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Chai YC, Mahadevan R, Ng CG, Chan LF, Md Dai F. Caregiver depression: The contributing role of depression in patients, stigma, social support and religiosity. Int J Soc Psychiatry 2018; 64:578-588. [PMID: 30074421 DOI: 10.1177/0020764018792585] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Depression has been well studied as part of caregiver burden among patients with severe mental illnesses. Curiously, though, there has been little data in terms of caregiver burden with specific focus on depression among caregivers of patients with major depressive disorder (MDD). AIM This study aims to determine the rate of depression among caregivers of person with depression and its psychosocial correlates, which include stigma, perceived social support, religious commitment and the severity of the patient's symptoms. METHODS A cross-sectional study was conducted among 165 patients diagnosed with MDD using the Mini-International Neuropsychiatric Interview (M.I.N.I.) together with their caregivers. Apart from gathering social demographic data, patients were administered the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated Version (QIDS-SR 16), whereas the caregivers were required to answer Patient Health Questionnaire-9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), Duke University Religion Index (DUREL) and Depression Stigma Scale (DSS). Those who scored ⩾5 on PHQ-9 were further assessed with interviewer-rated M.I.N.I. to diagnose the presence of depression. RESULTS A total of 47 (28.5%) caregivers were found to have depressive symptoms. Out of that total, 13 (7.9%) were diagnosed to have MDD using M.I.N.I. From univariate analysis, factors associated with depression in caregivers were the severity of symptoms in patients ( p < .001), personal stigma in caregivers ( p = .037), the patients' current depressive episode ( p = .026) and lower perceived social support from friends ( p = .048). From multivariate analysis, only the patients' severity of depressive symptoms ( p < .001) and personal stigma in caregivers ( p = .048) were significantly associated with the caregivers' depressive symptoms. CONCLUSION Our findings suggested that the severity of patient depression and personal stigma of the caregivers were significant factors correlated with caregiver depression. Therefore, beyond optimizing the treatment of depression in patients, the issue of stigma among caregivers also needs to be addressed as a potential target of intervention.
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Affiliation(s)
- Yee Chin Chai
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.,2 Department of Mental Health and Psychiatry, Hospital Sultanah Aminah, Johor Bahru, Malaysia
| | - Raynuha Mahadevan
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chong Guan Ng
- 3 Department of Psychological Medicine, Faculty of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Lai Fong Chan
- 1 Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Farahidah Md Dai
- 2 Department of Mental Health and Psychiatry, Hospital Sultanah Aminah, Johor Bahru, Malaysia
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Zhang Y, Subramaniam M, Lee SP, Abdin E, Sagayadevan V, Jeyagurunathan A, Chang S, Shafie SB, Abdul Rahman RF, Vaingankar JA, Chong SA. Affiliate stigma and its association with quality of life among caregivers of relatives with mental illness in Singapore. Psychiatry Res 2018; 265:55-61. [PMID: 29684770 DOI: 10.1016/j.psychres.2018.04.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 04/05/2018] [Accepted: 04/12/2018] [Indexed: 12/01/2022]
Abstract
Affiliated stigma often refers to internalized stigma among family members of stigmatized individuals. This study aimed to investigate the relationship between affiliate stigma and quality of life (QOL) among primary caregivers of individuals with mental illness undergoing treatment at the Institute of Mental Health, Singapore. Three hundred and fifty caregivers were recruited for the study. The World Health Organization Quality of Life questionnaire (WHOQOL-BREF) and Family Stigma Scale (FSS) were administered to the primary caregivers of patients with mental illness. Multiple linear regression analyses were conducted to investigate the association of affiliate stigma with QOL. A high proportion of caregivers of individuals with mental illness experience affiliate stigma in Singapore. All four QOL domains were significantly associated with affiliate stigma. These findings entail that it is imperative to improve public's perception of those with mental illness to reduce stigmatization and thus improve caregiver's QOL.
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Affiliation(s)
- Yunjue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore.
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Siau Pheng Lee
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Vathsala Sagayadevan
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | - Saleha Binte Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View Singapore 539747, Singapore
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Panicker AS, Ramesh S. Psychological status and coping styles of caregivers of individuals with intellectual disability and psychiatric illness. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:1-14. [PMID: 29947458 DOI: 10.1111/jar.12496] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 12/17/2017] [Accepted: 05/23/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The psychological status of caregivers of individuals with intellectual disability and psychiatric illness (PI) is important for effective management. The aim of this study was to examine the psychological status and its relationship with coping styles among these caregivers. MATERIALS & METHODS Caregivers (N = 80) of individuals with intellectual disability (n = 40) and PI (n = 40) were administered a socio-demographic questionnaire, depression, anxiety and stress scale and COPE Inventory. RESULTS Caregivers experienced depression, anxiety and stress symptoms. These symptoms were found to be significantly higher among caregivers of individuals with intellectual disability than those with PI. The most common coping style used was religious coping. Use of positive reinterpretation and growth was associated with lower levels of depression and stress symptoms. CONCLUSION Caregivers' mental health plays an important role in the quality of care delivery and outcome. Use of appropriate coping styles can reduce the impact of these symptoms.
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Affiliation(s)
- Anuja S Panicker
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Sonali Ramesh
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
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Yıldız M, İncedere A, Kiras F, Abut FB, Kırcalı A, İpçi K. Development of Self-Stigma Inventory for Families of the patients with schizophrenia (SSI-F): validity and reliability study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1480858] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Mustafa Yıldız
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Aysel İncedere
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Kocaeli, Turkey
| | - Fatma Kiras
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Fatma Betül Abut
- Department of Psychology, Kocaeli University Faculty of Art and Sciences, Kocaeli, Turkey
| | - Ayşe Kırcalı
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Kocaeli, Turkey
| | - Kübra İpçi
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Kocaeli, Turkey
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Abstract
This study examined the views about the future of persons with schizophrenia and their caregivers to understand what is at stake in engaging in recovery. The views of 60 Mexican-origin consumer-caregiver dyads were coded by three independent raters using a recovery literature-based coding system of recovery components: social relations, caregiving burden relief, independence, self-responsibility, and empowerment. General recovery expectations were also rated. Interrater reliability, component frequency, and congruence between the consumers and caregivers' expectations were statistically examined. Dominant recovery components for consumers and caregivers were independence (72.5%), general expectations for recovery (51%), and social relations (43%). Relatives differed in two important ways. Consumers held significantly greater expectations for independence (p < 0.01), whereas caregivers focused more on general recovery (p < 0.001). What matters for recovery for this sample of Mexican-origin consumers and caregivers differs. Addressing differences in views may facilitate person-centered treatment that considers the views of consumers and caregivers.
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The Effectiveness of a Knowledge Translation Cognitive-Educational Intervention for Family Members of Persons Coping with Severe Mental Illness. Community Ment Health J 2018; 54:485-495. [PMID: 28905138 DOI: 10.1007/s10597-017-0169-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
Abstract
Keshet, a course for family members of persons' coping with mental illness, was developed to enhance positive family cognitive communication skills. Improving communication with the use of mediation techniques, primarily used by therapists, creates a learning environment viewed as a strategy of Knowledge Translation. To examine the effectiveness of Keshet in improving attitudes, problem solving, communication skills and attenuation of burden a quasi-experimental research design was applied with study and control condition. The same group of participants (N = 38) completed questionnaires at different stages: 3 months prior to course, initiation and completion. Following participation, significant changes were observed in attitudes regarding knowledge of how to cope and interact with family member. A correlation was found between improved knowledge and decline in burden. Implementing interventions which provide caregivers with professional "know-how" leads to lessened burden, thus contributing to maintaining well-being of family caregiver population.
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Bademli K, Lök N, Kılıç AK. The Relationship Between the Burden of Caregiving, Submissive Behaviors and Depressive Symptoms in Primary Caregivers of Patients With Schizophrenia. Arch Psychiatr Nurs 2018; 32:229-234. [PMID: 29579517 DOI: 10.1016/j.apnu.2017.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/18/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Kerime Bademli
- Akdeniz University, Faculty of Nursing, Psychiatric Nursing Department, Antalya, Turkey.
| | - Neslihan Lök
- Selcuk University, Faculty of Health Science, Konya, Turkey
| | - Ayten Kaya Kılıç
- Antalya Kamu Hastaneleri Birligi Antalya Egitim A, Toplum Ruh Sagligi Merkezi, Antalya, Turkey
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Aylaz R, Yıldız E. The care burden and coping levels of chronic psychiatric patients' caregivers. Perspect Psychiatr Care 2018. [PMID: 28635006 DOI: 10.1111/ppc.12228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PURPOSE This descriptive study was conducted in order to determine care burden of caregivers of chronic psychiatric patients and their levels of coping with stress. METHODS The study was conducted with 134 caregivers of chronic psychiatric patients. The following data collection tools were used: the personal information form, the ZBI and SCI. The study participants were selected from the population by using an improbable random sampling method. RESULTS The average age of the caregivers was 49.95±13.68 and the majority were married and primary school graduates. CONCLUSION This study determined that caregivers experienced a high level of burden. However, while the deal with their difficulties of providing effective care was found to have more coping methods they use.
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Affiliation(s)
- Rukuye Aylaz
- Associate Professor, PhD, Department of Public Health Nursing, the Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Erman Yıldız
- PhD Student, Research Assistant, Department of Psychiatric Nursing, Faculty of Health Sciences, Inonu University, Malatya, Turkey
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Ribé Buitrón JM, Pérez Téstor C, Muros Guijarro R, Nofuentes García C. [Considerations about the interpretation of the Zarit scale in caregivers of patients with schizophrenia]. Aten Primaria 2018; 50:443-444. [PMID: 29551262 PMCID: PMC6837076 DOI: 10.1016/j.aprim.2017.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/04/2017] [Accepted: 10/19/2017] [Indexed: 12/11/2022] Open
Affiliation(s)
- José Miguel Ribé Buitrón
- Institut Universitari Salut Mental Vidal i Barraquer, Universitat Ramon Llull, Barcelona, España; Centre de Salut Mental d́Adults Sant Andreu, Barcelona, España.
| | - Carles Pérez Téstor
- Institut Universitari Salut Mental Vidal i Barraquer, Universitat Ramon Llull, Barcelona, España
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DeFreitas SC, Crone T, DeLeon M, Ajayi A. Perceived and Personal Mental Health Stigma in Latino and African American College Students. Front Public Health 2018. [PMID: 29536000 PMCID: PMC5834514 DOI: 10.3389/fpubh.2018.00049] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Mental health stigma occurs when people have negative thoughts and beliefs of those with mental health illnesses or mental health treatment. Mental health stigma is related to an assortment of negative outcomes including discrimination in housing and employment, reduced usage of mental health services, and poor mental health outcomes. These implications may be particularly salient for ethnic minorities such as African Americans and Latinos who already suffer from other types of discrimination. This study examines perceived and personal mental health stigma in African American and Latino college students from a nontraditional university to help elucidate factors related to the development of mental health stigma. Students completed surveys concerning their stigma beliefs. African American students were found to have higher rates of mental health stigma than Latino students. Furthermore, anxiety about those with mental illness was related to greater mental health stigma for both groups. For African Americans, it was found that their perception of their ability to visibly identify those with mental illness was related to greater mental health stigma. These findings suggest that interventions to reduce mental health stigma in college students should target specific ethnic minority groups and focus on issues that are particularly salient to those communities.
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Affiliation(s)
| | - Travis Crone
- Social Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Martha DeLeon
- Social Sciences, University of Houston-Downtown, Houston, TX, United States
| | - Anna Ajayi
- Social Sciences, University of Houston-Downtown, Houston, TX, United States
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Ata EE, Doğan S. The Effect of a Brief Cognitive Behavioural Stress Management Programme on Mental Status, Coping with Stress Attitude and Caregiver Burden While Caring for Schizophrenic Patients. Arch Psychiatr Nurs 2018; 32:112-119. [PMID: 29413060 DOI: 10.1016/j.apnu.2017.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 09/22/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
This experimental study was carried out using a pre-test/post-test control group model to evaluate the effect of a "Brief Cognitive Behavioural Stress Management Programme" (BCBSMP) on mental status, coping with stress attitude, and caregiver burden while caring for patients with schizophrenia. A total of 61 caregivers who provided care for schizophrenia patients at a community mental health centre were included in the study. Caregivers were matched according to gender and scale scores and were assigned to either the study or the control group. Before and after the programme, caregivers in both groups were given the "Demografic Data Form", "Zarit Caregiver Burden Scale", "Coping Attitude Evaluation Scale", "Stress Indicators Scale", and the "General Health Survey-28". Caregivers in the study group were taken to a BCSMP one session per week (each session lasted 120min) for seven weeks. We determined that the stress indicators, the risk of developing a psychological disorder, and caregiver burden decreased and skills related to both the problem-oriented and emotion-oriented aspects of stress increased in the study group after the programme.
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Affiliation(s)
- Elvan Emine Ata
- Nursing Department, Faculty of Healty Science, Giresun University, Piraziz, Giresun, Turkey.
| | - Selma Doğan
- Nursing Department, Faculty of Healty Science, Üsküdar University, Üsküdar, İstanbul, Turkey.
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Corrigan PW, Torres A, Lara JL, Sheehan L, Larson JE. The Healthcare Needs of Latinos with Serious Mental Illness and the Potential of Peer Navigators. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2018; 44:547-557. [PMID: 27236458 PMCID: PMC5997453 DOI: 10.1007/s10488-016-0737-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Latinos with serious mental illness get sick and die much younger than other adults. In this paper, we review findings of a community based participatory research project meant to identify important healthcare needs, barriers to these needs, solutions to the barriers, and the promise of peer navigators as a solution. Findings from focus groups reflected general concerns of people with mental illness (e.g., insurance, engagement, accessibility) and Latinos with serious mental illness (e.g., immigration, language, and family). Feedback and analyses especially focused on the potential of peer navigators. Implications of these findings for integrated care of Latinos with serious mental illness are discussed.
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Affiliation(s)
- Patrick W Corrigan
- Illinois Institute of Technology, 3424 South State St. First Floor, Room 1B9-2, Chicago, IL, 60616, USA
| | - Alessandra Torres
- Illinois Institute of Technology, 3424 South State St. First Floor, Room 1B9-2, Chicago, IL, 60616, USA
| | - Juana L Lara
- Illinois Institute of Technology, 3424 South State St. First Floor, Room 1B9-2, Chicago, IL, 60616, USA.
| | - Lindsay Sheehan
- Illinois Institute of Technology, 3424 South State St. First Floor, Room 1B9-2, Chicago, IL, 60616, USA
| | - Jonathon E Larson
- Illinois Institute of Technology, 3424 South State St. First Floor, Room 1B9-2, Chicago, IL, 60616, USA
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Inogbo CF, Olotu SO, James BO, Nna EO. Burden of care amongst caregivers who are first degree relatives of patients with schizophrenia. Pan Afr Med J 2017; 28:284. [PMID: 29942416 PMCID: PMC6011007 DOI: 10.11604/pamj.2017.28.284.11574] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 09/19/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Caring for a mentally ill family member is a challenging task. Caregivers who are first-degree relatives (FDR) are at a higher risk of experiencing the negative consequences of caregiving. This study was aimed at determining burden of care and its correlates in caregivers who are first-degree relatives of patients with schizophrenia. Methods A dyad of 255 patients and caregivers was recruited. A socio-demographic questionnaire was administered to both. The GHQ-12 was used to screen for psychiatric morbidity in the FDRs. Caregiver's burden was assessed with the Zarit Burden Interview. Patients' illness severity and level of functioning were assessed using the Brief Psychiatric Rating Scale and the Global Assessment of Functioning scales respectively. Results The mean ± SD age of caregivers and patients were 45.1 ±12.3 and 36.7 ±13.4 years respectively. About 49% of caregivers experienced high burden of care. Older caregiver's age (r = 0.179; p < 0.004) and greater illness severity (r = 0.332; p < 0.0001) in the patient had weak to moderate positive correlation with burden of care. Caregiver's burden also increased with poorer functioning of the patient (r = -0.467 p < 0.0001). Independent predictors of caregiver burden were low level of education of the caregiver (OR 2.45; 95% CI 1.27-4.73), psychiatric morbidity in the caregiver (OR 6.74; 95% CI 2.51-18.15) and poor patient functioning (OR 2.81; 95% CI 1.27-6.18). Conclusion Caregivers who are first-degree relatives of patients with schizophrenia experience varying degrees of burden of care during caregiving. Routine screening and early psychological intervention would help to ameliorate these negative consequences of caregiving.
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Affiliation(s)
- Chinwe Frances Inogbo
- Department of Clinical Services, Federal Neuropsychiatric Hospital Uselu, Benin City Edo State, Nigeria
| | - Sunday Osasu Olotu
- Department of Clinical Services, Federal Neuropsychiatric Hospital Uselu, Benin City Edo State, Nigeria
| | - Bawo Onesirosan James
- Department of Clinical Services, Federal Neuropsychiatric Hospital Uselu, Benin City Edo State, Nigeria
| | - Emmanuel Okechukwu Nna
- Safety Molecular Pathology Laboratory, Rangers Avenue Independence Layout Enugu, Enugu State, Nigeria
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Brown CA, Weisman de Mamani A. The mediating effect of family cohesion in reducing patient symptoms and family distress in a culturally informed family therapy for schizophrenia: A parallel-process latent-growth model. J Consult Clin Psychol 2017; 86:1-14. [PMID: 29172590 DOI: 10.1037/ccp0000257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although both patients with schizophrenia and their caregivers report elevated levels of depression, anxiety, and stress (DASS), affective symptoms in patients and family members seldom constitute a primary treatment focus. The present study tested whether a culturally informed family therapy for schizophrenia (CIT-S) outperformed standard family psychoeducation (PSY-ED) not only in decreasing patient schizophrenia symptoms, but also in decreasing individual DASS. Because CIT-S fostered family cohesion throughout treatment, we predicted that increases in family cohesion would mediate treatment effects. METHOD Participants included 266 patients and family members nested within 115 families, randomized to the CIT-S or PSY-ED conditions. We specified a series of multilevel latent growth and latent change models to examine direct effects of CIT-S on patient schizophrenia symptoms, individual DASS, and family cohesion over time. Next, we used parallel-process growth models to test the indirect effect of CIT-S on decreasing patient and caregiver psychopathology over time via changes in family cohesion. RESULTS The CIT-S treatment significantly reduced patient schizophrenia symptoms from baseline to follow-up (γ = -1.72, 95% confidence interval [CI] [-2.83, -0.60]), as well as individual DASS (γ = -4.39, 95% CI [-6.44, -2.34]) from baseline to termination. In line with treatment goals, CIT-S increased family cohesion from baseline to midpoint (γ = 0.93, 95% CI [0.06, 1.80]). The CIT-S-related change in cohesion mediated changes in DASS (γ = -0.87, 95% CI [-1.47, -0.27]), but not patient symptoms. CONCLUSION By integrating the family's cultural context into treatment, clinicians may foster family dynamics that enhance treatment outcomes and promote broad improvements in mental health. (PsycINFO Database Record
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Approche pour cibler le soutien auprès des proches aidants de personnes souffrant de troubles psychiatriques sévères. ANNALES MEDICO-PSYCHOLOGIQUES 2017. [DOI: 10.1016/j.amp.2017.03.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Gumus F, Dikec G, Ergun G. Relations Among Internalized Stigmatization, Depressive Symptom Frequency and Family Loading in First-degree Caregivers of the Patients Treated in the Psychiatry Clinic of a State Hospital. Arch Psychiatr Nurs 2017; 31:522-527. [PMID: 28927518 DOI: 10.1016/j.apnu.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/10/2017] [Accepted: 05/21/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Funda Gumus
- Dicle University, Ataturk School of Health, Department of Nursing, Diyarbakir, Turkey
| | - Gul Dikec
- Istinye University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey.
| | - Gul Ergun
- Mehmet Akif Ersoy University, Faculty of Health Sciences, Department of Emergency Aid and Disaster Management, Burdur, Turkey
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Grover S, Avasthi A, Singh A, Dan A, Neogi R, Kaur D, Lakdawala B, Rozatkar AR, Nebhinani N, Patra S, Sivashankar P, Subramanyam AA, Tripathi A, Gania AM, Singh GP, Behere P. Stigma experienced by caregivers of patients with severe mental disorders: A nationwide multicentric study. Int J Soc Psychiatry 2017; 63:407-417. [PMID: 28537123 DOI: 10.1177/0020764017709484] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Stigma is very common among caregivers of patients with severe mental disorder; however, there is lack of national level data from India. AIM To assess affiliate stigma and its correlates among caregivers of patients with severe mental disorders. METHOD For this, caregivers of patients with schizophrenia ( N = 707), bipolar disorder ( N = 344) and recurrent depressive disorder ( N = 352) were assessed on Stigma scale for Caregivers of People with Mental Illness and General Health Questionnaire. RESULTS Caregivers of patients with schizophrenia reported significantly higher stigma than patients with bipolar disorder and recurrent depressive disorder. Caregiver of patients with bipolar disorder reported significantly greater stigma than the caregivers of patients with recurrent depressive disorder. Higher caregiver stigma in all the diagnostic groups was associated with higher psychological morbidity in caregivers. Higher stigma in caregivers of schizophrenia was seen when the patient had younger age of onset and longer duration of treatment. In the bipolar disorder group, higher stigma in caregivers was seen when patient had higher residual manic symptoms. CONCLUSION This study suggests that caregivers of patients with schizophrenia experience higher stigma than the caregivers of patients with bipolar disorder and recurrent depressive disorder. Higher stigma is associated with higher psychological morbidity in the caregivers. Therefore, the clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the caregivers and plan intervention strategies to reduce stigma.
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Affiliation(s)
- Sandeep Grover
- 1 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- 1 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aakanksha Singh
- 1 Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amitava Dan
- 2 Calcutta National Medical College, Kolkata, India
| | | | | | | | | | | | | | | | - Alka A Subramanyam
- 10 Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, India
| | | | | | | | - Prakash Behere
- 14 D. Y. Patil Education Society (Deemed University), Kolhapur, India
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Singh P, Ghosh S, Nandi S. Subjective Burden and Depression in Mothers of Children with Autism Spectrum Disorder in India: Moderating Effect of Social Support. J Autism Dev Disord 2017; 47:3097-3111. [DOI: 10.1007/s10803-017-3233-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abstract
We aim to assess the level of family burden of schizophrenia patients and identify its predicting factors in a rural community sample of China. A sample of 327 primary caregivers was recruited through a one-stage cluster sampling in Ningxiang County of Hunan province, China. Family burden was assessed using the Family Burden Interview Schedule (FBIS) of Pai and Kapur. Our results showed that the mean score of FBIS was 23.62±9.76 (range, 0–48), with over half (52%) caregivers reported their family burden being moderate and severe. Among the six domains of family burden, financial burden (76%) was the commonest burden, while disruption of family interactions (37%) was the least mentioned. A multivariate analysis of family burden revealed that patient being admitted for over 3 times, caregiver being female, having a middle school education, and with additional dependents, as well as higher care network function were positive predictors of family burden, while higher patient function and family function, and increasing patient age were negative predictors of family burden. Intervention to decrease family burden may be best served by improving family function and exploring alternative care model instead of hospitalization.
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Alzahrani SH, Fallata EO, Alabdulwahab MA, Alsafi WA, Bashawri J. Assessment of the burden on caregivers of patients with mental disorders in Jeddah, Saudi Arabia. BMC Psychiatry 2017; 17:202. [PMID: 28558771 PMCID: PMC5450140 DOI: 10.1186/s12888-017-1368-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/23/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mental disorders are considered important public health problems not only to people with mental illness but also their caregivers. As is the case in many countries, the deinstitutionalization of mental health services in Saudi Arabia, has meant that informal caregivers are shouldering responsibilities for which they are not usually prepared; therefore, the current study was aimed at assessment of the burden on caregivers of people with mental illness. METHODS Through a cross-sectional design, a sample of the caregivers of people with mental illness (n = 377) was selected randomly from a psychiatric hospital in Jeddah. An Arabic version of the Involvement Evaluation Questionnaire (IEQ) was used for collection of data. The data were analyzed on the subscale scores and the 27 items in two ways. First, we used the summed scores for the subscales based on the Likert scale (0-4) for univariate and multivariate statistical analyses, as recommended. We also used parametric statistics (t-tests, one-way ANOVA) because the IEQ subscale scores were fairly normally distributed. RESULTS Males constituted more than one-half of the participating caregivers (55%), with a mean age of 36.6, SD = 11.4 years. As reported by the caregivers, most of the patients were males (62.7%) with a mean age of 33.8, SD = 13.7 years and a range of 17-90 years old. The total mean IEQ burden score of the caregivers was 38.4, SD = 17.5. "Tension" was significantly prominent among younger caregivers aged ≤30 years. "Worrying" was significantly higher among caregivers living with their spouse and children and those living in families with relatively fewer members (<6 members). "Urging" was significantly higher among caregivers who are living with the patient in the same household and those who had been in close contact with the patient for 28 days in the four weeks prior to the study (13.4, SD = 6.8) p < 0.05. Meanwhile, "Urging" was also significantly higher among caregivers caring for mentally ill females (13.5, SD = 6.6) and those not receiving any kind of professional support (12.8, SD = 6.7). The overall burden and the subscale scores were highest among caregivers caring for a close relative such as a parent (44.1, SD = 17.6), son/daughter (39.1, SD = 12.9), sibling (37.1, SD = 18.6), or spouse (37.1, SD = 18.6) p < 0.05. CONCLUSION Care for people with mental illness is burdensome for their caregivers, the magnitude of burden is potentially augmented by factors related to the patients and households. These factors should be considered when planning for preparing caregivers to cope with people with mental illness in Saudi Arabia.
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Affiliation(s)
- Sami H. Alzahrani
- 0000 0001 0619 1117grid.412125.1Family and Community Medicine Department, Faculty of Medicine, King Abdulaziz University, PO Box 80205, Jeddah, 21589 Saudi Arabia
| | | | | | - Wesam A. Alsafi
- Department of Psychiatry, Mental Health Hospital, Jeddah, Saudi Arabia
| | - Jamil Bashawri
- 0000 0001 0619 1117grid.412125.1Family and Community Medicine Department, Faculty of Medicine, King Abdulaziz University, PO Box 80205, Jeddah, 21589 Saudi Arabia
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Psychological status and quality of life among primary caregivers of individuals with mental illness: a hospital based study. Health Qual Life Outcomes 2017; 15:106. [PMID: 28526049 PMCID: PMC5438522 DOI: 10.1186/s12955-017-0676-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 05/04/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to explore the psychological status and quality of life among primary caregivers of individuals suffering from various mental illnesses including early psychosis, chronic schizophrenia, depressive disorders, anxiety disorders and dementia. Methods A total of 350 primary caregivers with relatives seeking treatment at a tertiary psychiatric hospital were recruited for this study. Socio-demographic data was obtained and the brief version of the World Health Organisation Quality of Life instrument was used to assess caregiver’s quality of life (QOL). Psychological status among primary caregivers was assessed using the General Anxiety Disorder - 7 item (GAD-7) and Patient Health Questionnaire - 9 item (PHQ-9) scales. Family Interview Schedule (FIS) was used to assess the impact of caregiving relating to social problems, interpersonal strain among family members, work related problems and financial difficulties as a result of their relative’s illness. The socio-demographic and clinical correlates of QOL, PHQ-9 and GAD-7 were examined using multiple linear and logistic regression analyses. Associations between QOL domains and psychological status was examined using multiple linear regression analyses. Results The mean age of the primary caregivers was 49.7 years (SD = 13.2), ranging from 21 to 82 years, with a preponderance of females (67.6%), aged 50–64 years old (45.7%). Majority were of Chinese ethnicity (57.5%), had secondary level education (43.1%), were married (65.2%), and employed (64.9%). 18.3% of primary caregivers had symptoms of depression (based on PHQ-9 cut-off point of 10 or greater) while 12.7% had symptoms of anxiety (based on GAD-7 cut-off point of 10 or greater). Multiple linear and logistic regression analyses revealed that primary caregivers aged between 35-49 years and 50–64 years, unemployed, living with others, providing care to those diagnosed with dementia and who had higher FIS scores were significantly more likely to report symptoms of depression whilst those who cared for their son/daughter were less likely to be associated with symptoms of depression. Primary caregivers who had lower education, were living with others, were single or divorced/separated, were unemployed and with higher FIS scores were associated with lower QOL domain scores. Those with symptoms of depression were significantly associated with low QOL across all four domains, whilst those with symptoms of anxiety were significantly associated with low QOL in the social relationships domain. Conclusion Psychological status of caregivers in the current study was associated with the various domains of QOL. In particular, caregivers’ symptoms of depression were significantly associated with lower QOL across all four domains of QOL whereas symptoms of anxiety were associated with lower scores in the social relationships domain. The study suggests a need to provide caregivers with social support and psycho-education to improve the QOL as well as aid in developing healthy coping strategies.
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72
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Gonçalves-Pereira M, González-Fraile E, Santos-Zorrozúa B, Martín-Carrasco M, Fernández-Catalina P, Domínguez-Panchón AI, Muñoz-Hermoso P, Ballesteros J. Assessment of the consequences of caregiving in psychosis: a psychometric comparison of the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). Health Qual Life Outcomes 2017; 15:63. [PMID: 28381222 PMCID: PMC5382493 DOI: 10.1186/s12955-017-0626-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 03/13/2017] [Indexed: 01/27/2023] Open
Abstract
Background The Zarit Burden Interview (ZBI) was originally developed to assess the level of subjective burden in caregivers of people with dementia. The Involvement Evaluation Questionnaire (IEQ) is amongst the leading scales to assess caregiving consequences in severe mental illness. We aimed to compare the psychometric properties of the ZBI, a generic tool, and of the IEQ, a more specific tool to assess the consequences of caregiving in schizophrenia and related disorders. Methods Secondary analyses of a 16-week, randomized controlled trial of a psychoeducational intervention in 223 primary caregivers of patients with schizophrenia or schizoaffective disorder. Psychometric properties (internal consistency, convergent and discriminative validity, and sensitivity to change) were evaluated for both ZBI and IEQ. Results Internal consistency was good and similar for both scales (ZBI: 0.91, 95% CI: 0.89, 0.94; IEQ: 0.86, 95% CI: 0.83, 0.89). Convergent validity was relevant for similar domains (e.g. ZBI total score vs IEQ-tension r = 0.69, 95% CI: 0.61, 0.75) and at least moderate for the rest of domains (ZBI total score, personal strain and role strain vs IEQ-urging and supervision). Discriminative validity against psychological distress and depressive symptoms was good (Area Under the Curve [AUC]: 0.77, 95% CI: 0.71, 0.83; and 0.69, 95% CI: 0.63, 0.78 – for ZBI against GHQ-28 and CES-D respectively; and AUC: 0.72, 95% CI: 0.65, 0.78; and 0.69, 95% CI: 0.62, 0.77 – for IEQ against GHQ-28 and CES-D respectively). AUCs against the reference criteria did not differ significantly between the two scales. After the intervention, both scales showed a significant decrease at endpoint (p-values < 0.001) with similar standardised effect sizes for change (-0.36, 95% CI: -0.58, -0.15 – for ZBI; -0.39, 95% CI: -0.60, -0.18 – for IEQ). Conclusions Both ZBI and IEQ have shown satisfactory psychometric properties to assess caregiver burden in this sample. We provided further evidence on the performance of the ZBI as a general measure of subjective burden. Trial registration (ISRCTN32545295).
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Affiliation(s)
- Manuel Gonçalves-Pereira
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.,Clínica Psiquiátrica de S. José (Sisters Hospitallers), Lisboa, Portugal
| | - Eduardo González-Fraile
- Institute of Psychiatric Research (Sisters Hospitallers), Bilbao, Spain. .,Universidad Internacional de La Rioja, Logroño, Spain.
| | | | - Manuel Martín-Carrasco
- Institute of Psychiatric Research (Sisters Hospitallers), Bilbao, Spain.,Padre Menni Psychiatric Clinic (Sisters Hospitallers), Pamplona, Spain.,CIBER Mental Health, Vitoria, Spain
| | | | | | | | - Javier Ballesteros
- University of the Basque Country, UPV/EHU, Leioa, Spain.,CIBER Mental Health, Leioa, Spain
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73
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Derajew H, Tolessa D, Feyissa GT, Addisu F, Soboka M. Prevalence of depression and its associated factors among primary caregivers of patients with severe mental illness in southwest, Ethiopia. BMC Psychiatry 2017; 17:88. [PMID: 28274223 PMCID: PMC5343306 DOI: 10.1186/s12888-017-1249-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/02/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Depression is a serious mental illness that affects patients' treatment outcome and caregiver's day to day life. The prevalence of depression among caregivers of patients with severe mental illness is greater than the general population. Little is known about depression among primary caregivers of patients with severe mental illness in Ethiopia. This study is aimed at assessing prevalence of depression and associated factors among primary caregivers of patients with mental illness. METHODS A cross-sectional study was conducted among primary caregivers of patients with severe mental illness in Jimma University Teaching Hospital. Patient health questionnaire (PHQ-9) was used to assess depression. A multidimensional scale of perceived social support (MSPSS) was used to assess perceived social support; Cut down, Annoyed, Guilty, Eye opener (CAGE) scale was used to assess alcohol use disorder. After conducting descriptive analyses, logistic regression analysis was finally used for bivariate and multivariable analysis. RESULT The overall prevalence of depression among primary caregivers of patients with mental illness was 12 (19%). Out of those caregivers with depressions, 11.3, 3.5 and 4.2% had moderate, moderately severe and severe types of depression respectively. The prevalence of depression among female primary caregivers was 25% (n = 40). Being single (aOR 2.62, 95% CI = 1.07, 6.41), giving care more than six hours per day (aOR 3.75, 95% CI = 1.51, 9.33) and caring for a patient who had more than once episodes of suicidal attempts (aOR 1.48, 95% CI = 1.07, 3.42) were positively associated with depression among caregivers of patients with mental illness. CONCLUSION We found that the prevalence of depression among primary caregivers was high. Depression among caregivers was associated with giving care more than six hours per day and caring for a patient who had two or more episodes of suicidal attempts. The prevalence of depression among female caregivers was higher than that of the male caregivers. Therefore, special focus should be given to primary caregivers spending long hours for providing care, those with low perceived social support; caregivers of patients with suicidal ideation and female caregivers.
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Affiliation(s)
| | - Daniel Tolessa
- 0000 0001 2034 9160grid.411903.eDepartment of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia ,Centre for International Health, Ludwig Maxmillians University, Munich, Germany
| | - Garumma Tolu Feyissa
- 0000 0001 2034 9160grid.411903.eDepartment of Health Education and Behavioral Science, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia ,0000 0004 1936 7304grid.1010.0The Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
| | - Fikir Addisu
- 0000 0001 2034 9160grid.411903.eDepartment of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. .,Centre for International Health, Ludwig Maxmillians University, Munich, Germany.
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74
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Stanley S, Balakrishnan S, Ilangovan S. Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. J Ment Health 2017; 26:134-141. [PMID: 28385096 DOI: 10.1080/09638237.2016.1276537] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Caregiving in schizophrenia is a demanding and exhausting activity that challenges the physical and emotional resources of family caregivers. In traditional societies such as India, this is further compounded by illiteracy, ignorance and religious and cultural explanations attributed to mental illness. AIMS This study aimed to assess primary caregivers of persons with schizophrenia in terms of their perceived burden, manifestation of psychological distress and quality of life (QOL). METHODS The study used a quantitative cross-sectional design and survey methodology to collect data from caregivers in a hospital setting in Thanjavur, India. Standardized instruments were used to collect data from patients and their caregivers. RESULTS High perceived burden and lower QOL were seen in the majority of caregivers. They also manifested high levels of anxiety and depression. Patient characteristics such as age, gender, symptoms and duration of illness did not influence the perceived burden of caregivers, while positive and negative symptoms and the duration of illness were correlated with their QOL. CONCLUSIONS Findings indicate the need for intervention for family caregivers to enable them cope more effectively with the demands of caregiving. Psychoeducation and participation in peer support groups are advocated as low resource and effective outcome strategies for caregivers in India.
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Affiliation(s)
- Selwyn Stanley
- a Faculty of Education , Health and Wellbeing, University of Wolverhampton , Wolverhampton , UK
| | | | - S Ilangovan
- c Department of Psychiatry , Thanjavur Medical College , Thanjavur , India
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Caregiver Burden Among Caregivers of Individuals With Severe Mental Illness: Testing the Moderation and Mediation Models of Resilience. Arch Psychiatr Nurs 2017; 31:24-30. [PMID: 28104054 DOI: 10.1016/j.apnu.2016.07.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 12/14/2022]
Abstract
The association between the socio-demographic characteristics of caregivers, such as gender and caregiver burden, is well documented; however, the process underlying this relationship is poorly understood. Based on the stress process model, we designed a cross-sectional study to examine the mediating and moderating effect of resilience on the relationship between gender and caregiver burden. Caregivers of individuals with severe mental illness (n=201) were recruited in two psychiatric outpatient clinics in Malaysia. The relationship between the gender of the caregiver and caregiver burden was mediated by resilience, thus supporting the stress process model. The findings from the present research contribute to the growing evidence of the interaction between socio-demographic variables of caregivers and resilience, and caregiver burden.
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76
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Nam SJ, Park EY. Relationship between caregiving burden and depression in caregivers of individuals with intellectual disabilities in Korea. J Ment Health 2017; 26:50-56. [PMID: 28084102 DOI: 10.1080/09638237.2016.1276538] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Individuals with intellectual disabilities (IWID) need intensive long-term care. Consequently, caregivers experience not only economic burdens but also tension, depression, insecurity, etc. AIM This study aimed to provide basic data and materials for preparing policy alternatives to improve caregiver quality of life of by examining relationships between IWID caregiving burden and depression. METHODS This study involved secondary analysis of data from the 2011 Survey on the Actual Conditions of Individuals with Developmental Disabilities, conducted by the Ministry of Health and Welfare of Korea. Effects of caregivers' characteristics, caregiving time and cost, and perceptions of time and cost, on depression were analyzed. RESULTS All components of caregiving burden and depression were significantly higher in the 1st grade, designating the most severe disabilities. Overall, caregiving burden tended to be higher in female caregivers, the unemployed, parents, co-residents, and people with health problems. Caregivers' characteristics such as spouse relationship, having health problems, and perception of caregiving time and cost were associated with depression. CONCLUSION Caregiving burden and depression vary depending on the characteristics of IWID and their caregivers. Services for decreasing caregiving burden may be optimized by focusing on these characteristics.
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Affiliation(s)
- Su-Jung Nam
- a Department of Home Economics Education and
| | - Eun-Young Park
- b Department of Secondary Special Education , College of Education, Jeonju University , Wansan-gu , Republic of Korea
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77
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Determining depression level of caregivers providing home healthcare services. North Clin Istanb 2017; 3:118-123. [PMID: 28058398 PMCID: PMC5206461 DOI: 10.14744/nci.2016.65487] [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: 11/24/2015] [Accepted: 10/23/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: Due to increase in elderly population as result of longer life expectancy and the incidence of chronic disease, greater importance should be given to elderly care and the needs of primary caregivers. The purpose of this study was to determine depression status of caregivers who were providing in-home healthcare services. METHODS: This study was conducted with caregivers for 63 home-dependent patients who benefited from the services provided by Kartal Dr. Lutfi Kirdar Training and Research Hospital Family Practice Clinic between May 15, 2013 and July 1, 2013 using a socio-demographic variables questionnaire and the Beck Depression Inventory. Data were analyzed using Kolmogorov-Smirnov test, Mann-Whitney U test, Student’s-t test and chi-square test. RESULTS: Of the total, 87.3% of survey participants were women. Average age was 52.47 years; 73% were married, 17.5% were single, and 9.5% were widows. Monthly income of 50.8% of participants was between TL 1000 and 3000. Of all the patients, 77.8% were totally, and 22.2% were semi-dependent. Depression was detected in 61.1% of patient relatives who were responsible for patient healthcare and in 22.2% of paid professional caregivers (p=0.052). Depression was detected at rate of 37% in caregivers who had been providing nursing care for less than 1 year, 63% for those who had been caregivers for 1 to 5 years, and for those providing care for more than 5 years, rate was 63 %. Rate of depression in study participants overall was 55.6%. CONCLUSION: Duration of providing care, dependency level of patient, and level of intimacy affect caregivers. They need psychological support.
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78
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Rexhaj S, Leclerc C, Bonsack C, Golay P, Favrod J. Feasibility and Accessibility of a Tailored Intervention for Informal Caregivers of People with Severe Psychiatric Disorders: a Pilot Study. Front Psychiatry 2017; 8:178. [PMID: 28983262 PMCID: PMC5613087 DOI: 10.3389/fpsyt.2017.00178] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/06/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES This study aimed to assess the acceptability and feasibility of a new tailored intervention for informal caregivers: the Ensemble (Together) program. METHODS An open pre-post within-subject comparison pilot study was conducted. Twenty-one informal caregivers completed the five-session Ensemble program. Two measurement tools were used: The Brief Symptom Inventory (BSI) and the Life Orientation Scale (LOT-R). RESULTS The results showed that informal caregivers were in need of individual support and were ready to participate in the Ensemble program independent of the patient's diagnosis or stage of illness. The participants were very satisfied, and 95.4% completed the program. The preliminary results also showed that in five sessions, informal caregivers' Global Severity Index measured by the BSI and their optimism about their future (measured by the LOT-R) were significantly improved. CONCLUSION This pilot study provided preliminary results concerning the feasibility and acceptability of the tailored Ensemble program and indicates the need for a randomized trial. The Ensemble program is appropriate for both the acute and chronic phases of disease. Individualized brief and useful interventions for informal caregivers may provide more positive outcomes in care.
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Affiliation(s)
- Shyhrete Rexhaj
- Institute of Higher Education and Research in Health Care, University of Lausanne, Lausanne, Switzerland.,Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland.,School of Nursing Sciences, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Claude Leclerc
- Institute of Higher Education and Research in Health Care, University of Lausanne, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland
| | - Jérôme Favrod
- Community Psychiatry Service, Department of Psychiatry, University Hospital Centre, Lausanne, Switzerland.,School of Nursing Sciences, La Source, University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
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79
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Corrigan PW, Torres A, Lara JL, Sheehan L, Larson JE. Prioritizing the healthcare needs of Latinos with mental illness. INTERNATIONAL JOURNAL OF CULTURE AND MENTAL HEALTH 2017; 10:19-32. [PMID: 30505348 PMCID: PMC6261424 DOI: 10.1080/17542863.2016.1246581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Latinos with serious mental illness have higher morbidity and mortality rates than same age peers. In this paper, we review findings of a community based participatory research project meant to identify important health needs of this group, barriers to these needs, solutions to the barriers and the promise of peer navigators as a solution. Findings from a prior qualitative study yielded 84 themes related to needs, barriers and solutions. These findings were transposed into individual items, to which 122 Latino participants with mental illness responded using a 7-point importance scale. Results showed item importance means ranging from 4.34 to 5.47, with counseling/therapy services and mental health treatment topping the list for healthcare needs. Analyses also examined differences between those born in the USA versus those born elsewhere. Latinos who were native to the USA differed significantly from those born abroad in over one quarter of importance ratings. Implications of these findings for integrated care of Latinos with serious mental illness are discussed.
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Affiliation(s)
- Patrick W Corrigan
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
| | - Alessandra Torres
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
| | - Juana L Lara
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
| | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
| | - Jonathon E Larson
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois
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80
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Banga G, Ghosh S. The Impact of Affiliate Stigma on the Psychological Well-Being of Mothers of Children with Specific Learning Disabilities in India: The Mediating Role of Subjective Burden. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:958-969. [DOI: 10.1111/jar.12311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Gazal Banga
- Tata Institute of Social Sciences; School of Social Work; Center for Health and Mental Health; Mumbai India
| | - Subharati Ghosh
- Tata Institute of Social Sciences; School of Social Work; Center for Health and Mental Health; Mumbai India
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81
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Hernandez M, Barrio C. Families and medication use and adherence among Latinos with schizophrenia. J Ment Health 2016; 26:14-20. [PMID: 27690706 DOI: 10.1080/09638237.2016.1222061] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Medication nonadherence among Latinos with schizophrenia represents a significant treatment obstacle. Although some studies have examined patient and family perceptions of adherence, few have examined these perceptions together. However, such knowledge can provide a deeper understanding of how family processes may contribute to or impede adherence among underserved groups such as Latinos. AIMS This study explored perceptions of medication and adherence among Latinos with schizophrenia and key family members. METHOD Purposive sampling was used to collect data from 34 participants: 14 patients with schizophrenia receiving community-based mental health services in an urban public setting and 20 key family members. Informed by grounded theory, semistructured interviews were analyzed by bilingual-bicultural team members. RESULTS Salient themes emerged indicating facilitators of and obstacles to medication use. Specifically, challenges centered on medication side effects, autonomy and choice, and illness insight, whereas facilitators focused on family support and holistic views of treatment and empowerment. CONCLUSIONS Because the majority of Spanish-speaking Latinos with schizophrenia live with family, it is important to examine family factors that may influence medication use. Findings suggest that patient and family perceptions of medication should be examined as part of the treatment process, particularly regarding issues of autonomy and choice.
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Affiliation(s)
- Mercedes Hernandez
- a School of Social Work, University of Southern California , Los Angeles , CA , USA
| | - Concepción Barrio
- a School of Social Work, University of Southern California , Los Angeles , CA , USA
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Park K, Seo M. Care burden of parents of adult children with mental illness: The role of associative stigma. Compr Psychiatry 2016; 70:159-64. [PMID: 27624436 DOI: 10.1016/j.comppsych.2016.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 06/28/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE Parents of offspring with mental illness must endure endless child care burden despite their old age, and must cope with associative stigma. This study analyzed the mediator effect of associative stigma on relationships between the main stressors, psychiatric symptoms and lowered social function of offspring with mental illness, assessed by the parents, and their care burden. METHOD 215 parents caring for an adult child with mental illness in Korea were surveyed (Mage=60.68, SD=13.58; 74.4% mothers). They were asked to assess the psychiatric symptoms and social function of their offspring, the stigma they experienced, and the objective/subjective care burdens they felt. RESULTS Our findings suggest that the symptoms and function of offspring directly affect the care burden of parents, but also have an indirect effect mediated by associative stigma. Among the predictor variables, symptoms have a greater effect on the subjective/objective burden and associative stigma than social function. CONCLUSIONS We suggest strategies for parents to overcome associative stigma and emphasize the professional endeavor required to meet the service needs of elderly parents taking care of an adult child with mental illness.
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Affiliation(s)
- Keunwoo Park
- Center on Gambling Problems, Kyungnam of Korea, 36 Bieum-ro, Changwon, 51454, Republic of Korea.
| | - Mikyung Seo
- Department of Social Welfare, Gyeongsang National University, 501 Jinjudae-ro, Jinju, 660-701, Republic of Korea.
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Gater A, Rofail D, Marshall C, Tolley C, Abetz-Webb L, Zarit SH, Berardo CG. Assessing the Impact of Caring for a Person with Schizophrenia: Development of the Schizophrenia Caregiver Questionnaire. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2016; 8:507-20. [PMID: 25680337 PMCID: PMC4662958 DOI: 10.1007/s40271-015-0114-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background The responsibilities of caring for a person with schizophrenia may significantly impact informal caregivers’ lives. The Zarit Burden
Interview (ZBI) was originally developed to assess burden among caregivers of people with Alzheimer’s disease. Objective This research was conducted to inform the development of a revised version of the ZBI, relevant to caregivers of people with schizophrenia. Methods Based on published qualitative research, the questionnaire was reviewed and modified in accordance with industry-standard guidelines. The resulting questionnaire [the Schizophrenia Caregiver Questionnaire (SCQ)] was then completed by 19 caregivers during cognitive debriefing interviews to assess understanding, relevance and comprehensiveness. Results Review of the ZBI resulted in a number of operational changes to improve face validity and potential sensitivity. Further questions were added based on key concepts identified in existing literature and minor phrasing alterations were made to improve content validity. Findings from caregiver interviews supported the content validity of the SCQ. Conclusion The SCQ provides a comprehensive view of caregivers’ subjective experiences of caregiving and demonstrated strong face and content validity. The questionnaire will be important in both clinical assessment and evaluating the efficacy of interventions designed to reduce or alleviate caregiver burden. Future research will seek to establish the psychometric validity of the questionnaire.
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Affiliation(s)
- Adam Gater
- Adelphi Values Ltd, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK.
| | - Diana Rofail
- Roche Products Ltd, Hexagon Place, 6 Falcon Way, Welwyn Garden City, Hertfordshire, UK
| | - Chris Marshall
- Adelphi Values Ltd, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | - Chloe Tolley
- Adelphi Values Ltd, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | - Linda Abetz-Webb
- Adelphi Values Ltd, Adelphi Mill, Bollington, Cheshire, SK10 5JB, UK
| | - Steven H Zarit
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA
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84
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Ong HC, Ibrahim N, Wahab S. Psychological distress, perceived stigma, and coping among caregivers of patients with schizophrenia. Psychol Res Behav Manag 2016; 9:211-8. [PMID: 27574475 PMCID: PMC4993414 DOI: 10.2147/prbm.s112129] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Nowadays, family members are gradually taking on the role of full-time caregivers for patients suffering from schizophrenia. The increasing burden and tasks of caretaking can cause them psychological distress such as depression or anxiety. The aim of this study was to measure the correlation between perceived stigma and coping, and psychological distress as well as determine the predictors of psychological distress among the caregivers. Results showed that 31.5% of the caregivers experienced psychological distress. “Community rejection” was found to be positively associated with psychological distress. In case of coping subscales, psychological distress had a positive correlation with substance use, use of emotional support, behavioral disengagement, venting, and self-blame, while it was negatively correlated with “positive reframing”. Behavioral disengagement was the best predictor of psychological distress among caregivers of patients with schizophrenia, followed by positive reframing, use of emotional support, self-blame, and venting. Health practitioners can use adaptive coping strategies instead of maladaptive for caregivers to help ease their distress and prevent further deterioration of psychological disorders.
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Affiliation(s)
| | - Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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85
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Singh A, Mattoo SK, Grover S. Stigma and its correlates among caregivers of schizophrenia: A study from North India. Psychiatry Res 2016; 241:302-8. [PMID: 27232551 DOI: 10.1016/j.psychres.2016.04.108] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 01/31/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
Abstract
This study aimed to study stigma experienced by caregivers of patients with schizophrenia. One hundred caregivers of patients with schizophrenia were evaluated on Stigma scale for caregivers of people with mental illness (CPMI), Explanatory model interview catalogue stigma scale (EMIC), General health questionnaire-12 (GHQ), Self-report attitude towards medications questionnaire and Knowledge of mental illness scale (KMI). On CPMI the score was higher for affective component (2.3±0.5) than for cognitive (1.9±0.9) and behavioural (1.8±0.6) components. More than half of caregivers 'agreeing' or 'strongly agreeing' on 20 out of 22 items of CPMI indicated high level of stigma. On EMIC the stigma score was 21.7±6.3. Higher level of affiliate and/or associative stigma was associated with shorter duration of illness and treatment, shorter duration of being in the caregiver role, younger, female and non-earning caregivers, prescription of higher number of pills, caregivers who less often accompany the patient to the hospital and caregivers experienced more psychological morbidity. To conclude this study suggests that caregivers of patients with schizophrenia experience substantial stigma; hospital and community level programs and services are required to reduce and prevent the same.
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Affiliation(s)
- Aakanksha Singh
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Surendra K Mattoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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86
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Resilience moderates the association between stigma and psychological distress among family caregivers of patients with schizophrenia. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.062] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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87
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Caqueo-Urízar A, Urzúa A, Jamett PR, Irarrazaval M. Objective and subjective burden in relatives of patients with schizophrenia and its influence on care relationships in Chile. Psychiatry Res 2016; 237:361-5. [PMID: 26809366 DOI: 10.1016/j.psychres.2016.01.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 12/04/2015] [Accepted: 01/07/2016] [Indexed: 01/28/2023]
Abstract
This study examined the burden on family members of patients with schizophrenia in a Chilean community. Sixty-five caregivers underwent the Subjective and Objective Family Burden Interview. The results showed moderate to high levels of subjective burden and low levels of support from others in providing care. Burden and containment of disturbed behaviour were correlated with worse relationships between patients and caregivers, with the latter spending less time working outside the home. The assessed sample showed a similar pattern of burden to that of caregivers from developed countries; however, the extent of the burden tended to be higher in Chilean caregivers.
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Affiliation(s)
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | | | - Matias Irarrazaval
- Departamento de Psiquiatría, Facultad de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile; Instituto Milenio para la Investigación en Depresión y Personalidad, Santiago, Chile
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88
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de Mamani AW, Suro G. The effect of a culturally informed therapy on self-conscious emotions and burden in caregivers of patients with schizophrenia: A randomized clinical trial. Psychotherapy (Chic) 2016; 53:57-67. [PMID: 26654115 PMCID: PMC4775443 DOI: 10.1037/pst0000038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Caring for a family member with schizophrenia often results in high degrees of self-conscious emotions (shame and guilt/self-blame), burden, and other serious mental health consequences. Research suggests that ethnic and cultural factors strongly influence the manner in which family members respond to mental illness. Research further indicates that certain cultural practices and values (spirituality, collectivism) may assist family members in coping with the self-conscious emotions and burden associated with caregiving. With this in mind, the authors have developed a family-focused, culturally informed treatment for schizophrenia (CIT-S). METHOD Using a sample of 113 caregivers of patients with schizophrenia (60% Hispanic, 28.2% Caucasian, 8% African American, and 3.8% other), the authors assessed the ability of CIT-S to reduce self-conscious emotions and caregiver burden above and beyond a 3-session psychoeducation (PSY-ED) control condition. They further examined whether self-conscious emotions mediated the relationship between treatment type and caregiver burden. RESULTS In line with expectations, CIT-S was found to outperform PSY-ED in reducing guilt/self-blame and caregiver burden. Furthermore, consistent with hypotheses, reductions in guilt/self-blame were found to mediate the changes observed between treatment type and caregiver burden. Although caregivers in both treatment groups demonstrated significant posttreatment reductions in shame, CIT-S was not found to outperform PSY-ED in reducing levels of this construct. CONCLUSIONS Results suggest that caregivers of patients with schizophrenia may respond well to a treatment that specifically taps in to their cultural beliefs, values, and behaviors in helping them cope with schizophrenia in a loved one. Study implications and future directions are discussed.
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Affiliation(s)
| | - Giulia Suro
- Department of Psychology, University of Miami
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89
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Kızılırmak B, Küçük L. Care Burden Level and Mental Health Condition of the Families of Individuals With Mental Disorders. Arch Psychiatr Nurs 2016; 30:47-54. [PMID: 26804501 DOI: 10.1016/j.apnu.2015.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/02/2015] [Accepted: 10/13/2015] [Indexed: 11/29/2022]
Abstract
This study was conducted to assess burden of care levels and the mental health of the family members providing care to persons with mental disorders. The data were collected using the Information Form, Burden Assessment Scale (BAS) and General Health Questionnaire-12 (GHQ) (N=243). Of the caregivers included in this study, 67.49% were found to be at risk, and 47.3% of the caregivers were found to be at a high risk of developing mental disorders like depression and anxiety. A positive and statistically significant relation was identified between the BAS scores and GHQ scores of the caregivers (r=0.498; p=0.001).
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Affiliation(s)
- Betül Kızılırmak
- GATA Haydarpaşa Educational Research Hospital, Selimiye Mah, Tıbbiye Cad, 34668, Üsküdar, Istanbul, Turkey.
| | - Leyla Küçük
- Istanbul University, Florence Nightingale Nursing Faculty, Department of Mental Health and Psychiatric Nursing, Şişli, Istanbul, Turkey.
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90
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Poon WC, Joubert L, Harvey C. A longitudinal study of the health and wellbeing of culturally and linguistically diverse caregivers of people with psychosis in Australia. Int J Soc Psychiatry 2015; 61:743-53. [PMID: 25838339 DOI: 10.1177/0020764015577843] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite Australia being an ethnically diverse country, there are limited longitudinal studies of the health and wellbeing of culturally and linguistically diverse (CALD) carers of people with psychosis. An Australian population-based survey found that 22.7% of carers of people with mental disorders were born overseas. AIMS This study aimed to explore the demographic profile, social connectedness, psychological health, quality of life, grief and caregiving consequences of CALD carers of people with psychosis over 12 months. METHOD This longitudinal study utilised a prevalence survey design and recruited 52 CALD carers who were born in 24 countries outside Australia. A series of validated instruments were administered to assess carer health and wellbeing. RESULTS Descriptive and inferential analysis of the results suggested that CALD carers experienced social isolation (34.7%), psychological distress (28.9%), moderate grief and caregiving consequences and poorer quality of life than the general population. Younger CALD carers and spouse carers experienced greater negative caregiving consequences than other kinship or friend carers. There were no significant changes in these outcomes over the 12-month period of the study. CONCLUSION Ethnic-sensitive interventions are needed to better support CALD carers experiencing negative caregiving consequences, especially younger carers or spouses, within the current level of service provision.
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Affiliation(s)
- Weng Cheong Poon
- School of Social Sciences, Faculty of Arts & Social Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Lynette Joubert
- Department of Social Work, School of Health Sciences, University of Melbourne, Carlton, VIC, Australia
| | - Carol Harvey
- Psychosocial Research Centre, Department of Psychiatry, University of Melbourne, Coburg, VIC, Australia North West Area Mental Health Service, Coburg, VIC, Australia
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91
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Hernandez M, Barrio C. Perceptions of Subjective Burden Among Latino Families Caring for a Loved One with Schizophrenia. Community Ment Health J 2015; 51:939-48. [PMID: 25952273 PMCID: PMC4619132 DOI: 10.1007/s10597-015-9881-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 05/02/2015] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to explore perceptions of subjective burden among Latino family members providing care for a loved one with schizophrenia. Data were collected from outpatient community mental health centers and featured 64 Latino family members who were primarily Spanish speaking and of Mexican origin. We used qualitative methods to examine subjective burden based on an open section of the Family Burden Interview Schedule. Five salient themes emerged capturing family members' subjective burden experience: (a) interpersonal family relationships, (b) emotional and physical health, (c) loss of role expectations, (d) religion and spirituality, and (e) stigma. Overall, findings illustrated that families perceived numerous challenges in their caregiving. Implications for research and practice among Latino family members are discussed.
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Affiliation(s)
- Mercedes Hernandez
- School of Social Work, University of Southern California, Montgomery Ross Fisher Building, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - Concepción Barrio
- School of Social Work, University of Southern California, Montgomery Ross Fisher Building, 669 W. 34th Street, Los Angeles, CA, 90089, USA.
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92
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Sintayehu M, Mulat H, Yohannis Z, Adera T, Fekade M. Prevalence of mental distress and associated factors among caregivers of patients with severe mental illness in the outpatient unit of Amanuel Hospital, Addis Ababa, Ethiopia, 2013: Cross-sectional study. J Mol Psychiatry 2015; 3:9. [PMID: 26457184 PMCID: PMC4599028 DOI: 10.1186/s40303-015-0014-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caregivers like family members or other relatives are central and provide not only practical help and personal care but also give emotional support, and they are suffering from plenty of challengeable tasks. These, eventually, cast out family caregivers into multidimensional problems prominently for mental distress like depression, anxiety, sleep problem and somatic disorder which are followed by physiologic changes and impaired health habits that ultimately lead to illness and possibly to death. Numerous studies demonstrate that mental distress of caregivers are two times compared to general populations. Despite it was not uncommon to observe manifestations of caregivers' mental distress, yet there was no study on this area. Therefore, this study was intended to assess the prevalence of mental distress and associated factors among the caregivers of persons with severe mental illness in the out patients unit of Amanuel Hospital, Ethiopia. METHODS Institutional based cross sectional study was conducted from May 1 to 31, 2013 at Amanuel Hospital, Addis Ababa, Ethiopia. Systematic random sampling technique with "k" interval of 13 was employed to withdraw a total of 423 participants from study population. Five psychiatric nurses carried out interview by using standardized and validated Self Reported Questionnaire (SRQ 20). Descriptive statistics, binary and multivariate logistic regression analysis were conducted. RESULTS This study revealed that the overall prevalence of mental distress was found to be 221(56.7 %). The factors like missed social support, two or more times admission of patient, care giving for psychotic patient, being farmer and being female were found to be predictors for mental distress of caregivers with this [AOR 95 % CI = 9.523(5.002, 18.132)], 3.293(1.474, 3.3560), 2.007(1.109, 3.634), 2.245(1.129, 4.463) and 3.170(1.843, 5.454)] respectively. CONCLUSIONS In this respect the study observed that there was a higher level of mental distress experienced by caregivers of patients with severe mental illness in Amanuel Hospital, and social support are strongly associated with mental distress besides to other variables. Effectively planned interventions have to be targeted at alleviating mental distress and actions like on-going psycho-education and mutual support that could expand social support should be implemented in Amanuel hospital health service delivery system.
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Affiliation(s)
- Mezinew Sintayehu
- />Department of Nursing, Mekelle University, College of Health Sciences, PO. Box 1871, Mekelle, Tigray region North Ethiopia
| | - Haregwoin Mulat
- />Department of psychiatry, College of Health sciences, University of Gondar, Amhara, North Ethiopia
| | - Zegeye Yohannis
- />Amanuel mental specialized hospital, Addis Ababa, Ethiopia
| | - Tewodros Adera
- />Amanuel mental specialized hospital, Addis Ababa, Ethiopia
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93
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Schiffman J, Reeves GM, Kline E, Medoff DR, Lucksted A, Hoagwood K, Fang LJ, Dixon LB. Outcomes of a Family Peer Education Program for Families of Youth and Adults with Mental Illness. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2015; 44:303-315. [PMID: 28798497 DOI: 10.1080/00207411.2015.1076293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Family members of consumers with mental illness often play important roles in initiating and supporting treatment. Self-help programs such as the National Alliance on Mental Illness (NAMI) Family-to-Family Education Program (FTF) have been shown to provide a variety of benefits for family members. Despite recognizing the benefits of FTF, little is known about who may benefit most, and in what ways they might benefit. One group of interest is family members of younger consumers, a group shown to report more negative caregiving experiences and more depression and anxiety than caregivers of older consumers. The current study assesses whether relatives of youth (ages 8-18) differ in their response to FTF as opposed to relatives of adults (19 years and older). Results suggest that all members benefit from FTF. Family members of youth in FTF, however, reported gains more pronounced on their depressive symptoms, and negative perceptions and experiences, relative to family members of adults. The importance of peer support programs is discussed, as well as the specific usefulness of these programs to effectively address concerns of relatives of youth with serious mental health concerns.
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Affiliation(s)
- Jason Schiffman
- Department of Psychology, University of Maryland, Baltimore County, Maryland, USA
| | - Gloria M Reeves
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Emily Kline
- Department of Psychology, University of Maryland, Baltimore County, Maryland, USA
| | - Deborah R Medoff
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Alicia Lucksted
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kimberly Hoagwood
- Department of Child and Adolescent Psychiatry, New York University, New York, USA
| | - Li Juan Fang
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lisa B Dixon
- Columbia University Medical Center, New York, USA
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94
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Yin Y, Zhang W, Hu Z, Jia F, Li Y, Xu H, Zhao S, Guo J, Tian D, Qu Z. Experiences of stigma and discrimination among caregivers of persons with schizophrenia in China: a field survey. PLoS One 2014; 9:e108527. [PMID: 25259732 PMCID: PMC4178170 DOI: 10.1371/journal.pone.0108527] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/22/2014] [Indexed: 01/19/2023] Open
Abstract
In China, caregivers for family members with schizophrenia play an important role in treatment and recovery but may experience stigma and discrimination simply because of their family relationship. The object of this study was to measure the degrees and correlates of stigma and discrimination experiences among this group. Four hundred twenty-seven caregivers participated in this hospital-based and cross-sectional study in Ningbo and Guangzhou, China. Data were collected by trained interviewers using fixed questionnaires. Stigma and discrimination experiences were measured by the Modified Consumer Experiences of Stigma Questionnaire (MCESQ). Caregivers’ social support was measured by the Social Support Rating Scale. Parametric analysis, nonparametric analysis and multivariate linear regression were used. The mean (SD) score of MCESQ was 2.44(0.45), 2.91(0.71) for stigma experiences and 1.97(0.37) for discrimination experiences on a five-point score (“1 = never” and “5 = very often”). Approximately 65% of caregivers reported that they tried to conceal their family members’ illness, and 71% lacked the support of friends. The experience of stigma was significantly negatively associated with the perceived social support of caregivers (standard β = −0.2,p<0.001). Caregivers who were children of the patients experienced fewer stigmas than other (standard β = −0.18, p<0.001). Urban residence (standard β = −0.12, p<0.01) and patients did not complete primary school education (standard β = −0.13, p<0.01) were negatively related with stigmas. In addition, stigma and discrimination was more experienced in Zhejiang than in Guangdong (p<0.05). In conclusion, this study performed that caregivers of people with schizophrenia in China experienced general stigmas and rare discrimination and found the relations with social support, kinship, patient’s educational level and regional differences. More interventions and supports should been given to caregivers who are lack of social support, who live in rural area and who are the patients’ parents, spouses or siblings.
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Affiliation(s)
- Yi Yin
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P. R. China
| | - Weijun Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P. R. China
| | - Zhenyu Hu
- Office of Director, Ningbo Kangning Hospital, Ningbo, Zhejiang, P. R. China
| | - Fujun Jia
- Guangdong Mental Health Center, Guangdong General Hospital, Guangzhou, Guangdong, P. R. China
| | - Yafang Li
- Department of Medical Affairs, Peking Union Medical College Hospital, Beijing, P. R. China
| | - Huiwen Xu
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, New York, United States of America
| | - Shuliang Zhao
- School of Public Management, Yunnan University of Finance and Economics, Kunming, Yunnan, P. R. China
| | - Jing Guo
- Department of Sociology, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China
| | - Donghua Tian
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P. R. China
| | - Zhiyong Qu
- School of Social Development and Public Policy, Beijing Normal University, Beijing, P. R. China
- * E-mail:
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95
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Zerr AA, Pina AA. Predictors of Initial Engagement in Child Anxiety Mental Health Specialty Services. CHILD & YOUTH CARE FORUM 2014; 43:151-164. [PMID: 24683301 PMCID: PMC3964616 DOI: 10.1007/s10566-013-9230-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Child and family mental health services remain largely underutilized despite the relatively high rate of youth suffering from mental, emotional, and behavioral (MEB) disorders. As such, it is important to address challenges and examine factors related to child mental health service use and engagement, especially when it comes to children in need of services for anxiety. OBJECTIVE Informed by the Behavioral Model of Health Services Use (BMHS), the present study sought to examine predictors of service use and engagement for families seeking assistance for their anxious children. Initial levels of engagement in culturally tailored services were predicted from predisposing characteristics (e.g., child age, ethnicity), enabling resources (e.g., Spanish services, transportation), and need characteristics (e.g., child clinical severity). METHOD Participants included Latino (n = 126) and Caucasian (n = 116) families who presented to a specialty clinic due to child emotional and behavior problems related to anxiety. Initial service utilization and engagement was assessed along the following levels toward services care: (1) initiated contact and completed a clinical intake, (2) completed a home screen, and (3) completed an on-site diagnostic assessment. All procedures were culturally tailored to the presenting needs of families. RESULTS Predisposing characteristics, enabling resources and need characteristics emerged as significant predictors of child mental health service use, with some variations. Child age, ethnicity, referral source, and enabling resources predicted completion of a home screen. Proximity to services predicted completion of the on-site diagnostic assessment. CONCLUSION Knowledge of factors that predict engagement in child mental health services can help identify avenues to promote service utilization, especially among ethnic minority children and families. Our culturally tailored approach to serving families appears to be promising in bridging the cross-ethnic services gap and therefore has implications for practice.
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96
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Cw Lam P, Ng P, Tori C. Burdens and psychological health of family caregivers of people with schizophrenia in two Chinese metropolitan cities: Hong Kong and Guangzhou. Community Ment Health J 2013; 49:841-6. [PMID: 23756723 DOI: 10.1007/s10597-013-9622-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 06/03/2013] [Indexed: 11/29/2022]
Abstract
Family members charged with the care of those suffering from schizophrenia experience considerable stress due to their multiple responsibilities. Research regarding the burdens of caregiving is scant in Hong Kong and China. The present study quantified the association of the duties of caregivers with mental health symptoms in two Asian cities having distinct health care systems (i.e., Hong Kong and Guangzhou, China). Thirty nine caregivers in Hong Kong and 70 caregivers in Guangzhou were recruited from nongovernmental mental health organizations. They were assessed using the Chinese version of the Involvement Evaluation Questionnaire and the General Health Questionnaire. While the Guangzhou family caregivers had a significantly higher burden than the Hong Kong sample, there was no significant difference in the psychological health status of family caregivers in the two cities. Result of correlational analyses, however, revealed high associations between burden of care variables and the psychological health of the caregivers. Findings for the present study have implications regarding the physical and mental health needs of those caring for seriously disturbed relatives.
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Affiliation(s)
- Paul Cw Lam
- Richmond Fellowship of Hong Kong, Hong Kong, PRC China,
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97
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Saunders J. "At wits' end!": perspectives of Hispanic caregivers of a family member with schizophrenia. Issues Ment Health Nurs 2013; 34:451-8. [PMID: 23805930 DOI: 10.3109/01612840.2012.741659] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this qualitative exploratory study was to explore the perspectives of Hispanic caregivers as they provide the day-to-day care for their family member with schizophrenia. Interviews were conducted by a promotora (a Spanish speaking trained community health worker) with ten Hispanic caregivers at a large community center in a southwest border city over a six month period. Sixty interviews were audio recorded, translated into English, transcribed, and then interpreted using content analysis. One main overarching perspective emerged: "at wits' end." The following four supportive themes emerged: feeling marginalized, seeking answers, relying on God, and lacking support.
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Affiliation(s)
- Jana Saunders
- Texas Tech University, Health Sciences Center, 3601 4th St., Lubbock, TX 79430, USA.
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98
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Lasebikan VO, Ayinde OO. Family Burden in Caregivers of Schizophrenia Patients: Prevalence and Socio-demographic Correlates. Indian J Psychol Med 2013; 35:60-6. [PMID: 23833344 PMCID: PMC3701362 DOI: 10.4103/0253-7176.112205] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aims to determine the prevalence and socio-demographic correlates of caregiver's burden in schizophrenia. MATERIALS AND METHODS A dyad of 368 schizophrenia patients and their caregivers were interviewed. Caregiver's burden was assessed using the Yoruba-version of the FBIS and GHQ-12. RESULTS Mean age of patients was 29.7 SD (8.6) years. Of the 368 caregivers, 81.5% were parents, mean age was 58.1 years (SD 19.6). Total mean objective FBIS score was 22.69 (6.21), 324 (85.3%) reported total objective burden and 310 (84.2%), subjective burden. There were significant differential demographic associations with caregivers' burden. CONCLUSION Caregivers of schizophrenia patients experience enormous burden and are potential "high risk group" for mental disorders. Thus, they require comprehensive intervention in order to reduce the growing incidence of chronic enduring diseases including mental disorders.
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Carrà G, Cazzullo CL, Clerici M. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Findings from an Italian population. BMC Psychiatry 2012; 12:140. [PMID: 22974195 PMCID: PMC3549782 DOI: 10.1186/1471-244x-12-140] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 09/11/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An appropriate understanding of the association between high-Expressed Emotion (EE) in family members of people with schizophrenia, patients' and relatives' correlates is needed to improve adaptation of psychoeducational interventions in diverse cultures. The aim of this study was to test the hypothesis that relatives designated as high EE would report higher subjective burden of care, and would be associated with objective variables that indicate greater illness severity i.e. number of previous hospitalizations and duration of illness. METHODS We performed secondary analyses of baseline data from a randomized controlled trial conducted in Italy. RESULTS High-EE relatives reported more subjective burden of care in disturbed behaviours and adverse effects areas, but did not perceive more deficits in social role performances. As regards illness severity characteristics, neither the number of previous hospital admissions nor the duration of illness was associated with high-EE. However, patients' previous psychosocial functioning, as measured by educational attainments, seems to protect the relative from high-EE status. CONCLUSION There is a need for cross-cultural comparisons of the subjective experience of distress and burden among high EE carers as a target for intervention, aimed at reducing family stress as much as improving patient outcomes.
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Affiliation(s)
- Giuseppe Carrà
- Department of Mental Health Sciences, University College London, Charles Bell House, London, W1W 7EY, UK.
| | | | - Massimo Clerici
- Association for Research on Schizophrenia (ARS), Via Andreani 4, 20122, Milan, Italy,Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca Medical School, Via Cadore, 48., 20052, Monza, Italy
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Abstract
Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families' perception of stigma related to mental illness, and to compare Arab families' approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families' perceptions of stigma: What impacts does stigma perception have on those families and on their relatives' care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families' perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members' perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives.
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Affiliation(s)
- Heyam F Dalky
- Jordan University of Science & Technology, School of Nursing, Community Mental Health Nursing, Irbid, Jordan.
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