精神病患的家庭結構、疾病症狀與壓力調適之探討

The Study of Family Stucture, Illness Symptom, and Stress Adapation of Psychotic Patients

蕭淑貞(Shujen Shiau) ； 楊秋月(Chiu-Yueh Yang) ； 葉櫻媛(Ying-Yuan Yeh) ； 黃瑞媛(Jui-Yuan Huang) ； 陳美雲(Mei-Yun Chen) ； 吳麗萊(Li-Lai Wu)

《The Kaohsiung Journal of Medical Sciences》 15卷6期 (1999/06) Pp. 359-371

https://doi.org/10.6452/KJMS.199906.0359

摘要

本研究主要目的為分析並比較精神分裂症、雙極性情感疾患的家庭結構、疾庚症狀與家庭壓力調適的情形，使護理人員在臨床工作或居家訪視時，能做家庭設理評估，伹作為設理處置之參考。本研究是由北部三家醫療院所之門診或出院的精神分裂症及雙極性情感疾患居家個案。，根據「情境家庭護理」理論及評估工具作家訪的方式進行資料的收集。共有151名個案之主要照顧者自嚴國84年1月至6月接受且完成評估。本研究對象多數未婚、年齡介於21-50歲、發病十年以上、在家扮演的主要角色是子女、父母為其主要照顧者，且主要照顧者大多為60歲以上，家庭受個案的影響發展階段停留在有青年期兒女的家庭，而雙極性情感性疾患有工作的個案較精神分裂症多。精神分裂症個案的疾病症狀方面活性症狀以妄想最多，負性症狀則不喜歡與人接觸最多，而情緒行為症狀以睡眠問題最嚴重；在家庭疾病擔憂感受最擔憂個案的未來安罝；在因應方面以因應懶惰行為、睡眠問題之困應效能最差。雙極性情感性疾患個案的疾病症狀方面，活性症狀以攻擊行為最多，負性症狀以活力低、沒抖以氣最多，而情緒刪為症狀以睡眠問題最嚴重；在家庭疾病擔憂感受最擔憂個案症狀問題；在因應方面以因應個案藥物副作用問題之因應效能最差。結果亦顯示家庭對個案的疾病 因應效能與個案的活性、負性症狀及情緒行為症狀之穩定性有相關。

並列摘要

The major purposes of this paper are to explore the phenomena of family structure, illness symptoms, family coping and adaptation for patients with schizophrenia or manic-depression psychosis. This paper tries to provide a good reference in strument for applicationj by nurses in home care, in order to understand and evaluate family needs. Subjects are schizophrenic or manic-depression out patients from 3 hospitals located in northern Taiwan. Date were collected though home interview with primary caregivers and observations. There were fifty subjects from each of the 3 hospitals, and 151 subjects in total. Descriptive statistics, t-test, one way ANOVA, Pearson correlation and multiple stepwise correlation were used to analyze data. Research indicates that most patients are aged between 31 to 40, with over 10 years elapsed since onset, and are not married. Most primary caregivers are parents over 60 years old. Most family development was at the stage with young adult offspring. The manic-depressive patients have more working opportunities than schizophrenic patients. For schizophrenic patients, paranoia was the most serious in active symptoms; lack of interpresonal interaction was the most serious in negative symptoms; the other major problem was sleep disturbance in emotion-behavior assessment. Patient’s disposition was the most concerning issue for families and the worst coping efficiency occurred with lazy behavior and sleep disturbance. For manic-depressive patients, aggressive behavior was the most serious active symptom, lack of energy ws the most serious in negative symptom, and sleep disturbance was the most concerning problem in emotion-behaveior assessment. The patient’s symptom was the most concerning issue for families and the worst coping efficiency was found in drug side effect. The result also in dicated that active and negative symptoms are both related to coping eff iciency.

並列關鍵字

psychosis ； symptom ； stress adaptation