Accepting and committing to caregiving for schizophrenia—a mixed method pilot study

IF 3.4 2区 医学 Q2 PSYCHIATRY BMC Psychiatry Pub Date : 2024-09-12 DOI:10.1186/s12888-024-05993-9
Aishwarjya Chakraborty, Somdeb Mitra, Deepshikha Ray
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Abstract

End of traditional institutionalized psychiatric care, diagnostic complexities, and associated stigma often negatively impact the social networks of caregivers, making them experience social isolation. Not the “identified patients”, caregiver perspectives are typically overlooked further adding to anticipatory stigma resulting in social death among them. Caregiving experience results in developing coping skills, preventing carers from responding to the nuances of the context, and identifying the useful rules— “Experiential Avoidance”. Psycho-education is typically combined with other formal treatment programs for case conceptualization, and to provide a clear rationale for the treatment approach but less as a distinct psychotherapy. Borrowing the philosophy of Functional Contextualism, the present study developed a “Present-Moment Awareness” guided psychoeducational intervention. The aim was to reduce schizophrenia caregiver burden and anticipatory stigma and promote the value of caregiver participation as ‘experts by experience’. Five family caregivers of remitted schizophrenia patients were recruited using purposive sampling. Pre-post measure was taken on caregiver burden, caregiving experience, sense of personal mastery, and caregiving competence. Results were analysed quantitatively and qualitatively. A significant decrease in caregiver burden, stigma, and negative effects on the family in post-intervention was observed. Self-compassion led to a rise in a sense of empowerment. A caregiver-centred “Present-Moment Awareness” guided psycho-education for schizophrenia caregivers can be considered a possible means to address perceived stigma in caregivers and to reduce associated distress of carers.
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接受并承诺照顾精神分裂症患者--一项混合方法试点研究
传统的精神病院式治疗的终结、诊断的复杂性以及相关的耻辱感往往会对照顾者的社交网络造成负面影响,使他们经历社会隔离。照护者不是 "被确认的病人",他们的观点通常被忽视,这进一步增加了预期的耻辱感,导致他们在社会中死亡。护理经验会导致护理者形成应对技能,使他们无法对环境的细微差别做出反应,也无法识别有用的规则--"经验回避"。心理教育通常与其他正规治疗方案相结合,用于病例概念化,并为治疗方法提供明确的理论依据,但较少作为一种独特的心理疗法。本研究借鉴功能情境主义(Functional Contextualism)的理念,开发了一种以 "当下意识"(Present-Moment Awareness)为指导的心理教育干预方法。其目的是减轻精神分裂症照护者的负担和预期耻辱感,提升照护者作为 "经验专家 "的参与价值。通过有目的的抽样,招募了五名精神分裂症缓解期患者的家庭照顾者。对照护者的负担、照护经验、个人主人翁意识和照护能力进行了前后期测量。对结果进行了定量和定性分析。干预后,护理负担、耻辱感和对家庭的负面影响明显减轻。自我同情增强了能力感。针对精神分裂症照护者的以照护者为中心的 "当下意识 "引导式心理教育可被视为解决照护者所感知到的耻辱感和减少照护者相关困扰的一种可行方法。
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来源期刊
BMC Psychiatry
BMC Psychiatry 医学-精神病学
CiteScore
5.90
自引率
4.50%
发文量
716
审稿时长
3-6 weeks
期刊介绍: BMC Psychiatry is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of psychiatric disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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