Psychological impact on caregivers traumatized by the violent behavior of a family member with schizophrenia
Psychological impact on caregivers traumatized by the violent behavior of a family member with schizophrenia
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DOI：
10.1016/j.ajp.2012.08.009
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发表时间：
2013-02-01
影响因子：
9.5
通讯作者：
Nakane, Yoshibumi
中科院分区：
文献类型：
--
作者：
Hanzawa, Setsuko;Bae, Jeong-Kyu;Nakane, Yoshibumi
背景资料：众所周知，药物滥用问题、药物不依从和洞察力不足等因素的组合会增加暴力行为的风险。然而，很少有人知道的心理影响照顾者谁是精神分裂症的家庭成员的暴力行为的创伤。因此，我们进行了一项调查，以衡量这种影响。方法：一份问卷，116个照顾者的个人精神分裂症的家庭支持小组在首尔和大邱，韩国。他们的反应，然后使用22项版本的事件的影响量表修订版（IES-R），8项简短版本的Zarit照顾者负担访谈（ZBI-8），和15项版本的精神疾病和障碍理解量表（MIDUS）进行评估。结果：平均（SD）IES-R得分为26.69（17.83）（范围，1-84）。多元回归分析显示，创伤经历的心理影响与以下因素显著相关：医疗不依从（P < 0.01），无患者生活（P < 0.01），照顾者负担（P < 0.05）。结论：我们的研究结果表明，即使家庭照顾者与患者分开居住，他们仍然会经历病人暴力行为造成的创伤的有害心理影响。由于照顾者的巨大负担以及患有精神分裂症的家庭成员尽管接受长期治疗和多次住院治疗但不坚持服药，心理影响继续存在。目前的研究结果表明，需要改善以社区为基础的预防性长期护理服务，包括服药依从性，精神分裂症门诊患者，而不是多次住院。(C)2012 Elsevier B. V.保留所有权利。
Background: A combination of factors such as substance abuse problems, medication noncompliance, and insufficient insight are generally known to increase the risk of violent behavior. However, little is known regarding the psychological impact on caregivers who are traumatized by the violent behavior of a family member with schizophrenia. Therefore, we carried out an investigation to measure this impact.Method: A questionnaire was given to 116 caregivers of individuals with schizophrenia in family support groups in Seoul and Daegu, Korea. Their responses were then evaluated using the 22-item version of the Impact of Event Scale-Revised (IES-R), the 8-item short version of the Zarit Caregiver Burden Interview (ZBI-8), and the 15-item version of the Mental Illness and Disorder Understanding Scale (MIDUS).Results: The mean (SD) IES-R score was 26.69 (17.83) (range, 1-84). Multiple regression analysis showed that the psychological impact of traumatic experiences was significantly associated with the following factors: medical non-adherence (P < 0.01), living without the patient (P < 0.01), and caregiver burden (P < 0.05).Conclusion: Our results from the present study suggest that even when family caregivers live apart from the patient, they still experience the harmful psychological impact of trauma from the patient's violent behavior. The psychological impact continued as a result of the huge caregiver burden and the medication non-adherence of the family member with schizophrenia in spite of receiving long-term treatment and multiple hospitalizations. The present findings suggest the need for improved community-based service for preventive long-term care, including medication adherence, for outpatients with schizophrenia instead of multiple hospitalizations. (C) 2012 Elsevier B.V. All rights reserved.