双相障碍患者照顾者身心发展概念框架的构建  

Development of Conceptual Framework for Physical and Mental Progression in Caregivers of People with Bipolar Disorder

作　　者：武甜甜 单亚维[1] 张新宇[1] WU Tian-tian;SHAN Ya-wei;ZHANG Xin-yu(School of Nursing,Shanghai University of Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学护理学院,上海201203

出　　处：《护理学报》2020年第9期1-5,共5页Journal of Nursing（China）

摘　　要：目的总结归纳双相障碍患者照顾者身心健康影响因素,构建身心发展概念框架,明确照顾者心理转归机制。方法基于社会生态系统理论、资源守恒模型及社会认知理论确定框架各大维度,以心理弹性模型与双相障碍或其他重性精神疾病相关领域文献为支撑,提取核心影响因素,构建身心发展概念框架。结果研究确定了以社会环境层、人与环境互动层、个体表现层及个体内在层的4大框架维度,涵盖因素包括文化价值、经济因素、雇佣关系、照顾负担;社会疏远/隔离、社会支持、社会冲突;精神或心理障碍、物质滥用、躯体状态、家庭暴力;个人心理特质、心理弹性。结论基于4大框架维度的核心因素之间相互影响、相互嵌套,对照顾者身心发展起到了评估与预示作用。该概念框架可为后续的实证研究提供理论基础,但尚需量性研究加以检验。Objective To summarize the influencing factors of physical and mental health of caregivers of people with bipolar disorder and to construct the conceptual framework for physical and mental progression which could explicit psychological prognosis mechanism of caregivers.Methods Based on social ecosystem theory,resource conservation model and social cognition theory,various dimensions of the framework were defined.Supported by psychological resilience model and literature related to bipolar disorder or other serious mental diseases,the core influencing factors were extracted to construct the conceptual framework of physical and mental progression.Results There were four major dimensions in the framework including social environment level,which contains the key influencing factors such as cultural value,economic factors,employment relationship and care burden;humanenvironment interaction level containing social alienation or isolation,social support,social conflict;individual performance level containing mental or psychological disorders,substance abuse,physical conditions,domestic violence;and individual inner level with psychological resilience and its risk and protective characteristics.Conclusion The core factors based on four dimensions in the framework are interactive and nesting,which play an evaluative and predictive role in the physical and mental development of family members.This conceptual framework can provide a theoretical basis for subsequent empirical studies,however,it still needs to be tested by quantitative studies.

关 键 词：双相障碍 照顾负担 精神疾病 

分 类 号：R471[医药卫生—护理学]