精神病人的家庭照护困境分析

Dilemma Analysis of Family Care for Mental Patients

在医学人文视角下,采用质性研究方法,探索出精神病人家庭照护的困境来源于两方面:一是家庭照护文化的隐蔽性,主要体现在精神病人的病理性行为、照护双方对康复的不同认知、照护者理性与情感的纠葛以及不一致的生活习惯。二是社会支持的脆弱性,主要体现在互助团体的“有限性”、政策支持的“不到位”、社区随访的“专业性”及阳光心园的“精致性”。照护者践行道德使命的动力主要来自“在归因中内化责任”“在关系中寻找意义”“在互惠中寻找慰藉”三方面,并从个体、社区及政策层面提出消解照护困境的建议,旨在为精神病人家庭照护注入更多支持和希望。

From the perspective of medical humanities,qualitative research methods are adopted to explore two dilemma sources of family care for mental patients:one is the concealment of family care culture,which is mainly reflected in the pathological behavior of mental patients,different cognitions on rehabilitation,caregivers rational and emotional entanglement and inconsistent living habits,the other is the vulnerability of social support,which is mainly reflected in the limited mutual aid group,poor policy support,unprofessional community follow-up and restrained Sunshine Heart Garden service.The motivation for caregivers to practice their moral mission mainly comes from three aspects:internalizing responsibility in attribution,finding meaning in relationship,and finding comfort in reciprocity.This paper offers suggestions to save caregivers from dilemma from individual,community and policy levels,and aims to inject more support and hope into the family care of mental patients.