北京市社区长期失能空巢老人配偶压力感知和应对体验的质性研究

Perceived stress and coping experience of spouses of long-term disabled empty nest elderly people in Beijing communities:a qualitative study

目的探讨长期失能空巢老人配偶的压力感知和应对体验。方法采用现象学研究方法,于2023年2—6月选取北京市某社区19名失能老人的配偶进行半结构式访谈,并采用Colaizzi 7步分析法进行资料分析。结果将长期失能空巢老人配偶的压力感知和应对体验归纳为3个主题和10个子主题,即配偶压力感知动态多变(压力随失能老人的状态同步变化、压力呈"U"形变化、压力递增式变化)、配偶在长期照顾失能老人中的挑战(意见观点难以统一、内心情感不被理解、自身养老难以保障、多种角色共存)、配偶的积极应对体验和策略(积极寻求外部支持、尊重失能老人的主观意愿、提高二元应对能力)。结论社区护理人员应根据长期失能空巢老人配偶压力感知特征的变化对承担照顾工作的配偶进行支持和指导,同时了解其在长期照顾中面临的多种挑战,借鉴配偶积极的应对经验,为构建居家养老友好型家庭支持体系提供依据。

Objective To explore the perceived stress and coping experience of spouses of elderly people with long-term disability and empty nest.Methods Using phenomenological research methods,semi-structured interviews were conducted with 19 spouses of disabled elderly people in a community in Beijing from February to June 2023,and data analysis was conducted using Colaizzi's 7-step analysis method.Results The perceived stress and coping experience of spouses of long-term disabled empty nest elderly people were summarized into three themes and ten sub-themes,namely,the dynamic and variable stress perception of spouses(stress changed synchronously with the state of disabled elderly people,stress changed in a"U"shape,and pressure increased in a progressive manner),the challenges for spouses in long-term care of disabled elderly people(difficult in unifying opinions and views,incomprehensible inner emotions,difficulty in ensuring their elderly care,and coexistence of multiple roles and identities)and positive coping experiences and strategies of spouses(actively seeking external support,respecting the subjective wishes of disabled elderly people,and improving dyadic coping abilities).Conclusions Community nursing staff should support and guide spouses who undertake care work based on changes in perceived stress characteristics of long-term disabled empty nest elderly people.At the same time,it is necessary to understand the various challenges they face in long-term care,draw on positive coping experiences of spouses,so as to provide a basis for building a friendly family support system for home-based elderly care.