照顾负担、应对方式和心理健康：对精神分裂症患者家属的追踪研究

Caregiver Burden, Coping Styles and Mental Health: A Longitudinal Study of Primary Caregivers of Schizophrenia Patients

目的:采用三波段的交叉滞后模型考察随时间变化照顾负担、不同类型应对方式以及心理健康之间的相互作用关系。方法:采用追踪设计,每间隔6个月对167名精神分裂症患者的主要照顾者用照顾负担访谈量表(FBIS)、简易应对方式问卷(SCSQ)、症状自评量表(SCL-90)进行3轮施测。结果:不同类型的应对方式与照顾负担、心理健康之间存在不同的作用关系。照顾负担不仅直接影响家属的心理健康还对其应对方式有消极影响。照顾负担与心理健康,心理健康与消极应对方式之间存在动态的相互作用关系且具有恶性循环效应。结论:照顾负担、应对方式和心理健康之间存在动态的相互作用关系,针对精神分裂症患者家属的干预应聚焦于切实的减轻照顾负担,矫正不良的应对方式。

Objective: The present study examined the reciprocal associations between caregiver burden, coping Styles and mental health by using a three-wave cross-lag model in primary caregivers of Schizophrenia patients. Methods: A number of 167 primary caregivers of Schizophrenia patients completed questionnaires assessing the three main study variables as well as Caregiver burden, Coping Styles and mental health three times at 6-month intervals. Results: Different types of coping styles had different functional relationships with caregiver burden and mental health. The caregiver burden not only directly affected the mental health of primary caregivers of Schizophrenia patients but also had a negative impact on their coping styles. The dynamic reciprocal relationship between the caregiver burden and mental health suggests that there is a vicious circle effect in the process of care, so distressed primary caregivers may do not recover easily. Moreover,there was a similar dynamic interaction pattern between mental health and negative coping styles. Conclusion: There is a dynamic interaction between the caregiver burden, coping styles and mental health. Interventions for the primary caregivers of Schizophrenia patients should focus on reducing the burden of care and correcting poor coping styles.