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Munie BM, Birhan Z, Legas G, Asnakew S, Belete A, Beyene GM, Shiferaw K, Mulu AT, Kassie YT, Aytenew TM, Tedla A. Predictors of depression among caregivers of patients with severe mental illness in Northwest Ethiopia, 2023: an explanatory sequential mixed-method study. Front Psychiatry 2024; 15:1422104. [PMID: 39371906 PMCID: PMC11450481 DOI: 10.3389/fpsyt.2024.1422104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 10/08/2024] Open
Abstract
Background Severe mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia. Objective The aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023. Methods This institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p-value <0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratios with a 95% confidence interval were used to determine the strength of the association. An in-depth interview was conducted with 11 participants, selected using purposive sampling. Results The prevalence of depression was 31.3% (95% CI = 29.7-38.6). The multivariate analysis showed that being female (AOD = 2.43, CI = 1.42-7.23), divorced/widowed (AOD = 1.8, CI = 1.32-6.34), poor social support (AOD = 2.2, CI = 1.9-5.87), and perceived stigma (AOD = 2.33, CI = 0.24-13.22) were positively associated with depression. The qualitative results suggest that being female, illiterate, severity of the illness, poor social support, and stigma were factors for depression. Conclusions and recommendations The prevalence of depression was high among caregivers of patients with severe mental illness. Female sex, being divorced or widowed, being illiterate, poor social support, and perceived stigma were the contributing factors. This implies that a greater focus on caregivers and the government increases mental health literacy and mental health community services.
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Affiliation(s)
- Birhanu Mengist Munie
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zelalem Birhan
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getasew Legas
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kirubel Shiferaw
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anemut Tilahun Mulu
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Munye Aytenew
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Assasahegn Tedla
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Çırakman D, Karslıoğlu EH, Bal NB, Çayköylü A. The effect of early or late initiation of long-acting antipsychotics on the caregiver burden in schizophrenia. Int Clin Psychopharmacol 2024; 39:313-322. [PMID: 37982305 DOI: 10.1097/yic.0000000000000524] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
The effective treatment in the early stages of schizophrenia is of critical importance to improve the prognosis. Schizophrenia affects patients' relatives too. The effects of early or late initiation of long-acting injectable antipsychotics (LAI-APs) on the patient have been shown, yet their effects on the caregiver are still unknown. We aimed to determine how the time of initiation of LAI-APs affects the caregiver burden by comparing the patients who were started on LAI-APs in the first 5 years of diagnosis and those who were started at a later period. Patients were classified as 'early-LAI' and 'late-LAI' according to the time of initiation of a LAI-AP. Their caregivers were also classified as the same way, as 'caregiver-early' and 'caregiver-late' and were compared in terms of caregiver burden. The quality of life, depression, anxiety, and caregiver burden scores of the caregiver-late group were significantly worse. The time of initiation of LAI-APs and the functioning levels of the patients were found to be determinant factors for the caregiver burden. This is the first study to investigate the effects of LAI-AP's initiation time on the caregivers to our knowledge. The use of LAI-APs in the early stages is associated with better outcomes for the caregiver.
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Affiliation(s)
| | - Ersin Hatice Karslıoğlu
- Department of Psychiatry, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
| | - Neşe Burcu Bal
- Department of Psychiatry, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital
| | - Ali Çayköylü
- Department of Psychiatry, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
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Parmar J, L’Heureux T, Lobchuk M, Penner J, Charles L, St. Amant O, Ward-Griffin C, Anderson S. Double-duty caregivers enduring COVID-19 pandemic to endemic: "It's just wearing me down". PLoS One 2024; 19:e0298584. [PMID: 38626216 PMCID: PMC11020535 DOI: 10.1371/journal.pone.0298584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/28/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants' anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
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Affiliation(s)
- Jasneet Parmar
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya L’Heureux
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Lobchuk
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jamie Penner
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley Charles
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Oona St. Amant
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Catherine Ward-Griffin
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Sharon Anderson
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Prasad F, Hahn MK, Chintoh AF, Remington G, Foussias G, Rotenberg M, Agarwal SM. Depression in caregivers of patients with schizophrenia: a scoping review. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1-23. [PMID: 37308691 DOI: 10.1007/s00127-023-02504-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/25/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Caregivers play a vitally important role in the lives of people with schizophrenia. However, their mental health can often be overlooked. In recent years, with increasing attention to mental health and wellness, common mental illness such as depression in caregivers of people with schizophrenia has received renewed attention. The purpose of this review was to consolidate and synthesize recent literature on (1) the prevalence of depression in caregivers of people with schizophrenia, (2) factors associated with depression in caregivers of people with schizophrenia, and (3) interventions that target depression in caregivers of people with schizophrenia. METHODS A systematic search focusing on literature published between 2010 and 2022 was done to retrieve relevant articles from the following databases: Ovid MEDLINE, Ovid EMBASE, and Ovid Psych INFO. RESULTS Twenty-four studies met inclusion criteria and were included in the review. Nine evaluated the prevalence of depression, 18 evaluated factors associated with depression in caregivers, and 6 examined interventions targeting depression. The prevalence of depression and depressive symptoms in samples of caregivers ranged between 12 and 40% across the studies. Females, especially mothers of people with schizophrenia, were more likely to experience depression, followed by younger caregivers. Several factors, including gender, interpersonal relationships, social support, stigma, literacy, and financial constraints, were identified as factors associated with depression in caregivers. Several interventions like yoga, emotional training, and psychoeducation were evaluated, and they showed a significant reduction in the level of depression and depressive symptoms experienced by the caregiver population. CONCLUSIONS Depression in caregivers in this clinical population may be widespread and warrants further study. There are promising interventions that can target depression in caregivers. Well-designed longitudinal studies may help identify caregivers at risk of developing depression and further inform targets for intervention.
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Affiliation(s)
- Femin Prasad
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Margaret K Hahn
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada
- Banting and Best Diabetes Centre (BBDC), University of Toronto, Toronto, Canada
| | - Araba F Chintoh
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada
| | - Gary Remington
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada
| | - George Foussias
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada
| | - Martin Rotenberg
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada
| | - Sri Mahavir Agarwal
- Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Canada.
- Department of Psychiatry, University of Toronto, 1051 Queen St W, Toronto, ON, M6J 1H3, Canada.
- Banting and Best Diabetes Centre (BBDC), University of Toronto, Toronto, Canada.
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Lou VWQ, Chung HF, Leung WCY, Chang RSK, Tsaw M, Lo CNR, Chiu ATG. Prevalence and predictors of depressive symptoms among caregivers of patients with epilepsy in Hong Kong. Epilepsy Behav 2023; 147:109411. [PMID: 37672823 DOI: 10.1016/j.yebeh.2023.109411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/13/2023] [Accepted: 08/19/2023] [Indexed: 09/08/2023]
Abstract
STUDY AIM To estimate the prevalence of high caregiving burden and depressive symptoms among caregivers (CG) of patients with epilepsy (PWEs) in Hong Kong and identify risk and protective factors for both outcomes after the Model of Stress and Carer Burden (MSCB). METHODS This cross-sectional study recruited participants from local epilepsy clinics to complete a 15-minute survey on a tablet. Caregiving burden (CB) was assessed using the 4-item Zarit Caregiver Burden Interview. Depressive symptoms were assessed using the 2-item Patient Health Questionnaire. Family functioning was assessed using the Short-Form Family Assessment Device General Functioning Subscale. Sociodemographic data of the caregivers and clinical data of the PWE they cared for were described. Hierarchical logistic regression models were used to analyze the factors associated with the outcomes. RESULTS A hundred and fifty-one CGs of PWEs were recruited for this study. The prevalence of high caregiving burden (ZBI-4 > 7) for CGs of PWEs was 58.9% (n = 89), whereas the prevalence of high depressive symptoms (PHQ2 > 2) was 23.8% (n = 36). Hierarchical logistic regression analysis revealed that entering patient characteristics and care situations did not enhance the model's predictability. In the full model, a high perceived CB was a risk factor for elevated depressive symptoms. Good physical health protects against depressive symptoms. CONCLUSIONS Among caregivers of PWE in Hong Kong, a high perceived caregiving burden was a risk factor for elevated depressive symptoms; however, the clinical characteristics of the PWEs were not. Self-reported physical health is a protective factor against increased depressive symptoms.
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Affiliation(s)
- Vivian W Q Lou
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong; Sau Po Centre of Ageing, University of Hong Kong, Hong Kong.
| | - Ho-Fung Chung
- Sau Po Centre of Ageing, University of Hong Kong, Hong Kong
| | - William C Y Leung
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Richard Shek-Kwan Chang
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Meagan Tsaw
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Cheuk Nam Rachel Lo
- Division of Neurology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Annie Ting-Gee Chiu
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong
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Nigussie K, Tesfaye D, Bete T, Asfaw H. Perceived stigma, common mental disorders and associated factors among primary caregivers of adult patients with mental illness attending at public hospitals, Harari regional state, Eastern Ethiopia: A multicenter cross-sectional study. Front Public Health 2023; 11:1024228. [PMID: 36935723 PMCID: PMC10017855 DOI: 10.3389/fpubh.2023.1024228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/02/2023] [Indexed: 03/06/2023] Open
Abstract
Background Giving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver's overall quality of life. Numerous studies show that caregivers frequently experience mental distress and feel stigmatized. However, there is limited study done on this topic in our country. Objective To determine the magnitude and associated factors of perceived stigma and common mental disorder among primary caregivers of adults with mental illness in public hospitals at Harari regional state, Eastern Ethiopia, 2022. Methods A cross-sectional study design was conducted. A total of 419 participants were recruited by a systematic random sampling technique. The data was collected by using a face-to-face interview and by reviewing patients' charts. Perceived stigma and common mental disorder were assessed by Family Interview Schedule and Self-Reporting Questionnaire, respectively. Epi-data version 4.6.2 was used to enter data, and SPSS version 20 was used to analyze. Bivariable and multivariable logistic regression were performed. P-values < 0.05 were considered statistically significant. Result The magnitude of perceived stigma and common mental disorder were 42.5% (95% CI, 37.7-47.3) and 39.4% (95% CI, 34.8-44.0) respectively. Age of caregiver between 26 and 33 [AOR = 3.13, 95% CI: (1.71-8.93)], no formal education [AOR = 3.85, 95% CI: (1.81-8.15)], illness duration ≥7 years [AOR = 1.93, 95% CI: (1.04-3.57)], family history of mental illness [AOR = 1.92, 95% CI: (1.09-3.39)] and poor social support [AOR = 4.87, 95% CI: (3.74-12.71)] were significantly associated with perceived stigma. Being female [AOR = 1.92, 95% CI: (1.31-3.34)], having no formal education [AOR = 4.04, 95% CI: (2.15-10.01)], having a family history of mental illness [AOR = 2.26, 95% CI: (1.29-4.00)], having comorbid other illness [AOR = 2.13, 95% CI: (1.15-3.94)], and having poor social support [AOR = 4.58, 95% CI: (2.53-8.28)] were significantly associated with common mental disorder. Conclusion The magnitude of perceived stigma and common mental disorder was high among primary caregivers of patients with mental illness compared with other studies. Age of caregiver between 26 and 33, no formal education, duration of illness ≥7 years, family history of mental illness and poor social support were associated with perceived stigma and being female, no formal education, family history of mental illness, comorbid other illness and poor social support were associated with common mental disorder.
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Affiliation(s)
- Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | | | | | - Henock Asfaw
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
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Nova R, Windarwati HD, Meidianto E. Correlation between family support with work productivity of people with severe mental disorders (PSMD) in Bantur Community Health Center, Malang, Indonesia. HEALTHCARE IN LOW-RESOURCE SETTINGS 2023. [DOI: 10.4081/hls.2023.11207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Introduction: One impact on People With Mental Disorders (PSMD) is decreased productivity. As the closest people, families are expected to support PSMD to be productive in the community. Therefore, this study aimed to identify the correlation between family support and the work productivity of people with mental disorders.
Design and Methods: This observational analytical study with a Cross-Sectional approach was conducted in the working area of the Bantur Community Health Center. Purposive sampling was used to obtain 107 samples. Data on family support were collected using a questionnaire and tested for validity, while the Endicott Work Productivity Scale (EWPS) questionnaire was used to measure PSMD work productivity.
Results: The results showed a significant correlation between family support and PSMD work productivity, p = 0.028. The correlation was negative, meaning lower PSMD work productivity implied higher family support. Furthermore,emotional support was the most form of support provided by family members to PSMD. Work productivity is generally low, with PSMD work attitudes in the high category only in sub-variables.
Conclusions: Family support is needed for people with mental disorders to be productive. Future studies should examine other factors that affect PSMD work productivity. Additionally, health services should innovate to create work programs that stimulate PSMD's potential and ability.
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Ampon-Wireko S, Zhou L, Quansah PE, Larnyo E. Understanding the effects of COVID-19 stigmatisation on job performance: a survey of frontline healthcare workers. Ann Med 2022; 54:2039-2052. [PMID: 35972371 PMCID: PMC9382904 DOI: 10.1080/07853890.2022.2089910] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The level of stigmatisation among health care providers has increased during the COVID-19 pandemic, and understanding the effect of COVID-19 stigmatisation on job performance has become increasingly important. The study explores the influence of COVID-19 stigmatisation on job performance among frontline health workers via the mediating role of anxiety. Furthermore, the moderating effect of resilience in the association between COVID-19 stigmatisation and anxiety is further examined. Participants were made up of 820 frontline health workers working in the epicentres of the Bono Ahafo, Western, Greater Accra, and Northern regions of Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. COVID-19 stigmatisation among frontline health workers directly affected anxiety and performance. In addition, the results showed that resilience moderated the relationship between COVID-19 stigmatisation and anxiety. The findings again demonstrated that anxiety partially mediated the association between concern for disclosure and public attitude and negative experience and job performance, whereas personalised stigma was insignificant. The study provides implications for establishing anti-stigma interventions and programs to enhance job performance among health workers.Key messagesMany healthcare workers are subject to stigmatisation during the COVID-19 pandemic.The study employs hierarchical regression methods to examine the impacts of COVID-19 stigmatisation on job performance among frontline health workers.The health management team should strengthen interventions to control the stigma experienced by health workers during COVID-19 treatments.
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Affiliation(s)
| | - Lulin Zhou
- School of Management, Jiangsu University, Zhenjiang, China
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Chen BC, Lui JHL, Benson LA, Lin YJR, Ponce NA, Innes-Gomberg D, Lau AS. After the Crisis: Racial/Ethnic Disparities and Predictors of Care Use Following Youth Psychiatric Emergencies. JOURNAL OF CLINICAL CHILD & ADOLESCENT PSYCHOLOGY 2022; 52:360-375. [DOI: 10.1080/15374416.2022.2127103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
| | - Joyce H. L. Lui
- Department of Psychology, University of California
- Department of Psychology, University of Maryland
| | | | | | | | | | - Anna S. Lau
- Department of Psychology, University of California
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Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, Visvalingam U, Roslan S, Abd Rahman FN, Lee KW. Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10122423. [PMID: 36553947 PMCID: PMC9777672 DOI: 10.3390/healthcare10122423] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
Due to the increasing importance of caregivers in the treatment outcomes of patients with mental illness, this study aimed to systematically review studies investigating the former's caregiver burden and determine its prevalence. An open search, without filters, was conducted. Articles were selected from Medline, Scopus, and PubMed from inception to 30 April 2022 using the PRISMA protocol. Subgroup analyses examined the between-group differences by study setting, measurements used, and disorder type. A total of 5034 caregivers from 23 countries were included in this review. Thirty-nine studies were included in the systematic review, and, among them, twenty-six were deemed eligible for meta-analysis. The overall pooled prevalence of caregiver burden among caregivers of individuals with mental illness was 31.67% (95% CI = 26.22-37.12). Pooled prevalence was the highest among care recipients receiving treatment in a hospital setting (36.06%; 95% CI = 22.50-49.63), followed by the community and clinic settings. Caregiver prevalence values were higher for burden measured using the Zarit Burden Interview (38.05%; 95% CI = 27.68-48.43). compared with other instruments, and for carers of care recipients with psychosis (35.88%; 95% CI = 27.03-44.72) compared with those without. Thus, targeted interventions should focus on caregivers of patients in hospital settings and with psychotic symptoms.
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Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
- Correspondence:
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia; (C.Q.C.); (C.R.K.)
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson 71010, Malaysia;
| | - Amira Najiha Yahya
- Department of Educational Psychology & Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Uma Visvalingam
- Department of Psychiatry, Hospital Putrajaya, Putrajaya 62250, Malaysia;
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Kai Wei Lee
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia;
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Avraam G, Samakouri M, Tzikos A, Arvaniti A. High Expressed Emotion and Warmth among Families of Patients with Schizophrenia in Greece. Healthcare (Basel) 2022; 10:healthcare10101957. [PMID: 36292404 PMCID: PMC9602413 DOI: 10.3390/healthcare10101957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2022] Open
Abstract
Expressed emotion (EE) is an established prognostic factor for relapse in schizophrenia. Through critical comments (CC), hostility (H) and emotional overinvolvement (EOI), a relative can be rated as high or low EE, but the role of warmth should also be evaluated in order to consider the influence of a positive affect within the family context. In this study, EE was assessed in a sample of 48 relatives of patients with schizophrenia using the Camberwell Family Interview (CFI). Questionnaires assessing coping (brief-COPE), their wellbeing (World Health Organization Well-Being Index WHO-5) and the socio-demographic variables were also administered. Relatives who expressed a higher level of warmth were found to make fewer CC (5.2 ± 4.6 vs. 8.4 ± 4.6, p = 0.009) and have, on average, higher EOI scores (3.2 ± 1.0 vs. 1.9 ± 1.1, p = 0.002) than those who expressed no or very little warmth. High EE was found to be associated with having fewer family members (p = 0.035), while relatives with a higher level of education expressed less warmth (p = 0.007). Relatives with a low level of warmth had higher maladaptive coping scores and tended to score worse for their overall wellbeing in comparison to relatives who showed a higher level of warmth (28.4 ± 5.0 vs. 24.1 ± 5.2, p = 0.006 and 39.1 ± 20.4 vs. 51.3 ± 22.0, p = 0.073, respectively). Since the role of warmth is important, it should be taken into account when designing family interventions, independently from lowering EE. Customized interventions to promote warmth and the routine screening of relatives are recommended.
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Affiliation(s)
- Georgios Avraam
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Correspondence: ; Tel.: +30-69-4252-0100
| | - Maria Samakouri
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
| | - Anthimos Tzikos
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
| | - Aikaterini Arvaniti
- Department of Psychiatry, Medical School, Democritus University of Thrace, 681 00 Alexandroupolis, Greece
- Department of Psychiatry, University General Hospital of Alexandroupolis, 681 00 Alexandroupolis, Greece
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12
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Jayasinghe A, Wrobel A, Filia K, Byrne LK, Melvin G, Berk L, Berk M, Cotton S. Psychological distress in siblings of people with mental illness: A systematic review and meta-analysis. Aust N Z J Psychiatry 2022; 57:642-660. [PMID: 36113083 DOI: 10.1177/00048674221123481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of this study was to characterise the prevalence and/or severity of psychological distress (namely, depression and anxiety symptoms) in siblings of people with mental illness (MI) and to examine correlates of distress in siblings of people with MI. METHOD Studies comparing distress in individuals with and without a sibling with MI were eligible. Studies reporting on correlates of distress in siblings were also eligible. A search of MEDLINE Complete, PsycINFO and Embase was conducted up until 17 March 2022. RESULTS Fifteen studies comprising 2304 siblings and 2263 comparison individuals were included. Meta-analyses indicated individuals with a sibling with MI experience significantly greater depressive symptoms (Hedges's g = 0.53, 95% CI = [0.32, 0.73], siblings n = 1962, comparison individuals n = 2248) and anxiety symptoms (Hedges's g = 0.40, 95% CI = [0.19, 0.61], siblings n = 653, comparison individuals n = 533) than those without. The sibling relationship, siblings' locus of control, interpersonal functioning and their appraisal of the impacts of MI were identified as important and potentially modifiable correlates. CONCLUSION Individuals with a sibling with MI experience greater depressive and anxiety symptoms than those without and would likely benefit from support. Future studies are required to elucidate the mechanisms underlying distress in siblings.
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Affiliation(s)
- Anuradhi Jayasinghe
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Orygen, Parkville, VIC, Australia
| | - Anna Wrobel
- Orygen, Parkville, VIC, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia
| | - Kate Filia
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Linda K Byrne
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Glenn Melvin
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Lesley Berk
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Michael Berk
- Orygen, Parkville, VIC, Australia.,Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Deakin University, Geelong, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychiatry, The Royal Melbourne Hospital, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- Orygen, Parkville, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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13
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Disease-Related Risk Factors for Caregiver Burden among Family Caregivers of Persons with Schizophrenia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031862. [PMID: 35162886 PMCID: PMC8835439 DOI: 10.3390/ijerph19031862] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 12/14/2022]
Abstract
This study aimed to conduct a quantitative synthesis of the clinical correlates of caregiver burden in schizophrenia studies published in the last two decades. Derived from eight electronic databases, this meta-analytic review revisits 34 English articles published from 2000 to 2020 relevant to family caregiver burden in the schizophrenia field. The Newcastle–Ottawa Scale (NOS) was used to assess study quality. The pooled effect sizes of the selected studies ranged from −0.390 to 0.751. The results indicated a significant association between a heavier burden and disease-related risk factors, including more severe symptoms, greater general psychopathology, greater severity of functional impairment, and longer duration of illness. The results show moderating effects of study characteristics (i.e., study quality, participants, and location) on the correlations between these disease-related risk factors and caregiver burden. This review highlights the roles of study characteristics in affecting the inconsistent results for the effects of disease-related risk factors on caregiver burden in families of patients with schizophrenia. Psychosocial interventions are essential for family caregivers of persons with schizophrenia. Future studies incorporating random samples from both high-income and low-to-middle-income countries will be crucial to understand the effects of cultural contexts on caregiver burden in families of persons with schizophrenia.
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14
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Yerriah J, Tomita A, Paruk S. Surviving but not thriving: Burden of care and quality of life for caregivers of patients with schizophrenia spectrum disorders and comorbid substance use in South Africa. Early Interv Psychiatry 2022; 16:153-161. [PMID: 33733599 DOI: 10.1111/eip.13141] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/25/2020] [Accepted: 03/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schizophrenia and schizophrenia spectrum disorders can be devastating for the patient and family. Early recognition and interventions for caregivers, who form part of an overburdened 'invisible health care system' in resource-limited settings with an extensive mental health treatment gap, are crucial for improved outcomes for patients and carers. The study investigated the burden of care and quality of life (QOL) among caregivers of patients with schizophrenia spectrum disorders and its determinants in South Africa. METHODS We conducted a study of 101 matched-paired samples of family caregivers and adult patients (N = 202) seeking care from two psychiatric hospitals in South Africa. The assessment consisted of the Zarit Burden Interview for caregiver burden, WHO-Quality of life scale and WHO ASSIST for substance use. RESULTS Most caregivers (n = 81; 80.2%) reported high or severe caregiver burden. None of the four QOL domains surpassed the 60% mark where the observed scores (out of 100) for physical health (56.2, SD = 16.2), psychological health (55.3, SD = 17,6), social relationships (47.1, SD = 19.3) and environment (53.5, SD = 16.3). Lower burden was associated with greater QOL score across all four domains among caregivers (p ≤ .05). Lower educational attainment was associated with poorer QOL, and higher household income with higher QOL in certain domains. Patient comorbid alcohol (p ≤ .05) and high-risk cannabis use (p < .02) were the only significant factors of increased caregiver burden scores. CONCLUSION The high caregiver burden, and its association with alcohol and cannabis use, suggests the need to address comorbid substance use and early pragmatic support for families.
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Affiliation(s)
- Jacqueline Yerriah
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.,KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Saeeda Paruk
- Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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15
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Gupta P, Bharti P, Bathla M, Singh AH, Bhusri L. A cross-sectional study to assess the caregiver burden and the quality of life of caregivers of the patients suffering with psychiatric illness. Ind Psychiatry J 2022; 31:151-157. [PMID: 35800861 PMCID: PMC9255620 DOI: 10.4103/ipj.ipj_228_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/15/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The impairment due to the psychiatric disorders makes the sufferer unable to become independent, therefore require long term support and care by their relatives. About 32% of years lived with disability (YLD) and about 13% of disability adjusted life-years (DALYs) is found in mental illness. AIMS AND OBJECTIVES The aims were to study the socio-demographic profile, the caregiver burden and quality of life of the caregivers of the patients with different psychiatric illness. Also, to compare the burden and quality of life among caregivers of different psychiatric groups. MATERIALS AND METHODS It is a cross sectional study in which 120 caregivers of patients with psychiatric illnesses were included; divided into four groups (30 each): Anxiety, psychotic, mood and substance use disorders. After the consent, Zarit burden interview, socio demographic profile and quality of life -10 scales were used to assess the objectives. RESULTS The results revealed that maximum caregivers were males, and spouses in relation with the patient. Most of them were married and educated. Maximum had mild to moderate level of burden (49.1%), followed by moderate to severe level of burden in about 22.5% caregivers. Significant association was seen with the burden level. But no significant association was seen with the quality of life. CONCLUSION Caregivers of the psychiatric patients have to suffer a lot and may land up into the psychiatric symptoms themselves.
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Affiliation(s)
- Parul Gupta
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Poonam Bharti
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Manish Bathla
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Angad Harshbir Singh
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
| | - Leezu Bhusri
- Department of Psychiatry, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
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16
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Chaudhury S, Gupta N, Samudra M, Dhamija S, Saldanha D. Perceived stigma among caregivers of psychiatric disorders as compared to chronic dermatological disorders. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2022. [DOI: 10.4103/mjdrdypu.mjdrdypu_916_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Law S, Andermann L, Chow W, Luo XW, Wang X. Experiences of Family Burden in Caring for the Severely Mentally Ill in a Foreign Land: A Qualitative Study of Chinese Immigrant Families in Toronto, Canada. Transcult Psychiatry 2021; 58:745-758. [PMID: 33757329 PMCID: PMC8673937 DOI: 10.1177/13634615211000552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is a relative dearth of qualitative studies on the actual experiences of families caring for members suffering from serious mental illness, and even less is known about disadvantaged ethnic minority immigrant families. This explorative qualitative study examines the burden experienced by 15 family members of Chinese immigrant background in Toronto, Canada. Six common themes emerged from the study: 1) significant worries about not being able to take care of ill members in the future; 2) on-going strain and changed family life; 3) pervasive social stigma, discrimination and lack of resources; 4) general appreciation of Canadian health and welfare systems and opportunities; 5) cultural factors and beliefs uniquely shape families' support and caring commitment; and 6) families find various ways to cope and help themselves. Opportunities for improved care delivery based on these understandings are discussed.
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Affiliation(s)
- Samuel Law
- Community Mental Health Services, Mount Sinai
Hospital, Canada
- Department of Psychiatry, University of Toronto,
Canada
| | - Lisa Andermann
- Community Mental Health Services, Mount Sinai
Hospital, Canada
- Department of Psychiatry, University of Toronto,
Canada
| | - Wendy Chow
- Community Mental Health Services, Mount Sinai
Hospital, Canada
- Department of Psychiatry, University of Toronto,
Canada
| | - Xing Wei Luo
- Medical Psychological Institute, Second Xiangya
Hospital of Central South University, P.R. China
| | - Xiang Wang
- Medical Psychological Institute, Second Xiangya
Hospital of Central South University, P.R. China
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18
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Albikawi Z, Abuadas M. Quality of life and self-stigma of schizophrenia patient's caregiver tool: Development and validation using classical test theory and Rasch analysis. S Afr J Psychiatr 2021; 27:1656. [PMID: 34917413 PMCID: PMC8661281 DOI: 10.4102/sajpsychiatry.v27i0.1656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/13/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Providing care for schizophrenia patients is complex, and it requires dealing with various psychosocial burdens. AIM To develop and validate a tool that measures the quality of life and self-stigma (SS) of the schizophrenia patient's caregiver (QLSSoSPC). SETTING Outpatient psychiatric services clinics in Saudi Arabia. METHODS The current study used a methodological cross-sectional design. A sample of 205 schizophrenia patients' caregivers was recruited by using a convenient sampling method. Classical Test Theory and Rasch Analysis approaches were used. RESULTS The developed tool has proven acceptable level of reliability and validity. The analysis confirmed seven-factor structure accounted for 74.4% of the total variance. Cronbach's reliability statistics for the developed tool were satisfactory and ranged from 0.80 to 0.91. CONCLUSION The psychometric properties of the QLSSoSPC tool supported its prospective use and allowing us to recommend the implementation of the tool on behalf of clinical and research purposes.
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Affiliation(s)
- Zainab Albikawi
- Community and Psychiatric/Mental Health Nursing Department, Nursing College, King Khalid University, Khamis Mushait, Saudi Arabia
| | - Mohammad Abuadas
- Community and Psychiatric/Mental Health Nursing Department, Nursing College, King Khalid University, Khamis Mushait, Saudi Arabia
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19
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Zhang B, Lv X, Qiao M, Liu D. The Full Mediating Role of Loneliness on the Relationship Between Social Support and Depression Among Rural Family Caregivers of Persons With Severe Mental Illness. Front Public Health 2021; 9:729147. [PMID: 34778172 PMCID: PMC8580924 DOI: 10.3389/fpubh.2021.729147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Depression is a common and overwhelming psychiatric disorder among family caregivers of persons with severe mental illness (SMI). The interrelationships among social support, loneliness, and depression, especially among this relatively vulnerable group, are poorly understood. The aim of the present study was to test the hypothesis that the social support contributes to the alleviation of depression, through its effect on reducing loneliness. Methods: A survey of 256 rural family caregivers of persons with SMI was conducted between December 2017 and May 2018 in Chengdu City, Sichuan Province, China. Social support, loneliness and depression were measured. A series of multiple linear regression models and bootstrapping procedure were performed to examine the mediating effects of loneliness on the association between social support as well as its components and depression. Results: The proportion of family caregivers of persons with SMI who reported significant depressive symptoms was 53.5%. Loneliness fully mediated the negative association between social support and depression. As to three components of social support, subjective support and objective support only had indirect associations with depression mediated by loneliness, while support utilization had both direct and indirect relationships with depression. Conclusion: The current study highlighted that social support and its three components may acted as protective factors by decreasing the feelings of loneliness, which created a beneficial effect on depression among family caregivers of persons with SMI.
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Affiliation(s)
- Baiyang Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xin Lv
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Mutian Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Danping Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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20
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Reyes-Rodríguez ML, Watson HJ, Smith TW, Baucom DH, Bulik CM. Promoviendo una Alimentación Saludable (PAS) results: Engaging Latino families in eating disorder treatment. Eat Behav 2021; 42:101534. [PMID: 34217036 PMCID: PMC8380698 DOI: 10.1016/j.eatbeh.2021.101534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/05/2021] [Accepted: 06/17/2021] [Indexed: 12/23/2022]
Abstract
Latinos/as are underrepresented in eating disorders clinical trials. This study compared results of a culturally adapted individual cognitive-behavioral treatment (CBT) for binge-spectrum eating disorders that included or excluded a family enhanced module (CBT + FE), in a proof-of-principle pilot study with a sample of Latina adults and one family member per patient. Twenty-five patients (Mage = 37 yrs) and 25 family members (Mage = 40 yrs) were randomized to CBT (n = 13) or CBT+ FE (n = 12). DSM-IV eating disorder diagnoses were: 48% (n = 12) bulimia nervosa, 28% (n = 7) binge-eating disorder, and 24% (n = 6) eating disorder not otherwise specified. Effect sizes favored CBT + FE on adherence and retention, and scores on treatment satisfaction and therapeutic alliance were high, indicating treatment acceptability. In spite of the hypothesis that family outcomes such as support, familism, cohesion, pride, family cultural conflict, burden, and marital satisfaction (in couples) would be superior in CBT + FE, the preliminary data were inconclusive and results were mixed. The hypothesis that eating disorder outcomes including global eating psychopathology, binge eating, and purging would improve in CBT + FE was not supported. There was some evidence that patients in CBT improved more particularly on binge eating, otherwise the groups had no differences. In conclusion, the results suggest that CBT + FE could enhance treatment adherence and retention, although this did not automatically translate to better family and symptom outcomes.
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Affiliation(s)
- Mae Lynn Reyes-Rodríguez
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States of America.
| | - Hunna J. Watson
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC,Division of Paediatrics, The University of Western Australia, Perth, Australia,School of Psychology, Curtin University, Perth, Australia
| | - Tosha Woods Smith
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Donald H. Baucom
- Department of Psychology, University of North Carolina, Chapel Hill, NC
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC,Department of Nutrition, University of North Carolina, Chapel Hill, NC,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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21
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Guan Z, Cross W, Lam L, Wiley JA, Sun M, Bai X, Tang S. Feasibility of brief distress screening for family caregivers of adults diagnosed with schizophrenia in Changsha, Hunan, China. J Psychiatr Ment Health Nurs 2021; 28:174-185. [PMID: 32495993 DOI: 10.1111/jpm.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
What is known on the subject? Distress screening amongst FGs is emphasized in worldwide studies, but existing general tools were found time-consuming and sometimes inconvenient when using them amongst FGs of patients diagnosed with schizophrenia. The DT, a single-item scale, was widely used to detect distress amongst FGs of cancer patients, showing good reliability, validity and discrimination power. The 21-item Depression Anxiety and Stress Scale (DASS21) can identify distress in the general population and serve as a criterion to determine an optimal cut-off score of the DT. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The DT presented good reliability, validity and discriminatory power amongst FGs of adults diagnosed with schizophrenia. A cut-off score of six maximized sensitivity (77%) and specificity (76%). Over half of the FGs of adults diagnosed with schizophrenia reached this cut-off score and experienced significant distress. Distress was higher in FGs of male patients, when FGs were parents, and for FGs whose educational background was primary school or below. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The DT is an effective alternative to existing instruments in identifying distressed FGs of adults diagnosed with schizophrenia. It is important to provide FGs with distress screening programmes and interventions (e.g. skill-building psychoeducation) to identify and relieve distress. In addition, future research could explore brief measures to simultaneously recognize potential negative and positive impacts of caregiving in FGs.
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Affiliation(s)
- Ziyao Guan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wendy Cross
- School of Nursing Healthcare Professions, Federation University Australia, Mount Helen, VIC, Australia
| | - Louisa Lam
- School of Nursing Healthcare Professions, Federation University Australia, Mount Helen, VIC, Australia
| | - James A Wiley
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Institute of Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Hunan Women's Research Association, Changsha, Hunan, China
| | - Xiaoling Bai
- Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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22
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The Effects of Family Psychoeducation Courses on Depression, Anxiety and Family Functioning in the Caregivers of Schizophrenic Patients. HEALTH SCOPE 2021. [DOI: 10.5812/jhealthscope.104116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Schizophrenia is one of the most serious psychiatric diseases that affects the patient’s family members in addition to the patient himself. This disease can lead to depression and anxiety in the family members of the patient and even affect their functioning. Objectives: The present study was conducted to investigate the effect of a short-term family psychoeducation course on the depression and anxiety family functioning in caregivers Methods: In this before-after clinical trial, 163 first-degree family members of patients with schizophrenia were invited to participate in a short-term FPE course. A total of 65 of this group attended the first training session. Prior to the first session, the beck depression inventory (BDI), the beck anxiety inventory (BAI), and the family assessment device (FAD) were completed for the participants based on a family functioning model. Six months after the end of the FPE course, the 36 subjects who had completed the initial questionnaires and fully attended the sessions were invited to complete the questionnaires again. A total of 31 subjects completed the questionnaires again at this stage. The data were analyzed by SPSS-20 software using Mann–Whitney and Wilcoxon rank tests. Results: The mean age of the participants in both stages of questionnaire completion was 48.64 ± 11.85 years. Among them, 16 (51.6%) were female, and 15 (48.4%) were male. Also, six (19.4%) subjects had an education above high school, and mothers were the most frequent participating family members with a frequency of 11 (35.5%). The anxiety and depression scores of these subjects were 10.8 ± 5.14 and 6.9 ± 2.45 at baseline, respectively. These scores decreased significantly after six months to 5.03 ± 2.48 and 4.40 ± 1.9, respectively. In addition, among family functioning, Role and Behavioral control was significantly improved (P-value < 0.05). Conclusions: The results of this study showed that depression and anxiety levels decreased in the family members of the examined patients six months after an FPE course. This effect can be further investigated through studies conducted with control groups. These findings suggest that the integration and institutionalization of FPE programs in the healthcare system are essential for improving the status of patient caregivers with severe psychiatric illnesses and their families.
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23
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Zhou Z, Wang Y, Feng P, Li T, Tebes JK, Luan R, Yu Y. Associations of Caregiving Knowledge and Skills With Caregiver Burden, Psychological Well-Being, and Coping Styles Among Primary Family Caregivers of People Living With Schizophrenia in China. Front Psychiatry 2021; 12:631420. [PMID: 34122169 PMCID: PMC8187614 DOI: 10.3389/fpsyt.2021.631420] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/15/2021] [Indexed: 02/03/2023] Open
Abstract
Background: There is a lack of clarity regarding the correlation of caregiving knowledge and skills with caregiving experiences of people living with schizophrenia (PLSs). To address this gap, this comprehensive study examines the relationships of caregiving knowledge and skills to the primary family caregiver's experiences of burden, psychological well-being (stress, anxiety, depression, caregiving rewarding feelings), and coping styles in China. Methods: A total of 395 primary family caregivers of PLSs were enrolled in a cross-sectional study between May 2019 and September 2019. Each family caregiver was independently assessed on caregiving knowledge and skills, caregiver burden, and psychological well-being, as well as coping styles. Results: A higher level of caregiving knowledge and skills was positively correlated with less stress (b = -0.48, P < 0.001), anxiety (b = -0.23, P = 0.029), depression (b = -0.29, P = 0.013), and more caregiving rewarding feelings (b = 0.54, P < 0.001). Also, caregivers with more knowledge and skills were more inclined to adopt positive coping strategies (b = 0.44, P < 0.001). Despite these differences, caregivers with different levels of caregiving knowledge and skills reported comparable caregiver burden (b = 0.11, P = 0.705) and the use of a passive coping style (b = 0.10, P = 0.169). Conclusion: Caregiving knowledge and skills are a reliable predictor of psychological well-being and active coping among the primary family caregivers of PLSs. These findings inform the development of psychoeducational interventions to support family caregivers of PLSs.
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Affiliation(s)
- Zonglei Zhou
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yao Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Ping Feng
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Tongxin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jacob Kraemer Tebes
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Rongsheng Luan
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
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Abdeta T, Desalegn D. Common Mental Disorders Among Informal Primary Caregivers of Adults With Mental Illness During the Coronavirus Disease 2019 Epidemic in Eastern Ethiopia: A Cross-Sectional Study. Front Psychiatry 2021; 12:676379. [PMID: 34497543 PMCID: PMC8419243 DOI: 10.3389/fpsyt.2021.676379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/21/2021] [Indexed: 01/16/2023] Open
Abstract
Background: Coronaviruses (CoVs) are emerging respiratory viruses and cause illnesses ranging from the common cold to severe acute respiratory syndrome (SARS). Informal primary caregivers of individuals with mental illness were special populations suffering from both the burden of caring for mentally ill individuals and the danger of the Coronavirus disease 2019 (Covid-19) epidemic. Objective: The objective of the study was to assess the prevalence and associated factors of common mental disorders (CMDs) among the informal primary caregivers of adults with mental illness during the Covid-19 epidemic. Methods: A hospital-based cross-sectional study design was conducted from July 1 to 30, 2020. A systematic random sampling technique was used to get samples of informal primary caregivers. Data were analyzed by bivariable and multivariable logistic regression analysis. In the final model, variables having a p-value < 0.05 were declared as associated with CMDs. Result: Out of a total of 218 informal primary caregivers, 215 responded to this study. The prevalence of CMDs was 40.5% [95% confidence interval (CI) = 36.66, 44.3%] among informal primary caregivers. Being female informal primary caregivers [adjusted odds ratios (AOR) 1.98, 95% CI = 1.05, 3.76], being student informal primary caregivers (AOR 5.8, 95% CI: 1.2, 28.4), caring patients with psychosis (AOR 3.33, 95% CI: 1.12, 9.92) and caring patients with bipolar disorder (AOR 3.12, 95% CI: 1.35, 7.23) were significantly associated with CMDs. Conclusion: Our study cannot show the causal relationship due to its cross-sectional study design nature. However, this study showed relatively higher prevalence of CMDs among informal primary caregivers of adults with any mental illness during the Covid-19 epidemics relative to pre-Covid-19 times. Being a female caregiver, being a student caregiver, and caring for adults with psychosis and bipolar disorder were factors associated with CMDs. Attention should be given, and essential psychosocial care should be provided, to maintain the mental health of informal primary caregivers of individuals with mental illness especially during the Covid-19 pandemic.
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Affiliation(s)
- Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Defaru Desalegn
- Department of Psychiatry, Faculty of Public and Medical Science, Mettu University, Mettu, Ethiopia
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Weiss P, Redlich-Amirav D, Daass-Iraqi S, Hadas-Lidor N. Aspects of Shared Decision Making in a Cognitive-Educational Intervention for Family Members of Persons Coping With Severe Mental Illness. Front Psychiatry 2021; 12:681118. [PMID: 34354610 PMCID: PMC8329361 DOI: 10.3389/fpsyt.2021.681118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Partnerships and family inclusion are embedded in mental health policies. Shared Decision Making (SDM) is as an effective health communication model designed to facilitate service users and providers engagement in reaching jointly decisions concerning interventions. Keshet is a 15 bi-weekly academic course for family members of people with mental illnesses that enhances positive family cognitive communication skills. Purpose: To exhibit how SDM is inherently expressed in Keshet. Method: We conducted a secondary analysis of previous Keshet evaluation studies and course protocols that focused on revealing SDM use. Results: SDM was found to be a prominent feature in Keshet interventions in both the structure of the course as well as the process and procedures. Following participation in the program, making decisions jointly was found to be a prominent feature. Conclusions: Interventions such as Keshet that include an SDM approach can contribute to the integration of academic, professional and "lived experience" within a shared perspective, thus promoting an enhanced equality- based SDM model that benefits individuals as well as mental health systems.
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Affiliation(s)
- Penina Weiss
- Occupational Therapy Department, Rabin Medical Center, Petach Tikva, Israel.,National School of Mental Health Rehabilitation, Ono College, Kiryat Ono, Israel
| | | | - Sara Daass-Iraqi
- National School of Mental Health Rehabilitation, Ono College, Kiryat Ono, Israel
| | - Noami Hadas-Lidor
- National School of Mental Health Rehabilitation, Ono College, Kiryat Ono, Israel
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26
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Pathak A, Biswal R. Mental Illness in Indian Hindi Cinema: Production, Representation, and Reception before and After Media Convergence. Indian J Psychol Med 2021; 43:74-80. [PMID: 34349311 PMCID: PMC8295583 DOI: 10.1177/0253717620927869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Abhijit Pathak
- Dept. of Humanities and Social Sciences, National Institute of Technology Rourkela, Rourkela, Odisha, India
| | - Ramakrishna Biswal
- Dept. of Humanities and Social Sciences, National Institute of Technology Rourkela, Rourkela, Odisha, India
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Yitayih Y, Mekonen S, Zeynudin A, Mengistie E, Ambelu A. Mental health of healthcare professionals during the early stage of the COVID-19 pandemic in Ethiopia. BJPsych Open 2020; 7:e1. [PMID: 33256883 PMCID: PMC7844150 DOI: 10.1192/bjo.2020.130] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general. AIMS To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia. METHOD A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method. RESULTS The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work. CONCLUSIONS This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks.
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Affiliation(s)
| | - Seblework Mekonen
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Ethiopia
| | - Embialle Mengistie
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
| | - Argaw Ambelu
- Department of Environmental Health Science and Technology, Jimma University, Ethiopia
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28
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Bai X, Wang A, Cross W, Lam L, Plummer V, Guan Z, Sun M, Tang S. Validation of the distress thermometer for caregivers of children and adolescents with schizophrenia. J Adv Nurs 2020; 76:687-698. [PMID: 31600000 DOI: 10.1111/jan.14233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/05/2019] [Accepted: 10/03/2019] [Indexed: 11/29/2022]
Abstract
AIM To develop and psychometrically test the distress thermometer for caregivers (DT-C) and document the distress level in primary caregivers of children and adolescents diagnosed with schizophrenia. DESIGN A validation diagnostic accuracy study and descriptive cross-sectional survey. METHODS DT-C was adopted based on Harverman's distress thermometer for parents. The cut-off score was detected by using receiver operating characteristic analysis with the Depression Anxiety Stress Scale-21 as a reference standard in a sample of 324 caregivers of children and adolescents diagnosed with schizophrenia in China collected between Jan 2017 and Feb 2018. RESULTS One-item DT of DT-C indicated a good retest reliability (r = 0.86) and one-item DT and the Problem List (PL) indicated good convergent validity (r = 0.67-0.88). Overall and individual PL domains showed good internal consistency (KR 20 values ranged from 0.70-0.90). Setting seven as the cut-off score, the values of sensitivity (0.72-0.81), specificity (0.86-0.90), Youden's index (0.61-0.70), positive predictive value (0.67-0.74), and negative predictive value (0.84-0.92) were most satisfactory and area under curve values showed significantly excellent discrimination (0.88-0.90). The average DT score for the 324 participants was 6.34 (SD 2.49), with 46.9% of the participants above the cut-off. Caregivers above the cut-off score faced significant multiple problems in practical, family/social, cognitive, emotional, and parenting domains. CONCLUSION The DT-C, with six domains containing 35 items in Problem List and with the cut-off score at seven, can be a rapid screening tool to measure distress in these caregivers. The level of distress in caregivers was relatively high. Psychoeducation on specific needs and a solid mutual support network are recommended for mitigating caregivers' distress. IMPACT This study adapted a reliable DT-C to measure distress of caregivers, which has the potential to be introduced to caregivers of other types of child and adolescent mental disorders in research, assessments and care planning for health professionals.
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Affiliation(s)
- Xiaoling Bai
- Nursing Department of Guizhou Provincial People's Hospital, Guiyang, China
| | - Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Wendy Cross
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Vic, Australia
| | - Louisa Lam
- School of Nursing and Healthcare Professions, Federation University Australia, Berwick, Vic, Australia
| | - Virginia Plummer
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.,Peninsula Health, Mornington, Vic., Australia
| | - Ziyao Guan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Mahatme NS, Kakunje A, Karkal R. Comparison of maternal stress and psychiatric morbidity among mothers of children having psychiatric disorders and those of typically developing children. Indian J Psychiatry 2020; 62:707-712. [PMID: 33896978 PMCID: PMC8052877 DOI: 10.4103/psychiatry.indianjpsychiatry_733_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/07/2020] [Accepted: 05/03/2020] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Motherhood is regarded to be stressful, but when the child has a psychiatric illness, the mother is affected more than the father since she is the primary caregiver. She gets affected not only emotionally but also psychologically. Increasing severity of stress in mothers may lead to negative outcome on a child's care. AIMS The aim of this study was to evaluate the stress levels in mothers of children diagnosed with psychiatric disorder and to study the association between children having a psychiatric disorder and the psychiatric morbidity in their mothers. MATERIALS AND METHODS This was a case-control study with a total of 150 participants, in which 75 consecutive mothers of children were diagnosed with any psychiatric illness using ICD-10 criteria and compared to 75 mothers of typically developing children. The study was approved by the Institutional Ethics Committee. The Parental Stress Scale and the Mini-International Neuropsychiatric Interview-Plus questionnaire were used for assessments. RESULTS The study showed statistically significant stress scores (49.54) in mothers having children diagnosed with psychiatric illnesses as compared to scores (30.98) in mothers of normally developing children. Psychiatric morbidity in cases (n = 58; 77.3%) was statistically significant as compared to controls (n = 23; 30.6%). Depression and anxiety were among the most common psychiatric morbidities evaluated, and the highest was for mothers having children with severe mental retardation. CONCLUSION In all children with psychiatric disorders, mothers have to be screened for psychiatric morbidity to prevent, detect, and manage it at the earliest.
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Affiliation(s)
- Nupur Shashank Mahatme
- Department of Psychiatry, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Anil Kakunje
- Department of Psychiatry, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
| | - Ravichandra Karkal
- Department of Psychiatry, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka, India
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Rexhaj S, Monteiro S, Golay P, Coloni-Terrapon C, Wenger D, Favrod J. Ensemble programme for early intervention in informal caregivers of psychiatric adult patients: a protocol for a randomised controlled trial. BMJ Open 2020; 10:e038781. [PMID: 32737097 PMCID: PMC7394301 DOI: 10.1136/bmjopen-2020-038781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Informal caregivers play a major role in the support and maintenance of community patients with severe psychiatric disorders. A pilot study showed that an individualised brief intervention such as the Ensemble programme leads to significant improvements in psychological health state and optimism. METHODS AND ANALYSIS This randomised controlled trial aims to compare the efficacy of using Ensemble in improving informal caregivers' psychological health states and the ability to play an active role in their situations with that of support as usual. Improvements on the psychological health global index will be measured three times (T0-pre, T1-post and T3 2 months follow) with standardised questionnaires (the Global Severity Index of Brief Inventory Symptoms, the Life Orientation Test-Revised, the 36-item Medical Outcome Study Short-Form Health Survey and the French Zarit Burden Interview). Differences between groups in post-test and pretest values will be examined using an analysis of covariance for each outcome variable. The severity of illness measured by the Social and Occupational Functioning Assessment Scale will also be collected at T0 and T2 to compare eventual patient improvements. At the end of the programme, the experiences of the 20 patients participating in the Ensemble programme will be evaluated qualitatively. ETHICS AND DISSEMINATION The research protocol received full authorisation from the Human Research Ethics Committee of the Vaud state, Switzerland. The principal paper will concern the results of the experimental design used to test the Ensemble programme. The research team will prioritise open access publications. TRIAL REGISTRATION NUMBER NCT04020497.
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Affiliation(s)
- Shyhrete Rexhaj
- La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland, HES-SO, Lausanne, Vaud, Switzerland
| | - Shadya Monteiro
- La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland, HES-SO, Lausanne, Vaud, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne, CHUV, Lausanne, VD, Switzerland
| | - Claire Coloni-Terrapon
- La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland, HES-SO, Lausanne, Vaud, Switzerland
| | - Daniel Wenger
- La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland, HES-SO, Lausanne, Vaud, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland, HES-SO, Lausanne, Vaud, Switzerland
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Yu Y, Liu ZW, Li TX, Li YL, Xiao SY, Tebes JK. Test of the stress process model of family caregivers of people living with schizophrenia in China. Soc Sci Med 2020; 259:113113. [PMID: 32646627 DOI: 10.1016/j.socscimed.2020.113113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
Across the world, people living with schizophrenia (PLS) are often cared for by family caregivers. This is especially true in China where community-based systems of care for PLS are underdeveloped. Thus, family caregivers of PLS may experience emotional distress and burden in the absence of community-based services. Pearlin (1990) proposed a highly influential model for understanding the stress process and its relationship to health and wellbeing. Although the model has been examined worldwide, it has yet to be studied in China for caregivers of PLS. In the present study, we use Pearlin's stress process model to examine the mediating effect of perceived caregiver burden, family functioning, and caregivers' positive feelings about caregiving on PLS global functioning and caregiver depressive symptoms. We also examine whether the model differs for parent and spouse caregivers. A total of 327 primary family caregivers of PLS in Hunan province, China, were assessed cross-sectionally using culturally-validated measures. Bootstrap methods with Hayes's PROCESS Macro were used to test multiple mediation models of global functioning scores of PLS and caregiver depressive symptoms. In this first study of the stress process model of family caregivers of PLS in China, the results generally support the model. Caregiver perceived burden, family functioning, and positive caregiver feelings about caregiving all mediate the relationship between PLS global functioning and caregiver depression, with perceived caregiver burden having the strongest indirect effect. Analyses also show that the stress process differs between parent and spouse caregivers, with perceived caregiver burden a mediator for both groups but family functioning only a mediator for parent depressive symptoms. We discuss implications of these findings for extending the stress process model cross-culturally; suggest hypotheses for future research to examine parent and spouse differences; and discuss fruitful directions for intervention.
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Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China; Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
| | - Zi-Wei Liu
- Department of Preventive Medicine, School of Medicine, Hunan Normal University, Tongzipo Road 172, Changsha, Hunan, 410008, China.
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Yi-Lu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
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Selvakumar N, Panicker AS. Stress and Coping Styles in Mothers of Children with Autism Spectrum Disorder. Indian J Psychol Med 2020; 42:225-232. [PMID: 32612326 PMCID: PMC7320725 DOI: 10.4103/ijpsym.ijpsym_333_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/24/2019] [Accepted: 03/12/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) require well-balanced care and a comprehensive therapeutic approach. Mental health problems often go unnoticed in mothers of children with ASD due to the focus on training for the children. The presence of stress and depressive symptoms in mothers can interfere with the quality of care and therapy given to the child. The present study aimed to assess the quality of life, coping styles, and symptoms of depression, anxiety, and stress in mothers of children with ASD. METHODS This study recruited thirty mothers of children with ASD, to whom Depression, Anxiety and Stress Scale (DASS 21), WHO Quality of Life Scale (WHOQOL-BREF), and COPE Inventory were administered. RESULTS Results indicated the presence of depressive and anxiety symptoms and impaired quality of life among the mothers. Despite this, they exhibited positive coping styles. CONCLUSION As part of a comprehensive intervention for children with ASD, there is also a need to address the psychological distress and coping styles of mothers.
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Affiliation(s)
- Nivedhitha Selvakumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India
| | - Anuja S Panicker
- Department of Psychiatry, PSG Institute of Medical Sciences and Research (PSGIMSR), Coimbatore, Tamil Nadu, India
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Yu Y, Liu ZW, Li TX, Zhou W, Xi SJ, Xiao SY, Tebes JK. A comparison of psychometric properties of two common measures of caregiving burden: the family burden interview schedule (FBIS-24) and the Zarit caregiver burden interview (ZBI-22). Health Qual Life Outcomes 2020; 18:94. [PMID: 32252766 PMCID: PMC7137330 DOI: 10.1186/s12955-020-01335-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/19/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The Family Burden Interview Schedule (FBIS-24) and the Zarit Caregiver Burden Interview (ZBI-22) are among the most widely used measures for assessing caregiving burden, but their psychometric performances have not been compared in the same study of caregivers of people living with schizophrenia (PLS). This is important because the measures assess overlapping constructs- the FBIS-24 assesses objective burden (e.g., completion of manual tasks) and the ZBI-22 assesses subjective burden (e.g., perceived distress, stigma). This study seeks to fill this gap by comparing the reliability and validity of the FBIS-24 and the ZBI-22 in a Chinese community sample of caregivers of PLS. Methods A Cross-sectional stud was conducted in a community-based mental health service program in Central South part of China. A total of 327 primary family caregivers of PLS completed face-to-face interviews of the FBIS-24, the ZBI-22, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the Family Adaptation, Partnership, Growth, Affection and Resolve Index scale (APGAR), and PLS were assessed using the Global Assessment of Function scale (GAF). Results Our findings show that both the FBIS-24 and ZBI-22 have comparable psychometric performance in terms of the internal consistency, convergent validity and known group’s validity. Conclusion Both the FBIS-24 and the ZBI-22 are psychometrically sound measures of caregiving burden but the choice of which measure to use will depend on the research question.
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Affiliation(s)
- Yu Yu
- Hospital Evaluation Office, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.,Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
| | - Zi-Wei Liu
- School of Medicine, Hunan Normal University, 371 Tongzhi Road, Changsha, Hunan, 410013, China
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China
| | - Shi-Jun Xi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Mental Health Center, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA
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Dixon De Silva LE, Ponting C, Ramos G, Guevara MVC, Chavira DA. Urban Latinx parents' attitudes towards mental health: Mental health literacy and service use. CHILDREN AND YOUTH SERVICES REVIEW 2020; 109:104719. [PMID: 37842164 PMCID: PMC10575228 DOI: 10.1016/j.childyouth.2019.104719] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Latinx youth report elevated internalizing symptomatology as compared to their non-Latinx White counterparts and are less likely to access mental health care for these problems. This qualitative study examined the knowledge, beliefs and perceptions that Latinx parents (86% foreign-born; 66.7% monolingual Spanish speakers) living in urban communities have about mental health and service use for anxiety and depression in children. We used thematic analysis to analyze interview data from 15 Latinx parents who expressed concerns about their child's (age 6-13) worry or sadness. Analyses revealed that Latinx parents often have difficulty identifying mental health problems, report stigma about mental health problems and help-seeking and want more information about how they can help their children. Although Latinx parents report significant mental health and treatment-seeking stigma, the majority were open to seeking mental health services for their children or were already receiving services. Findings suggest that stigma although prevalent, may not deter service utilization for some Latinx families. Implications for community health and future research are discussed.
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Affiliation(s)
| | - Carolyn Ponting
- Department of Psychology, University of California Los Angeles
| | - Giovanni Ramos
- Department of Psychology, University of California Los Angeles
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Savitz AJ, Xu H, Gopal S, Nuamah I, Mathews M, Soares B. Efficacy and safety of paliperidone palmitate 3-month formulation in Latin American patients with schizophrenia: A subgroup analysis of data from two large phase 3 randomized, double-blind studies. ACTA ACUST UNITED AC 2020; 41:499-510. [PMID: 30994855 PMCID: PMC6899357 DOI: 10.1590/1516-4446-2018-0153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 11/26/2018] [Indexed: 11/24/2022]
Abstract
Objective: To analyze the efficacy and safety of paliperidone palmitate 3-monthly (PP3M) in Latin American patients with schizophrenia vs. rest-of-world (ROW). Methods: We analyzed data from two multinational, double-blind (DB), randomized, controlled phase 3 studies including patients with schizophrenia (DSM-IV-TR) previously stabilized on PP1M/PP3M (open-label [OL] phase). Patients were randomized to PP3M or PP1M (noninferiority study A) and PP3M or placebo (study B) in DB phase. The subgroup analysis included Latin American (Argentina, Brazil, Colombia, Mexico) patients. Primary efficacy endpoints were relapse-free rates (study A) and time-to-relapse (study B). Results: In study A, 63/71 (88.7%) and in study B 38/43 (88.4%) Latin American patients completed the DB phase. In study A, relapse-free percentage was similar in Latin America (PP3M: 97%, PP1M: 100%) and ROW (PP3M: 91%, PP1M: 89%). In study B, median time-to-relapse was not estimable in the Latin American subgroup for either placebo or PP3M groups, nor for the ROW PP3M group; the median time-to-relapse in the ROW placebo group was 395 days. Caregiver burden improved in patients switching from oral antipsychotics (OL baseline) to PP3M/PP1M in DB phase (Involvement Evaluation Questionnaire score mean ± SD change, -9.4±15.16; p < 0.001). Treatment emergent adverse events with PP3M during DB phase were similar in Latin America (study A: 24/34 [70.6%]; study B: 15/21 [71.4%]) and ROW (study A: 318/470 [67.7%]; study B: 84/139 [60.4%]) subgroups. Conclusion: PP3M was efficacious and showed no new safety concerns in patients with schizophrenia from Latin America, corroborating ROW findings. Clinical trial registration: NCT01515423, NCT01529515
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Affiliation(s)
- Adam J Savitz
- Janssen Research & Development, LLC, Pennington, NJ, USA
| | - Haiyan Xu
- Janssen Research & Development, LLC, Pennington, NJ, USA
| | - Srihari Gopal
- Janssen Research & Development, LLC, Pennington, NJ, USA
| | - Isaac Nuamah
- Janssen Research & Development, LLC, Pennington, NJ, USA
| | - Maju Mathews
- Janssen Research & Development, LLC, Titusville, NJ, USA
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Rivera-Segarra E, Varas-Díaz N, Santos-Figueroa A. "That's all Fake": Health professionals stigma and physical healthcare of people living with Serious Mental Illness. PLoS One 2019; 14:e0226401. [PMID: 31851706 PMCID: PMC6919598 DOI: 10.1371/journal.pone.0226401] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 11/26/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND People living with a Serious Mental Illness (SMI) die earlier than the general population due to preventable medical conditions. Latinos living with SMI are a particularly vulnerable population with higher prevalence of chronic medical conditions. Stigma has been identified as a factor that fosters health inequities for Latinos/as with SMI, particularly Puerto Ricans. Although personal and social consequences of stigmatization have been well documented, research regarding the role of cultural factors on healthcare interactions is scarce. Furthermore, little research has focused on addressing stigma from the perspective of healthcare professionals. METHODS We investigated this process through a qualitative design using semi-structured individual interviews with 11 healthcare professionals (8 physicians and 3 nurses) in Puerto Rico. We conducted a thematic analysis to analyze the data. RESULTS Following a thematic analysis, we found three main themes and nine sub-themes related to the stigmatization process. Some participants reported perceptions of dangerousness and uneasiness, social distance and inadequate care. Participants also emphasized a lack of medical training regarding SMI within the Puerto Rican context. CONCLUSIONS These findings support the need to develop culturally appropriate public health interventions targeting healthcare professionals in order to address stigma and eliminate health disparities among Latinos/as with SMI.
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Affiliation(s)
- Eliut Rivera-Segarra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- * E-mail:
| | - Nelson Varas-Díaz
- Department of Global and Sociocultural Studies, Florida International University, Miami, United States of America
| | - Axel Santos-Figueroa
- Department of Psychology, University of Puerto Rico, Mayagüez Campus, Mayagüez, Puerto Rico
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Gandhi S, Palled VK, Sahu M, Jagannathan A, Khanna M, Jose A. Effectiveness of Caregivers' Yoga Module on Psychological Distress and Mental Well-Being among Caregivers of Patients Admitted to Neurological Rehabilitation Wards of a Tertiary Care Institute, Bengaluru, Karnataka, India. J Neurosci Rural Pract 2019; 10:657-665. [PMID: 31831987 PMCID: PMC6906090 DOI: 10.1055/s-0039-3399613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background
Caregivers of patients admitted to neurorehabilitation wards may experience higher psychological distress (PD) and poor mental well-being (MWB). This study aimed to empower caregivers to cope effectively with PD and maintain well-being by practicing yoga.
Materials and Methods
A total of 34 caregivers were randomized to the experimental group (EG) and waitlisted control group in a multiphase manner. Data were collected using sociodemographic schedule, Kessler’s Psychological Distress scale–10, and Warwick–Edinburgh’s Mental Well-being Scale. Caregivers’ yoga module (CYM) consisting of
satsanga
(theory),
asanas
(postures),
pranayama
(breath control), imagery, meditation, and relaxation techniques was taught to those in the EG at 35 m/d for eight consecutive days. They were encouraged to continue on their own for another 3 weeks. Posttest data were collected from both groups on the 15th and 29th days. Analysis was done with IBM SPSS statistics version 22 (IBM Corp., Armonk, New York, United States).
Results
There was statistically significant reduction of PD and improvement of MWB among caregivers of EG within (PD:
F
= 17.78,
p
< 0.001; MWB:
F
= 5.48,
p
< 0.03) and between (PD:
F
= 15.87,
p
< 0.001; MWB:
F
= 15.87,
p
< 0.01) the groups after the CYM. A significant negative correlation was found between pretest MWB and PD (
r
=–0.579,
p
< 0.01). Caregivers who were married and caregivers’ perception of poor improvement of patient condition were significantly associated with PD.
Conclusion
Findings provide preliminary evidence for the effectiveness of CYM on PD and MWB among caregivers of patients admitted to neurorehabilitation wards.
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Affiliation(s)
- Sailaxmi Gandhi
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Vinaya Kumar Palled
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Maya Sahu
- Department of Nursing, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Aarti Jagannathan
- Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Meeka Khanna
- Neuro Rehabilitation, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
| | - Amrutha Jose
- Department of Biostatistics, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India
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Depressive Symptoms and Sexually Transmitted Disease: Evidence from a Low-Income Neighborhood of New York City. Community Ment Health J 2019; 55:1147-1151. [PMID: 31073663 DOI: 10.1007/s10597-019-00405-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 05/06/2019] [Indexed: 02/05/2023]
Abstract
We examined the association between sexually transmitted disease (STD) and depressive symptoms. Our analysis utilized the 2015 cross-sectional Washington Heights Community Survey. Multivariable binary logistic regression analysis was used to examine the primary association between having a history of STD and patient health questionnaire-9 (PHQ-9) score while adjusting for potential confounders. Then in separate models, we adjusted for the interaction of social factors with PHQ-9 score to test for modification effect on the primary association. In this low-income neighborhood, STD history was not significantly associated with PHQ-9 score in the overall logistic regression model for the primary association. However, in interaction models, STD and depressive symptoms were associated in sub-groups defined by social factors, namely being Hispanic [odds ratio (OR) 1.08; 95% confidence interval (CI) 1.02-1.15], foreign-born (OR 1.08; 95% CI 1.02-1.15), and having low to moderate social support (OR 1.09; 95% CI 1.02-1.15). Our results demonstrate a need for targeted interventions to be applied to vulnerable subgroups identified.
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Handi A, Gultom DP, Husada MS, Loebis B, Effendy E, Amin MM, Camellia V, Nasution NM. The Comparison of Hospital Anxiety and Depression Scale-Anxiety Scores between Female Caregivers of People with Schizophrenia According to Gender Difference. Open Access Maced J Med Sci 2019; 7:2630-2633. [PMID: 31777621 PMCID: PMC6876818 DOI: 10.3889/oamjms.2019.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Caregiver plays an important role for a better outcome in people with schizophrenia, although it usually causes emotional distress for the caregiver. Anxiety is one of the emotional distress. Gender of schizophrenic patients is associated with the emotional distress of caregiver. The differences in HADS-A scores between female caregivers of people with schizophrenia according to gender in Indonesia remain unclear. AIM: To determine whether HADS-A scores are higher in a male group compare with the female group. METHODS: This study was an analytical study with a cross-sectional approach to determine the comparison of HADS-A score between 27 female caregivers of male schizophrenic patients (male group) and 27 female caregivers of female schizophrenic patients (female group) in Prof. Dr M. Ildrem Mental Hospital Medan, using a HADS rating scale. RESULTS: There is no difference between the male and female group in caregivers age, marital status, employment status, family income/month, education time, the relationship with people with schizophrenia, caring time, time spent / weeks, and the patients age, employment status, education time, PANSS score and number of relapses. The comparison between total HADS-A score between the male group and the female group is not significant with 9.52 ± 4.90 v 8.70 ± 4.49 (p = 0.53). CONCLUSION: HADS-A scores are not higher in caregivers of male with schizophrenia compared with caregivers of a female with schizophrenia.
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Affiliation(s)
- Andrew Handi
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dapot Parulian Gultom
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Muhammad Surya Husada
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Bahagia Loebis
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Elmeida Effendy
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Mustafa Mahmud Amin
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Vita Camellia
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Kumar G, Sood M, Verma R, Mahapatra A, Chadda RK. Family caregivers' needs of young patients with first episode psychosis: A qualitative study. Int J Soc Psychiatry 2019; 65:435-442. [PMID: 31190603 DOI: 10.1177/0020764019852650] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The caregivers of patients with first episode psychosis (FEP) experience significant distress. It is important to understand their needs to plan adequate interventions for them. AIM The aim of this study was to explore the needs of caregivers of young patients with FEP in India, using a qualitative approach. METHODS The study was conducted in two phases. In phase I, a script for conducting focus group discussions (FGDs) with caregivers was developed, based on literature search and expert opinion generated from FGD with mental health professionals. In phase II, five FGDs were conducted with 30 caregivers of young patients with FEP having minimal of 6 participants in each FGD. Data was analyzed using principles of grounded theory. RESULTS Seven broad themes and subthemes of the needs of caregivers emerged from the FGDs. The final themes, which highlighted the needs of caregivers of young patients with FEP, were (in order of ranking) as follows: information regarding treatment, information regarding illness, services provided by the government, optimum quality of care from treatment facility, management of psychosocial issues related to patient's illness, availability and accessibility of treatment, and identification and recognition of mental health and physical problems in family members. CONCLUSION Qualitative method was useful to identify the needs of the caregivers of young patients with FEP in multiple domains.
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Affiliation(s)
- Ganesh Kumar
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Mamta Sood
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rohit Verma
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Ananya Mahapatra
- 2 Dr. Ram Manohar Hospital and Postgraduate Institute of Medical Education and Research, New Delhi, India
| | - Rakesh Kumar Chadda
- 1 Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Oñate L, Calvete E. The moderating role of age in the relationship between different stressors and the quality of life of the relatives of people with intellectual disabilities. Qual Life Res 2019; 28:2969-2978. [PMID: 31250337 DOI: 10.1007/s11136-019-02239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The level of support needed for adaptive functioning and behavioral problems of individuals with intellectual disabilities (ID) can be a source of stress for caregivers. The aim of this study was to explore the moderating role of caregivers' age on the associations between these stressors and quality of life (QoL) of the family caregivers. As these sources of stress in people with ID can coexist, the triple interaction between stressors and age was also examined. METHODS 208 relatives (mean age = 50.98 years, SD = 12.86) of people with ID participated in the research. Participants answered a questionnaire with sociodemographic variables, measures of stressors (level of support for adaptive functioning of the people with ID and behavioral problems) and measures of QoL (WHOQOL-BREF). RESULTS The association between the level of support needed for adaptive functioning and lower QoL was only significant among older relatives, whereas the association between behavioral problems and lower QoL was only significant among younger relatives. A three-way interaction between behavioral problems, level of support needed, and age indicated that the association between the level of support for adaptive functioning and QoL in older relatives was greater when there were higher levels of behavioral problems. CONCLUSIONS The role of caregivers' age in their QoL differs depending on the nature of the stressor, and an accumulation of stressors can have a particularly negative impact on older caregivers. Interventions should be adapted for caregivers of different ages and take into account the particular sources of stress they have to cope with.
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Affiliation(s)
- Lucía Oñate
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Apdo. 1, 48080, Bilbao, Biscay, Spain.
| | - Esther Calvete
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Apdo. 1, 48080, Bilbao, Biscay, Spain
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42
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The Influence of Social Support and Care Burden on Depression among Caregivers of Patients with Severe Mental Illness in Rural Areas of Sichuan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111961. [PMID: 31159499 PMCID: PMC6603995 DOI: 10.3390/ijerph16111961] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
Depression is one of the most common psychological consequences of caregiving. Caring for patients with severe mental illness (SMI) adds significant challenges to family caregivers’ mental health. The purpose of this study was to describe the prevalence of depression among caregivers of SMI patients in rural areas of Sichuan province of China, to examine the influence of social support and care burden on depression, and to explore the intermediary effect of care burden between social support and depression among caregivers of SMI patients. Data were collected from 256 primary caregivers of SMI patients in rural Sichuan Province in China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. We found that a total of 53.5% of caregivers had depression. Both care burden (β = 0.599, 95%CI: 0.392–0.776) and social support (β = −0.307, 95%CI: (−0.494)–(−0.115)) were directly related to depression, while social support had a direct association with care burden (β = −0.506, 95%CI: (−0.672)–(−0.341)). Care burden mediated the relationship between social support and depression. For the socio-demographic variables, gender, education level and per capita annual income of household had significant correlations with depression (p < 0.05). The results strongly demonstrated that social support and care burden were predictors of depression, especially social support. Policymakers should fully recognize the role of primary family caregivers in caring for SMI patients and promote interventions to decrease care burden and reduce caregivers’ depression by improving social support and network. More attention should be given to female caregivers and caregivers with lower education and lower household income levels.
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Abstract
OBJECTIVES To explore Australian mental health carers' prioritisation of key elements of caregiving and establish the extent to which particular issues contribute to carer burden. DESIGN Cross-sectional survey. SETTING All Australian States and Territories. PARTICIPANTS Responses were received from 231 Australian mental health caregivers. MAIN OUTCOME MEASURES The Involvement Evaluation Questionnaire was used to assess caregiver burden. RESULTS Smallest space analysis identified three distinct regions, which we conceptualise as: 1) promoting the safety and health of mental health consumers; 2) impact of caring on caregivers' personal lives and 3) enabling daily living functional recovery of mental health consumers. The analysis demonstrates that carers are most concerned with enabling daily living functional recovery, for which the mean value was considerably higher than the personal impact and promoting safety and health regions. In terms of the individual questionnaire items, the issues of most importance are assisting with self-care, worrying about consumers' future, finances and general health, encouraging consumer involvement in activities and concerns over the treatment consumers are receiving. CONCLUSION Caregiving often came at significant personal cost. The burden that results from caring for mental health consumers could perhaps be alleviated through the expansion of psychiatric disability services, increasing government financial support and providing tailored psychosocial interventions that meet the needs of families.
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Affiliation(s)
- Paul Morrison
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - Norman Jay Stomski
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
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44
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Yu W, Chen J, Hu J, Hu J. Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia. FAMILY PROCESS 2019; 58:370-383. [PMID: 29363737 DOI: 10.1111/famp.12340] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross-sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis-stress perspective. Goodness-of-fit indices (χ2 /df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis-stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden.
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Affiliation(s)
- Wenjun Yu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, GuangZhou, China
- College of Education, JingGangShan University, Ji'An, China
| | - Jia Chen
- Education Center of Master of Social Work, JingGangShan University, Ji'An, China
| | - Jize Hu
- College of Psychology and Sociology, ShenZhen University, ShenZhen, China
| | - JingChu Hu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, GuangZhou, China
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45
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Salamin V, Ray P, Gothuey I, Corzani S, Martin-Soelch C. An Internet-Based Intervention for the Relatives of People with Mental Illnesses. SWISS JOURNAL OF PSYCHOLOGY 2019. [DOI: 10.1024/1421-0185/a000219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Abstract. Relatives of individuals with mental illness are exposed to an elevated level of burden. Consequently, it is important to provide them with coping strategies. We explored the benefits of an online skills-training intervention. This open, uncontrolled interventional pilot study included 104 relatives of individuals with a mental illness. They participated either in a face-to-face group ( n = 60) or online intervention ( n = 44); participants were free to choose the type of intervention. Depressive symptoms and emotion regulation were assessed before and after the interventions. The analysis was based on an intention-to-treat model. About one-third of both samples did not complete the posttest assessments. The results of a multivariate analysis of variance revealed a significant effect of the interaction between time and intervention type, F(2,101) = 11.77, p < .01. Reductions in depressive symptoms, F(1,102) = 9.41, p < .01, ε2p = .08, and emotion-regulation difficulty, F(1,102) = 8.01, p < .01, ε2p = .07, following the online intervention were greater relative to the group intervention. Despite the limitations of this study because of group differences, the results demonstrated the benefits of an online intervention for the relatives. These encouraging initial results require further confirmation using a randomized controlled trial.
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Affiliation(s)
| | - Philippe Ray
- Fribourg Mental Health Network, Fribourg, Switzerland
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46
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Stomski NJ, Morrison P. Predictors of burden in Australian mental health caregivers: a cross-sectional survey. J Ment Health 2019; 30:411-416. [PMID: 30862222 DOI: 10.1080/09638237.2019.1581340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The shift towards providing mental healthcare in the community has resulted in caregivers becoming more involved in the delivery of these services. Supporting mental health consumers can be burdensome which, in conjunction with the anguish that may result from observing their relative develop a mental illness, can lead to carers experiencing significant levels of distress. AIMS This study aimed to quantify the extent to which specific aspects of caregiving contribute to mental health burden in Australia. METHODS Participants were included if they were Australian mental health caregivers. An online questionnaire was distributed via email. Multivariate logistic regression was used to identify predictors of burden in mental health caregivers. RESULTS Completed questionnaires were collected from 231 respondents. The logistic regression analysis yielded five factors that contributed significantly to mental health caregiver burden. Of these factors, a strained atmosphere and regularly carrying out tasks for consumers were the two strongest predictors of burden. CONCLUSION Community health professionals could focus on interpersonal relationships between family members, access to disability and financial support services, and carers' views about the quality of healthcare provided to consumers. Addressing these issues may decrease carer burden and improve the quality of life for all family members.
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Affiliation(s)
- N J Stomski
- College of Science, Health, Engineering, and Education, Murdoch University, Perth, Australia
| | - P Morrison
- College of Science, Health, Engineering, and Education, Murdoch University, Perth, Australia
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47
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Molina Y, Henderson V, Ornelas IJ, Scheel JR, Bishop S, Doty SL, Patrick DL, Beresford SAA, Coronado GD. Understanding Complex Roles of Family for Latina Health: Evaluating Family Obligation Stress. FAMILY & COMMUNITY HEALTH 2019; 42:254-260. [PMID: 31403986 PMCID: PMC6693639 DOI: 10.1097/fch.0000000000000232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We developed a measure of family obligation stress and compared its relationship to health and unmet health care needs relative to social support among a sample of US-based Latinas. Data come from a randomized controlled trial within 4 clinics to increase mammography among Latinas (n = 539). The 1-factor measure had acceptable reliability and construct validity. Family obligation stress was associated with worse health and greater unmet health care needs. Family obligation stress varied by years in the United States and country of origin. Our measure of family obligation stress contributes new venues to family research among Latino populations.
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Affiliation(s)
- Yamilé Molina
- Community Health Sciences Division, School of Public Health, University of Illinois at Chicago (Dr Molina); University of Illinois Cancer Center, Chicago (Dr Henderson); Departments of Health Services (Drs Ornelas and Patrick) and Epidemiology (Dr Beresford), School of Public Health, University of Washington, Seattle; Department of Radiology, School of Medicine, University of Washington, Seattle (Dr Scheel); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (Ms Bishop); Health Education Program Coordinator, Sea Mar Community Health Centers, Seattle, Washington (Ms Doty); and Kaiser Permanente Research Center for Health Research, Portland, Oregon (Dr Coronado)
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48
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Lovell B, A Wetherell M. Caregivers' characteristics and family constellation variables as predictors of affiliate stigma in caregivers of children with ASD. Psychiatry Res 2018; 270:426-429. [PMID: 30316169 DOI: 10.1016/j.psychres.2018.09.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 10/28/2022]
Abstract
Affiliate stigma is one risk factor for psychological distress in familial caregivers. Few studies however, and none involving caregivers in the UK and US, have explored caregivers' characteristics and family constellation variables as risk and protective factors for affiliate stigma. This study aimed to fill this gap. Moreover, we believe this study is only second to explore these relationships among caregivers of children with autism spectrum disorder (ASD), a group particularly vulnerable to affiliate stigma. A sample of n = 192 caregivers of children with ASD completed an online survey assessing caregivers' characteristics and family factors, and affiliate stigma. Non-partnered caregivers were more likely to report affiliate stigma, as were caregivers with shorter sleep duration. These findings might help clinicians and other health professionals identify caregivers at risk for affiliate stigma and concomitant psychological distress.
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Affiliation(s)
- Brian Lovell
- Northumbria University, Northumberland Road Newcastle upon Tyne NE1 8ST, United Kingdom.
| | - Mark A Wetherell
- Northumbria University, Northumberland Road Newcastle upon Tyne NE1 8ST, United Kingdom.
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49
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Applying psychoeducational program on general health and communication skills in caregivers of patients with schizophrenia: A randomized controlled trial. EUROPEAN JOURNAL OF PSYCHIATRY 2018. [DOI: 10.1016/j.ejpsy.2018.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Prevalence and Associated Factors of Mental Distress among Caregivers of Patients with Epilepsy in Ethiopia: A Cross-Sectional Study Design. PSYCHIATRY JOURNAL 2018; 2018:2819643. [PMID: 30363640 PMCID: PMC6180922 DOI: 10.1155/2018/2819643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/06/2018] [Indexed: 11/24/2022]
Abstract
Background Caregiving to individuals with mental illness is a broad responsibility, including not only practical help and care but also emotional support. Cross-sectional studies in different localities suggested a significant burden of mental distress among caregivers of patients with epilepsy, but we are not aware about the condition in Ethiopia. Therefore, the aim of the current study is to assess the prevalence and associated factors of mental distress among caregivers of patients with epilepsy in Ethiopia. Methods An institutional based cross-sectional study was conducted in Neuropsychiatric Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Using systematic random sampling technique, 409 caregivers participated in the study. Data was collected by face to face interview using standardized and validated Kessler Psychological Distress Scale (K-10) to assess mental distress. Descriptive, bivariate, and multivariate logistic regression models were used for analysis. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) was used to show the odds, and P-value < 0.05 was considered as statistically significant. Results The mean age of respondents was 43.3 years with standard deviation of ±11.4 years. Two hundred eighteen (53.3%) of the respondents were male. The prevalence of mental distress was found to be 27.1% with 95% CI [22.6-31.1]. Relationship with patient of being mother [AOR: 5.67, 95% CI: (1.68-13.70)], father [AOR: 4.42, 95% CI: (1.25-12.58)], wife/husband [AOR: 10.59, 95% CI: (2.43-14.19)], and child [AOR: 5.37, 95% CI: (1.27-12.69)]; caring for young person below 20 years of age [AOR: 4.00, 95% CI: (1.43-11.21)]; poor social support [AOR: 7.26, 95% CI: (3.60-14.65)]); and experienced stigma [AOR: 3.03, 95% CI: (1.63-5.66)] were statistically and significantly associated factors of mental distress among caregivers of patients with epilepsy. Conclusion and Recommendation We found a lower prevalence of mental distress among caregivers of patients with epilepsy compared to other low- and middle-income settings. Being caring for young patients, being parents to the patient, poor social support, and stigma were statistically significant associated factors of mental distress among caregivers. Therefore, appropriate psychosocial interventions are warranted to be designed and implemented emphasizing the aforementioned associated factors.
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