目的 探索老年痴呆患者照护者心理危机自我表露的阻碍与促进因素，为缓解照护者心理危机，改善其心理健康提供依据。方法 采用目的抽样法选取某三级甲等综合医院老年病科住院的老年痴呆患者的主要照护者（医院护工和家属）23名为研究对象。通过深度访谈收集资料，运用Braun和Clarke主题分析方法进行资料分析。结果 老年痴呆患者照护者心理危机表露的影响因素包括6个阻碍因素及（表达能力受限、道德观念束缚、工作负担过重、家庭支持缺乏、社会支持网络不完善及缺乏安全表露环境）3个促进因素（感知表露后益处、掌握表露相关技能、积极舆论导向）。结论 老年痴呆患者照护者心理危机自我表露行为受多重影响。临床护理和健康服务应从多层面着手，帮助照护者塑造良好自我认知，为照护者营造良好的自我表露氛围，以缓解其心理危机，改善心理健康状况。

Objective To explore the barriers and facilitators of psychological crisis and its self-disclosure among caregivers of elderly patients with dementia,and to provide evidence for alleviating these problems and improving their mental health.Methods 23 hospital and family caregivers were selected from a tertiary A hospital with purposive sampling.Data were collected through in-depth interviews and analyzed using Braun and Clarke’s thematic analysis method.Results The influencing factors of psychological crisis and its disclosure among caregivers of elderly patients with dementia included 6 obstacles and 3 facilitators.The former included limited expressive ability,moral constraints,excessive workload,lack of family support,incomplete social support network,and the absence of a safe disclosure environment.The latter included perceived benefits after disclosure,mastery of disclosure-related skills,and positive public opinion.Conclusions The psychological crisis of dementia caregivers’ self-disclosure behavior is affected by multiple factors.Clinical nursing and health services should help them to have a good self-awareness and provide self-disclosure atmosphere for them in various ways,so that their psychological crisis could be alleviated and mental health improved.

R473.74

湖北省重点实验室开放项目-护理专项（2022 KFH016）；武汉大学腾飞计划（TFLC2018001）