期待之变:精神分裂症患者家庭的压力考察  

The Change of Expectations:A Study on Family Stress in the Process of Re‐covery from Schizophrenia

作　　者：师艺萌 高万红 HI Yimeng;GAO Wanhong

机构地区：[1]云南大学民族学与社会学学院,昆明650091 [2]云南大学民族学与社会学学院社会工作系,昆明650091

出　　处：《社会工作》2024年第2期101-122,161-163,共25页Journal of Social Work

基　　金：国家社科基金一般项目“精神残障社会工作的本土实践与创新研究”(项目编号:19BSH174)阶段性成果。

摘　　要：精神分裂症患者家庭的压力研究多集中于照顾负担主导的静态压力分析,但该疾病的长期性与复杂性带来了家庭压力的不断变化,因此,基于动态过程视角研究精神分裂症患者家庭的压力十分必要。本研究以14户精神分裂症患者家庭为例,基于精神分裂症的四阶段模型,开展深度访谈和参与式观察,分析该类家庭的压力阶段性表征与生成机制。研究结果表明,精神分裂症患者家庭的压力主要表现为病源性压力和角色性压力,在不同康复阶段,这两类压力分别或共同处于显性状态,从而影响家庭的压力体验。进一步分析发现,社会文化所形塑的家庭生活期待与疾病所影响的家庭现实情景之间的张力是家庭压力生成机制的关键。家庭有两个核心期待贯穿康复历程始终:摆脱疾病困扰的健康期待和实现“成人”的角色期待。家庭在现实情境中遭遇的期待之变构成了家庭压力的动态变迁。由此,社会工作者在开展精神分裂症患者家庭服务时,可通过家庭期待调整和情景行动增能来协助家庭应对压力,从而激发此类家庭的主体性。As the primary caregiver and the pivotal agency to the social welfare system,families play an essential role in facilitating personal recovery from schizophrenia.However,inadequate comprehension of stress experienced by families during the process of recovery often leads to unwarranted blame being placed on them.Conse‐quently,the institutional and structural factors influencing recovery remain obscured amidst these unfounded accusations.This study aims to explore family stress in the process of recovery from schizophrenia through a qualitative method.The utilization of a dynamic-process based perspective distinguishes this study from traditional stress research in schizophrenic families,which predominately focuses on the static stress analysis conceptualized with caregiver burdens.The application of the four stage model of schizophrenia to 14 families with affected members revealed two dis‐tinct types of stress experienced by these families.One type is disease-related stress,which encompasses financial difficulties,time and energy constraints,stigma,and social interaction challenges arising from the treatment of the illness.The other type is role-related stress,which arises from difficulties fulfilling social roles and main‐taining family stability.In different stages of the recovery,the two types of stress may be separately or together exhibited explicitly,thereby influencing the experi‐ence of family stress.In the initial stage of overwhelmed by the disability,families experience heightened explicit role-related family stress,often associated with early signs of illness onset as these occurrences are unexpected by families.In the second stage of struggling with disability,families experience significant disease-related stress due to the burdens of time and energy investment,financial strain,and con‐flicts within the family.Meanwhile,families also experience implicit role stress,manifesting the difficulties in maintaining previous roles.In the third stage of living with the disability,the stress associ

关 键 词：家庭压力 精神分裂 社区康复 社会工作 

分 类 号：C916[经济管理]