同伴支持服务在精神障碍患者照护者中的应用

Application of peer support services for caregivers of mental disorder patients

  • 摘要:
    目的 探讨同伴支持模式对精神障碍患者照护者心理健康以及所照料患者领悟社会支持及精神症状的影响。
    方法 选择长期在社区进行康复的精神障碍患者与主要照护者参与本研究, 根据照护者与患者1∶1匹配共筛选44对满足条件的患者及照护者。仅针对照护者开展系统性同伴支持活动。干预前、干预后均使用一般健康问卷(GHQ)、90项症状自评量表(SCL-90)对照护者的心理健康状况进行评估。干预前后均采用领悟社会支持量表(PSSS)和简明精神病评定量表(BPRS)对患者感受社会支持领悟能力及精神状况进行评估。
    结果 共收集照护者有效调查问卷44份,患者有效调查问卷42份。干预后,照护者GHQ评分以及SCL-90中的项目总分、阳性项目数量、阳性总分、阳性均分均低于干预前,差异有统计学意义(P < 0.05或P < 0.001)。干预后,患者PSSS中家庭支持评分、家庭外支持评分、总分均高于干预前,差异有统计学意义(P < 0.05)。与照护者同伴支持干预前相比,干预后,患者BPRS中焦虑和抑郁、缺乏活力、思维障碍、激活性、敌对猜疑评分及总分均较低,差异有统计学意义(P < 0.05或P < 0.001)。
    结论 同伴支持模式有助于改善精障患者照护者的心理健康状况,并改善患者精神状况。

     

    Abstract:
    Objective To investigate the impact of a peer support model on the mental health of caregivers and the perceived social support and psychiatric symptoms of the mental disorder patients under their care.
    Methods Patients with mental disorders undergoing long-term community-based rehabilitation and their primary caregivers were recruited for this study. A total of 44 pairs of eligible patients and caregivers were selected based on a 1∶1 matching ratio. Systematic peer support activities were conducted exclusively for the caregivers. The General Health Questionnaire (GHQ) and the Symptom Checklist-90 (SCL-90) were administered before and after the intervention to assess the mental health status of caregivers. The Perceived Social Support Scale (PSSS) and the Brief Psychiatric Rating Scale (BPRS) were employed to evaluate the patients' perceived social support and psychiatric conditions before and after the intervention.
    Results A total of 44 valid questionnaires from caregivers and 42 from patients were collected. The GHQ score and the total scores, the number of positive item, positive total scores, and positive mean scores of and SCL-90 of caregivers were significantly lower after the intervention compared to pre-intervention (P < 0.05 or P < 0.001). For patients, the family support score, extracurricular support score, and total score of the PSSS were significantly higher post-intervention compared to pre-intervention (P < 0.05 or P < 0.001). Compared to pre-intervention, patients'scores on anxiety and depression, lack of energy, thought disturbance, activation, hostility and suspicion, and the total score on the BPRS were significantly lower after the caregiver peer support intervention (P < 0.001).
    Conclusion The peer support model contributes to improving the mental health of caregivers for patients with mental disorders and enhancing the patients'psychiatric conditions.

     

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