ各维度均具有相关性（P〈0．01）。结论精神分裂症患者照料者存有不同程度的心理问题，社会支持和应对方式是导致心理问题产生的重要原因。医务工作者应积极采取各种途径给予其心理救助，帮助其维持心理健康，以便为精神分裂症患者创造一个良好的家庭康复环境。

Objective To explore the psychological stress condition of schizophrenia caregivers in order to provide well family environment for the patients with schizophrenia. Methods The psychological stress condition of 300 caregivers of the patients with schizophrenia were investigated with the SCL-90, CSQ and SSRS. Results The detection rate of the schizophrenia caregivers with psychological problems was 63.0%, the total score of SCL-90 of the caregivers with psychological problems was （157.79±29.52） higher than that of the inland norm （ 129.96±38.76 ）, and the difference was statistically significant （ t = 9.50, P 〈 0.01 ）. The score of the solving problems factor and seeking help factor of caregivers with psychological question respectively were （6.16±2.18） and （4. 19±1.77） significantly lower than （8. 19±2.37） and （5.71±1.92） of the earegivers without psychological problems （ t = 7.54,6.96, respectively ; P 〈 0.01 ）, and the score of remorse, fantasy, retreats and rationalization factors of the caregivers with psychological problems respectively were （5.86±2.59）,（5.44±2.57）,（5.88±2.75）,（4.71±2.80） higher than that （4.25±1.49）,（3.63±2.03）, （4. 18±1.82）, （3.23±1.42 ）of the caregivers without psychological problems,and the difference was statistically significant （P 〈 0. 01 ）. The total score of SSRS of caregivers with psychological question was （35.67±5.34 ） significantly lower than （41.81±6.52 ）of the earegivers without psychological problems （t = 8.85, P 〈 0.01 ）, and there was a relativity between SCL-90 and SSRS, CSQ （P 〈 0.01 ）. Conclusions Schizophrenia caregivers have different psychological problems, social support and coping style are the important factors of the psychological problems. So, medical staff should take many measures to help those caregivers and keep their mental health so as to provide a well family environment.