精神分裂症患者家庭主要照顾者心理脱离在照顾者负担和连带病耻感间的中介作用

目的：探讨精神分裂症患者家庭主要照顾者心理脱离在照顾负担与连带病耻感间的中介作用，为缓解其连带病耻感制定相应干预措施提供依据。方法：采用便利抽样法选取132例精神分裂症患者家庭照顾者为研究对象。采用一般资料调查问卷、心理脱离量表（PD）、照顾者负担量表(ZBI)、贬低-歧视感知量表（PDD）进行调查，运用多元回归中介效应分析及Bootstrap法进行验证。结果：精神分裂症患者主要照顾者的照顾负担与心理脱离呈负相关（r=-0.540,P<0.05））；照顾负担与连带病耻感呈正相关（r=0.629,P<0.05）；心理脱离与连带病耻感呈负相关（r=-0.688,P<0.05）；中介效应分析显示，心理脱离在照顾负担与连带病耻感之间起完全中介作用，效应值为78.42%。结论：在精神分裂症患者家庭主要照顾者中，心理脱离是照顾负担与连带病耻感的中介变量。医护人员应多关注精神分裂症患者主要照顾者的心理情况，采取积极措施提高其心理脱离水平，使其从繁重的照顾工作中脱离出来，进而促进其身心健康。

The mediating role of psychological detachment in care burden and affiliate stigma in the primary caregivers of patients with schizophrenia

Objective: To explore the mediating role of psychological detachment between care burden and affiliate stigma in the primary caregivers of patients with schizophrenia, and to provide the basis for alleviating affiliate stigma. Methods: A total of 132 primary caregivers of patients with schizophrenia were selected as subjects by convenience sampling method. The general data questionnaire, Psychological Detachment Scale(PD), Zarit Caregiver Burden Interview(ZBI) and Perceived Devaluation-Discrimination Scale(PDD) were used to investigate, and the multiple regression mediating effect analysis and Bootstrap method were used to verify the results. Results: There was a negative correlation between the care burden of the primary caregivers and psychological detachment(r=-0.540,P＜0.05); There was a positive correlation between care burden and affiliate stigma(r=0.629,P＜0.05); Psychological detachment was negatively correlated with affiliate stigma(r=-0.688,P＜0.05); The mediating effect analysis showed that psychological detachment played a full mediating role between care burden and affiliate stigma, with an effect value of 78.42%. Conclusion: Psychological detachment is a mediating variable between care burden and affiliate stigma in the primary caregivers of patients with schizophrenia. Medical staff should pay more attention to the psychological situation of caregivers of patients with schizophrenia, take positive measures to improve the level of psychological detachment, so as to help caregivers to get rid of the heavy care work, and then promote their physical and mental health.