心境障碍伴非自杀性自伤青少年照顾者不同阶段照顾困境的质性研究

doi:10.3761/j.issn.0254-1769.2023.24.010

摘要/Abstract

摘要：

目的基于时机理论，探讨在心境障碍伴非自杀性自伤青少年疾病发展不同阶段中照顾者照顾困境的动态变化，为构建干预方案提供支持。方法该研究为现象学研究。采用目的抽样法，选取2022年5月—2023年2月在河南省某三级甲等精神专科医院住院的11例心境障碍伴非自杀性自伤青少年的照顾者作为研究对象。根据时机理论，依次于青少年诊断期、住院治疗期、出院准备期、调整期、适应期对照顾者进行5次半结构式访谈，采用Colaizzi 7步分析法对资料进行分析。结果共提炼出5个主题。①诊断期：情感反应复杂，面临不知所措的困境。②住院治疗期：缺乏疾病、育儿知识，自觉照顾困难。③出院准备期：缺乏居家照顾信心，降低对青少年未来的期望。④调整期：照顾技巧不足，渴望获得专业支持。⑤适应期：消极应对疾病，存在持续的照顾困境。结论在心境障碍伴非自杀性自伤青少年疾病发展不同阶段，照顾者的照顾困境呈动态变化，医护人员应根据其不同阶段的照顾体验和需求，有计划、持续地提供个体化专业支持，以提高其照顾质量、促进青少年康复。

关键词: 非自杀性自伤, 心境障碍, 青少年, 照顾者, 照顾困境, 时机理论, 质性研究, 护理

Abstract:

Objective Based on“timing it right” framework，this study explored the dynamic changes of care dilemma in caregivers of adolescents with mood disorder and non-suicidal self-injury at different stages of disease development，and provided support for the construction of intervention programs. Methods This study adopted phenomenological research and purposive sampling method to select 11 caregivers of adolescents with mood disorders and non-suicidal self-injury behavior who were treated and hospitalized in a tertiary A psychiatric hospital in Henan Province from May 2022 to February 2023 as research subjects. According to the “timing it right” theory，5 semi-structured interviews were conducted with caregivers during the adolescent diagnostic period，hospitalization period，discharge preparation period，adjustment period，and adaptation period. The data was analyzed by the Colaizzi 7-step analysis method. Results The following themes were summarized.①Diagnostic period：complex emotional reactions，facing a dilemma at a loss.②Hospitalization period：lack of knowledge of disease and childcare，self-conscious care difficulties.③Discharge preparation period：lack of confidence in home care and lower expectations for the future of adolescents.④Adjustment period：lack of care skills and desire professional care support.⑤Adaptation period：negatively coping with diseases，with persistent care difficulties. Conclusion The care dilemma of caregivers of adolescents with mood disorders and non-suicidal self-injury behavior in different stages of disease development is dynamic. Medical staff should provide personalized professional support in a planned and continuous manner based on their different stages of care experience and needs，in order to improve the quality of their care and promote adolescent rehabilitation.

Key words: Non-Suicidal Self-Injury, Mood Disorder, Adolescents, Caregivers, Care Dilemma, Timing It Right, Qualitative Research, Nursing Care

郜志远, 尚超娜, 严芳, 张俊蕾, 张冬红. 心境障碍伴非自杀性自伤青少年照顾者不同阶段照顾困境的质性研究[J]. 中华护理杂志, 2023, 58(24): 3011-3017.

GAO Zhiyuan, SHANG Chaona, YAN Fang, ZHANG Junlei, ZHANG Donghong. Caring dilemma of adolescent caregivers with mood disorder with non-suicidal self-injury behavior at different stages：a qualitative study[J]. Chinese Journal of Nursing, 2023, 58(24): 3011-3017.

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