健康与遗传心理学研究室知识库

自1982年我国将计划生育确定为一项基本国策以来，经过三十多年的实施，虽然给我国人口增长和经济发展问题起到了不可忽视的积极作用，但也同时带来了一批特殊的社会群体——失独群体。在失独群体之中，又存在一群极其特殊的群体，即需要承担隔代养育责任的失独老年人。该群体不仅遭受了自己的独生子女去世的严重打击，而且还需要承担起对丧亲孙辈的隔代养育责任，因此这一特殊群体的隔代养育及心理健康问题已成为我国教育、公共卫生等领域备受关注问题，需要社会各界给予更多关注。本研究通过质性与量化研究二者相结合的研究范式，采用半结构性访谈法、参与式观察法以及问卷调查法深入探讨了失独老年人的隔代养育特征及其心理健康状况。主要分析失独老年人隔代养育的成因、养育类型、影响后果及影响因素等突出特征，并对承担隔代养育责任的失独老年人心理健康状况进行问卷调查，并分析影响其心理健康的因素。本研究由两个子研究组成。

研究一旨在探讨失独老年人隔代养育的主要特征。对来自全国6个省份的14名失独老年人进行半结构化访谈和参与式观察。结果显示：（1）隔代养育的成因主要按失独事件发生前、后分为两类，一类是失独前已全程主动参与孙辈养育、失独前未主动参与孙辈养育；一类是失独后有子女参与孙辈养育、失独后没有子女参与孙辈养育。（2）失独老年人隔代养育的类型可划分为四类：民主协商型、过度关注型、相互依靠型、严厉管教型。（3）隔代养育影响分为正性、负性两个方面。其中正性影响有：重塑生命意义、得到情感寄托、得到社会支持、孙辈健康成长和传承传统美德。负性影响包括：身心健康水平降低、经济压力水平增加、角色冲突、社会排斥和孙辈发展不良。（4）隔代养育受到失独老年人自身状况、丧亲孙辈发展状况和社会支持状况等因素的影响。

研究二目的是探究正在承担隔代养育责任的失独老年人心理健康状况及其主要影响因素。采用创伤后应激障碍量表（PCL-5）、失独老年人心理健康状况调查问卷对来自全国9个省份的147名正在进行隔代养育的失独老年人进行调查。结果显示：（1）隔代养育的失独老年人PTSD发生率为63.9%，与PTSD发生率有关的人口学特征为女性、个人每月经济收入低、自身患病、无子女参与隔代养育、退休后仍在工作、孙辈的健康状况和学习成绩不良。（2）从生活满意度、抑郁、焦虑、孤独感、正性情绪和负性情绪等6个方面而言，正在承担隔代养育责任的失独老年人心理健康状况较差。（3）隔代养育失独老年人的心理健康受有无子女参养孙辈、个人每月经济收入水平、孙辈身体健康状况和学习成绩、失独老年人自身患病情况等因素的影响。

综上，本研究得出如下结论：失独老年人进行隔代养育的特征与正常家庭的隔代养育特征相比，从成因、养育类型、影响以及影响因素等方面而言都具有其自身的独特性和复杂性。正在承担隔代养育责任的失独老年人心理健康状况较差，其中来自失独老年人自身状况、丧亲孙辈发展状况、社会支持状况等三方面因素不仅影响其进行隔代养育，也对承担隔代养育责任的失独老年人心理健康产生重要影响。因此，今后在针对正在承担隔代养育责任的失独老年人的帮扶工作中，社会各界应从这三个角度综合考虑，以便提供全面、有效、及时和可持续的政策支持和心理援助。

Since family planning was launched as a basic national policy of China in 1982, positive outcomes have been achieved in terms of settling population and development problems over the past three decades. However, a special social group was born against such backdrop—people who have lost the only child. Among these people, there is another special group: elderly people who have lost the only child and have to raise their grandchildren, having to raise their grandchildren under the great grief of losing the only child. In this light, such inter-generational parenting and the mental health of these people has become an issue that has attracted great concerns from the education and public health sector, and needs more attention from all sectors in the society. This thesis, combining qualitative research with quantitative study, has applied such methods as semi-structured interview, participatory observation and questionnaire to probe into the characteristics of inter-generational parenting as well as the mental health of the elders who have lost the only child. This thesis mainly analyzes the major characteristics of such phenomenon, including the cause, types of parenting, consequences and influencing factors. Besides, surveys on the mental health of the elders have also been conducted hand relevant causes have been explored. Two sub-studies are involved in this thesis.

Study 1 aims to explore the major characteristics of inter-generational parenting of the elders who have lost the only child. Semi-structured interviews and participatory observations were conducted for 14 elderly people who have lost the only child from 6 provinces across the country. The results show (1) The causes of inter-generational parenting could be divided into two categories according to the time order of losing the only child. One is having participated in parenting grandchildren before losing the only child and never participating in parenting grandchildren before. The other is having children left to help parenting grandchildren, and having no children left to help parenting grandchildren. (2) The types of inter-generational parenting can be divided into four types: democratic consultation, excessive concern, interdependence, and strict discipline. (3) The consequences of inter-generational parenting can be divided into two categories: positive and negative. Positive consequences include: finding the meaning of life again, getting emotional sustenance, receiving social support, healthy growth of grandchildren and inheriting traditional virtues. Negative consequences include: undermining physical and mental health, increasing economic burden, role conflicts, social exclusion, and underdevelopment of grandchildren. (4) Inter-generational parenting is influenced by such factors as the status quo of the elders who have lost the only child as well as social support.

Study 2 aims to explore the mental health of the elders who have to raise grandchildren after losing the only child and the influencing factors. A post-traumatic stress disorder scale (PCL-5) and a questionnaire on mental health of the elders who have lost the only child were applied against 147 elderly people who are raising grandchildren after losing the only child from 9 provinces across the country. The results show (1) The incidence rate of PTSD among the elders who have lost the only child is 63.9%. The demographic characteristics related to PTSD are: female, low monthly income, suffering from certain disease, having no children left to participate in inter-generational raising, still working after retirement, grandchildren having poor health condition and academic performance. (2) Mental health of these elderly people are relatively poor in such aspects as life satisfaction, depression, anxiety, loneliness, positive emotion and negative emotion. (3) The mental health of elders who have to raise grandchildren after losing the only child is affected by such factors as monthly income, health condition and academic performance of grandchildren, disease, etc.

According to the above results, the following conclusions could be drawn: comparing with the inter-generational parenting of normal families, inter-generational parenting of elderly people losing the only child has its own uniqueness and complexity in terms of causes, parenting types, consequences and influencing factors. The mental health of elderly people who have to raise their grandchildren after losing the only child is relatively poor. Factors in such aspect as the status of elderly people who have lost the only child, the growth of grandchildren and social support would not only exert impact on inter-generational parenting, but also on the mental health of elderly people. In this light, various sectors in the society should provide comprehensive, effective and timely support and assistance for elderly people who have to raise their grandchildren after losing the only child from the above three perspectives.