脑卒中患者功能独立性与家庭照料者负担感的关系：以社会支持为中介变量和调节变量

研究对203名脑卒中患者的家庭照料者进行了问卷调查，以探讨患者的功能独立性对家庭照料者负担感的作用机制。结果显示，82.3%脑卒中患者的家庭照料者有明显的负担感；患者的功能独立性与家庭照料者的负担感显著负相关；来自患者的社会支持在患者功能独立性与家庭照料者负担感之间起中介作用，而来自患者之外的社会支持则起调节作用。结果表明，在家庭照料负担的干预实践中，应注意区分来源不同的社会支持及其作用机制。

Relationship between Stroke Patient’s Functional Independence and Family Caregiver Burden: Social Support as Mediator and Moderator

Many researchers believe that there is a significant relationship between patient’s functional independence and family caregivers’ burden. But in different family caregiving situations, the effect of a patient’s functional independence on the family caregiver’s burden is different. Researchers have found that social support is a very important variable to relieve stress, and social support can be separated into two categories according to different sources which are social support from patients and social support from non-patients. The present study aimed at investigating the relationship between functional independence and family caregiver’s burden by adding 2 "third variables", namely, mediator and moderator. After summarizing the relevant reports, social support from the patient was considered as the mediator and social support from the non-patient as the moderator. 203 family caregivers of stroke patients were selected to fill 3 scales. The 3 scales used in this study were functional independence measure, social support questionnaire and caregiver strain index. Approximately 82.3% family caregivers of stroke patients felt stress apparently. There was a significantly negative correlation between the stroke patient’s functional independence and the family caregiver’s burden. Social support from stroke patients mediated the relationship between stroke patient’s functional independence and family caregivers’ burden, while social support from non-patient moderated the effect of stroke patient’s functional independence on family caregiver’s burden. Specifically, stroke patient’s functional independence makes him (or her) act in concert with the caregiver, which would reduce family caregiver burden. This means that stroke patient’s functional independence affects family caregiver’s burden through increasing family caregiver’s social support from patient. But social support from non-patient has a different mode of action and it could change the relationship between stroke patient’s functional independence and family caregiver burden. In other words, if a family caregiver receives a lot of support from outside, the patient’s functional independence’ influence on the caregiver’s burden would be weaken. However, if a caregiver only receives little support, family caregiving burden would be decided mainly by the patient’s functional independence. So, the results suggest that social supports of different sources should be distinguished when a plan of intervention on family caregiver burden is implemented. The present study came up with two new ideas. First, it divided social support to family caregivers into two types:from the patient or from the non-patient. Second, there were different theoretical assumptions about the role of different social support to be verified.