伴暴力行为精神分裂症主要照料者应付方式与总体幸福感特征 及其关系研究
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重庆市卫生和计划生育委员会医学科研计划项目(2013-2-147)


Characteristics and relationship between coping style and general well-being of the main caregivers of schizophrenia with violence
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    摘要:

    目的 探索伴有暴力行为的精神分裂症患者主要照料者的应付方式与总体幸福感。 方法 通过连续取样的方式选取 2014 年 1 月至 2016 年 12 月在重庆市精神卫生中心住院治疗的 487 例 伴暴力行为的精神分裂症住院患者主要照料者作为研究组,选取 479 例与暴力精神分裂症患者年龄、 性别、受教育年限、病程相匹配的不伴有暴力的精神分裂症患者的主要照料者作为对照组。使用应付 方式问卷、总体幸福感量表评定,对伴暴力行为精神分裂症患者主要照料者的应付方式与总体幸福 感进行评估。结果 研究组的总体幸福感得分低于对照组[(101.92±10.43)分比(103.91±11.03)分, P< 0.05];不同暴力行为(杀人、伤人、打砸、其他)患者照料者的总体幸福感得分比较,差异有统计学 意义[(99.54±11.06)分比(100.17±10.23)分比(103.03±10.28)分比(103.01±9.78)分,P< 0.05];应付方 式各因子间得分比较,差异无统计学意义(均P> 0.05)。研究组的应付方式问卷退避评分高于对照组 [(0.68±0.20)分比(0.65±0.21)分],而解决问题[(0.68±0.19)分比(0.72±0.18)分]、自责[(0.62±0.22)分比 (0.65±0.22)分]、求助[(0.57±0.18)分比(0.64±0.17)分]、合理化[(0.70±0.22)分比(0.75±0.21)分]评 分低于对照组,差异均有统计学意义(均P< 0.05)。不同照料关系照料者的总体幸福感得分比较,差异 无统计学意义;在解决问题[(0.71±0.17)、(0.65±0.20)、(0.78±0.11)分]、求助[(0.60±0.17)、(0.55±0.19)、 (0.61±0.13)]方面,不同照料关系(配偶、父母、子女)组间差异有统计学意义(均P< 0.05);在自责、幻 想、退避、合理化方面,不同照料关系组间比较差异无统计学意义(均P> 0.05)。精神分裂症患者主 要照料者的总体幸福感与解决问题呈正相关(r=0.177,P< 0.01),与幻想呈负相关(r=-1.03,P< 0.05)。 结论 伴暴力行为的精神分裂症患者主要照料者的总体幸福感较不伴暴力行为的精神分裂症患者主要 照料者低,应付方式较差;不同暴力行为的精神分裂症主要照料者的总体幸福感存在差异,不同照料关 系主要照料者应付方式存在差异,总体幸福感与应付方式存在相关。

    Abstract:

    Objective To explore the coping style and general well-being of the main caregivers of schizophrenia patients with violence. Methods The main caregivers of 487 schizophrenic inpatients with violence hospitalized in Chongqing Mental Health Center from January 2014 to December 2016 were selected as the study group by continuous sampling method. The main caregivers of 479 schizophrenic patients without violence matched with the age, gender, years of education and course of disease of violent schizophrenic patients were selected as the control group. The coping style and general well-being of the main caregivers of schizophrenic patients with violence were evaluated by coping style questionnaire (CSQ) and general wellbeing scale (GWB). Results The total GWB score of the study group was lower than that of the control group [(101.92±10.43) vs (103.91±11.03), P < 0.05]. There was significant difference in the GWB scores of caregivers of patients with different violence style [killing (99.54±11.06), wounding (100.17±10.23), smashing (103.03±10.28), others (103.01±9.78). There was no significant difference in the scores of various factors of CSQ (P > 0.05). The scores of withdraw [(0.68±0.20) vs (0.65±0.21)] in the study group were higher than those in the control group, while the scores of problem-solving [(0.68±0.19) vs (0.72±0.18)], self accusation [(0.62±0.22) vs (0.65±0.22), help seeking [(0.57±0.18) vs (0.64±0.17)], rationalization [(0.70±0.22) vs (0.75±0.21)] were lower than those in the control group, and the differences were statistically significant (P< 0.05). There was no significant difference in the GWB score of caregivers with different care relationships. There was significant difference between groups with different care relationships (partner, parent, spring) in problem-solving [(0.71±0.17), (0.65±0.20), (0.78±0.11)] and help seeking [(0.60±0.17), (0.55±0.19), (0.61±0.13)], respectively (P< 0.05). There was no significant difference between groups with different care relationships in self blame, fantasy, retreat and rationalization (P > 0.05). There was a significant positive correlation between the general well-being and problem-solving (r=0.177,P< 0.01), and a negative correlation with fantasy (r=-1.03, P< 0.05). Conclusions The main caregivers of schizophrenia with violence had lower general well-being and poor coping style than those without violence. The general well-being of schizophrenic primary caregivers with different violent behaviors was different, and the coping styles of primary caregivers with different care relationships were different. The general well-being of the main caregivers of violent schizophrenia was correlated with coping styles.

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傅惊鸿 史战明 赵新民 马玉娟 陈俊杉.伴暴力行为精神分裂症主要照料者应付方式与总体幸福感特征 及其关系研究[J].神经疾病与精神卫生,2022,22(1):
DOI :10.3969/j. issn.1009-6574.2022.01.006.

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  • 在线发布日期: 2022-01-29