稳定期精神分裂症患者照顾者心理灵活性与照顾者负担及病耻感的关系

Relationship between mental flexibility and caregiver burden and stigma in stable schizophrenics

目的探究稳定期精神分裂症患者照顾者心理灵活性与照顾者负担,病耻感的相关性。方法对2023年1月~2023年12月资阳市精神病医院342例稳定期精神分裂症患者照顾者进行回顾性分析,采用中文版接纳与行动问卷(Acceptance and Action Questionnaire-Second Edition,AAQ-Ⅱ)评估照顾者心理灵活性;Zarit照顾者负担量表(Zarit Caregiver Burden Interview,ZBI)评估照顾者负担;病耻感量表(Affiliated Stigma Scale,ASS)评估照顾者病耻感,比较不同心理灵活性的ZBI和ASS评分,不同负担程度的AAQ-Ⅱ和ASS评分,不同病耻感程度的AAQ-Ⅱ和ZBI评分差异,采用Pearson相关系数分析AAQ-Ⅱ评分与ZBI评分,ASS评分的相关性。结果心理灵活性较高组的ZBI和ASS评分<心理灵活性中等组<心理灵活性较低组,差异具有统计学意义(P<0.05);照顾负担较轻组的AAQ-Ⅱ和ASS评分<照顾负担中等组<照顾负担较重组,差异具有统计学意义(P<0.05);病耻感较低组的AAQ-Ⅱ和ZBI评分<病耻感中等组<病耻感较高组,差异具有统计学意义(P<0.05)。AAQ-Ⅱ评分与ZBI评分,ASS评分呈正相关(P<0.05,r=0.422,0.614)。结论随着精神分裂症患者照顾者心理灵活性的提升,其所承受的照顾压力和与疾病相关的羞耻感呈现减轻趋势,临床应视照顾者具体情况提供个性化情绪支持干预,以增强其心理适应能力,消除照顾过程中产生的心理负担及病耻感。

Objective To explore the correlation between psychological flexibility,burden and stigma of caregivers of stable schizophrenia patients.Methods 342 caregivers of patients with stable schizophrenia in Ziyang psychiatric hospital from January 2023 to December 2023 were retrospectively analyzed.Chinese version of Acceptance and Action Questionnaire-Ⅱ(AAQ-Ⅱ)was used to assess the psychological flexibility of caregivers.Zarit Caregiver Burden Inventory(ZBI)was used to assess caregiver burden.Stigma Scale(ASS)was used to assess the stigma of caregivers.ZBI and ASS scores of different psychological flexibility,AAQ-Ⅱand ASS scores of different degrees of burden,AAQ-Ⅱand ZBI scores of different degrees of stigma were compared.Pearson correlation coefficient was used to analyze the correlation between AAQ-Ⅱscore,ZBI score and ASS score.Results The ZBI and ASS scores of the high psychological flexibility grouP<psychological flexibility grouP<low psychological flexibility group(P<0.05).The AAQ-Ⅱand ASS scores of the low caregiving burden grouP<moderate caregiving burden grouP<high caregiving burden group(P<0.05).The AAQ-Ⅱand ZBI scores of the low affiliate stigma grouP<moderate affiliate stigma grouP<high affiliate stigma group(P<0.05).The AAQ-Ⅱscore was positively correlated with the ZBI score and the ASS score(P<0.05,r=0.422,0.614).Conclusion With the improvement of psychological flexibility of caregivers of patients with schizophrenia,their care pressure and disease-related shame show a decreasing trend.Clinical caregivers should provide individualized emotional support intervention according to their specific conditions,so as to enhance the psychological adaptability and eliminate the psychological burden and stigma in the process of care.