Development of a Family Support System for Families of the Relatives with Mental Illness

精神病对患病的亲属及其家人都有影响。有充分的记录表明，患有精神疾病的亲属的家庭承受着照顾的各个方面的负担。然而，关于家庭如何应对精神疾病负担的研究还很少。本研究的目的是确定精神疾病患者家庭的照护负担和应对方式，并为精神病患者家庭建立一个社区家庭支持系统。本研究分为四个阶段，在第一阶段，对照看负担和应对进行了识别，构建了照看负担-应对模型。研究还确定了四种家庭应对方式：共荣、融合型、自我保护型和消极型。这些应对方式被解释为“家庭对生病亲属的福利的反应”和“家庭的自我养成”。在第二和第三阶段，编制了一份问卷来衡量照顾负担和应对方式。根据构建的照顾负担-应对模型，我们假设照顾负担是由患病亲属的困难行为、家庭的照顾资源、家庭的社会支持和家庭的应对方式共同预测的。虽然家庭的社会支持和家庭应对方式与照料负担有关，但多元回归分析表明，照料资源的缺乏、病友的为难行为、隐瞒疾病等因素共同作用于照料负担。该系统旨在：(A)提高患病亲属和家庭的生活质量；(B)发展家庭照料资源和支助；(C)减少耻辱；(D)促进家庭康复，同时加强家庭的应对技能。

Mental illness affects both the ill relative and his/her family. It has been well documented that families of relatives with mental illness experience various aspects of caregiving burden. However, research investigating how families cope with the burden is scarce.The purpose of this study was to identify caregiving burden and coping and to develop a community family support system for families of the mentally ill. This study consists of four phases.During the first phase, caregiving burden and coping were identified and a caregiving burden-coping model was constructed. Four family coping styles were also identified : co-prosperous, fused, self-protective, and demoralized styles. Those coping styles were explained by "family's responsiveness" to the welfare of the ill relative and "family's self-nurturance" of their own well-being.During the second and third phases, a questionnaire was developed to measure caregiving burden and coping. From the constructed caregiving burden-coping model, we hypothesized caregiving burden would be predicted by a combination of ill relative's difficult behavior, family's caregiving resources, family's social support, and family's coping. Though family's social support and family's coping were related to caregiving burden, a multiple regression analysis indicated a combination of lack of caregiving resources, ill relative's difficult behavior, and hiding of the illness contributed to caregiving burden.During the final phase, a family support system was developed. The system was designed to, a) improve both the ill relative's and family's quality of life, b) develop family's caregiving resources and support, c) decrease stigma, and d) facilitate family's recovery while strengthening family's coping skills.