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Abstract
BACKGROUND Caregivers have different experiences in the patient care process during which the role of providing care is fulfilled. AIM The aim of this study was to provide data on the feelings, thoughts and experiences of the caregivers of patients with schizophrenia. METHOD In this study, the phenomenological method was used. RESULTS The results of this study revealed the following themes: meaning of schizophrenia, the meaning of being caregiver, life before being caregiver, feeling of patients' relatives, difficult areas while providing care, coping situations and metaphors produced by the caregivers. CONCLUSION The results obtained from the study revealed that the caregivers of patients with schizophrenia need information about the mental illness and have a higher emotional burden. PRACTICE IMPLICATIONS Nurses should listen to caregivers' experiences, inquire about the experience of caregivers regarding patient care and advise caregivers on how to take care of their patients.
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Affiliation(s)
- Kerime Bademli
- Psychiatric Nursing Department, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Neslihan Lök
- Psychiatric Nursing Department, Faculty of Nursing, Selcuk University, Konya, Turkey
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Ferliana H, Damayanti NA, Aisyah DN, Huda N, Ernawati D. Determinants of family independence in caring for hebephrenic schizophrenia patients. J Public Health Res 2020; 9:1828. [PMID: 32728569 PMCID: PMC7376482 DOI: 10.4081/jphr.2020.1828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Schizophrenic patients are very susceptible to recurrent incidences, therefore the family plays a key role in providing care as a part of the recovery team. This study aimed to determine the relationship between knowledge, perceptions, attitudes and support with family independence in caring for hebephrenic schizophrenic patients. Design and Methods: It was used a correlational analytic design with cross sectional approach, and consecutive sampling technique was used, which attained 57 respondents. The independent variables were knowledge, perceptions, attitudes, and support, while independence was the dependent variable, and both were measured using questionnaires, and Spearman rank test was used for data analysis. Results: The results indicate the presence of a relationship between knowledge, perceptions, attitudes, as well as support and family independence in caring for hebephrenic schizophrenia. In addition, the spearman rank test showed P-values of 0.008, 0.011, 0.032, and 0.027 in family knowledge, perception, attitudes and support, respectively, at <0.05. Conclusions: This study indicates the importance of family support in attempts to improve the self-esteem of schizophrenic patients. Based on this data, the hospital is expected to improve the family-based patient recovery program.
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Affiliation(s)
| | - Nyoman Anita Damayanti
- Department of Health Policy and Administration, Faculty of Public Health, Universitas Airlangga, Mulyorejo
| | | | - Nuh Huda
- Hangtuah Institute of Health Science, Surabaya, Indonesia
| | - Dwi Ernawati
- Hangtuah Institute of Health Science, Surabaya, Indonesia
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Guan Z, Huang C, Wiley JA, Sun M, Bai X, Tang S. Internalized stigma and its correlates among family caregivers of patients diagnosed with schizophrenia in Changsha, Hunan, China. J Psychiatr Ment Health Nurs 2020; 27:224-236. [PMID: 31639239 DOI: 10.1111/jpm.12571] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 10/11/2019] [Accepted: 10/21/2019] [Indexed: 01/30/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Schizophrenia is a severe and highly stigmatized mental illness. High internalized stigma affects FGs' quality of life and caregiving capacity. Worldwide studies aimed at internalized stigma among patients diagnosed with mental illness or their FGs have reported significant stigma and some correlates, but studies involving FGs that focus on a specific mental illness (e.g. schizophrenia) and report the impact of potential psychosocial variables (e.g. coping and hope) on internalized stigma are limited. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: Internalized stigma was common among Chinese FGs of patients diagnosed with schizophrenia and half of them presented at a mild level. Internalized stigma was negatively associated with hope and positively associated with passive coping. FGs, who live with patients, have difficulty supervising medication, or care for a male relative has higher internalized stigma. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Regarding informative support, interventions (e.g. enhancing mental health literacy programs and cognitive therapies) to provide knowledge about schizophrenia, the skills to manage patients' adherence to medications, the benefits of treatment and the possibilities of rehabilitation are necessary for FGs. Regarding psychosocial processes, effective interventions (e.g. group psychoeducation and group social skills training) aimed to enhance hope, social support and coping styles towards internalized stigma should be implemented among FGs. Both informative support and psychosocial interventions used to decrease FGs' internalized stigma can be delivered by healthcare providers or by peer caregivers. ABSTRACT: Introduction Internalized stigma is prevalent among patients diagnosed with schizophrenia. Their family caregivers (FGs) also suffer from internalized stigma, but limited studies have addressed the issue. Aim The aim of this study was to determine the severity of internalized stigma and its correlates among FGs of patients diagnosed with schizophrenia in Changsha, Hunan, China. Methods A consecutive sample of 299 FGs was recruited at the psychiatric outpatient department of a tertiary hospital in Changsha. This study explored the relationships between internalized stigma and potential factors. Results Nearly 50% of the FGs perceived mild internalized stigma, 24% of the FGs reported moderate level, and 6% had a severe level. Internalized stigma was associated with patients' characteristics (severity of illness) and FGs' characteristics (hope, social support, passive coping, age, education background, residence with the patient, caring for a male or a young patient and difficulty in supervising medication). Discussion and implications for practice Informative and psychosocial interventions based on education and contact for FGs such as enhancing mental health literacy programs, cognitive therapies and group psychoeducation can provide FGs with a better understanding of schizophrenia and to promote hope, active coping and social support.
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Affiliation(s)
- Ziyao Guan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - James A Wiley
- Xiangya School of Nursing, Central South University, Changsha, China.,Department of Family and Community Health and Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoling Bai
- Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Sit HF, Huang L, Chang K, Chau WI, Hall BJ. Caregiving burden among informal caregivers of people with disability. Br J Health Psychol 2020; 25:790-813. [PMID: 32472979 DOI: 10.1111/bjhp.12434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/04/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Chinese informal caregivers experience burden due to their caregiving responsibilities that violate their belief of reciprocal parent-child relationship, but little is known about this burden and coping processes among Chinese. It is believed that internal coping (i.e., self-reliance) and external coping (i.e., seeking help from others) better captured cultural characteristics of coping styles observed among Chinese. Thus, the aim of this study was to estimate the prevalence of mental ill health, identify correlates, investigate the impact of caregiving burden on mental health, and explore the potentially moderating role of two coping strategies. DESIGN A purposive sample of 234 informal caregivers of family with intellectual or mental disability in Macao (SAR), China, from August to September 2018 was investigated. METHODS DASS-21, Caregiving Burden Inventory (CBI), Perceived Difficulty Scale (PD), and a modified Chinese Coping Scale were used. Multiple regression analyses were conducted. RESULTS CBI and PD were associated with depression, anxiety, and stress. Whereas internal coping buffered the effect of PD on depression and anxiety, external coping exacerbated the effect of PD on anxiety and the effect of CBI on depression and anxiety. CONCLUSION Poor mental health among caregivers is associated with greater caregiving challenges and burdens. Internal coping helped to buffer but external coping worsened the effect of burdens on mental health outcomes. Interventions that improve internal coping and mental health might be helpful for ageing informal caregivers.
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Affiliation(s)
- Hao Fong Sit
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Lei Huang
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Kay Chang
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Wai I Chau
- Fuhong Society of Macau, Macao (SAR), China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: a cross-sectional study. Qual Life Res 2020; 29:2745-2757. [PMID: 32394137 DOI: 10.1007/s11136-020-02518-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aimed to examine correlates of caregiver burden and health-related quality of life (HRQoL) among primary family caregivers of individuals with schizophrenia in inpatient psychiatric rehabilitation facilities. METHODS A cross-sectional study was conducted with 157 Taiwanese primary family caregivers of individuals with schizophrenia residing in inpatient psychiatric facilities. Measures included socio-demographic questionnaires and clinical information, Mutuality Scale, Family Crisis-Oriented Personal Evaluation Scales, Zarit Burden Interview, and World Health Organization Quality of Life-brief version. To describe the degree of caregiver burden and domains of HRQoL, descriptive statistics were computed. Independent sample t test, one-way analysis of variance, and Pearson's correlation analysis followed by multiple regression analyses were performed to determine correlations and relationships between characteristics of patients and primary family caregivers with caregiver burden and domains of HRQoL. RESULTS Primary family caregivers experienced mild to moderate caregiver burden and poor HRQoL. Primary family caregivers who were older and unemployed, caring for patient's severe psychiatric symptoms, and had low monthly incomes, decreased mutuality, and fewer family coping strategies were associated with greater caregiver burden and poor HRQoL. Greater mutuality and family coping strategies of reframing and seeking spiritual support were the most significant factors in improving caregiver burden and all domains of HRQoL, respectively. CONCLUSION Family-focused interventions for caregivers of institutionalized persons with schizophrenia that include psychological support and peer support groups are recommended to enhance mutuality and family coping strategies, reduce caregiver burden, and improve HRQoL.
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Chen GF, Luo HY, Wu G, Zhou C, Wang K, Feng K, Xiao ZW, Huang JJ, Gan JC, Zhao P, Liu PZ, Wang Y. Improving Mental Time Travel in Schizophrenia: Do Remembering the Past and Imagining the Future Make a Difference? COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10083-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Fan X, Zhao X, Zhu B, Qin H. Retrospective Evaluation of the Correlation Between Previous Hospitalizations, the Type of Current Living Space, and Quality of Family Function. Front Psychiatry 2020; 11:215. [PMID: 32256417 PMCID: PMC7090217 DOI: 10.3389/fpsyt.2020.00215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/04/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND AIM There are important public health issues involving rehabilitation of patients living with schizophrenia in the community. The purpose of this study was to analyze the correlations between number of previous hospitalizations, living space and quality of family function in the rehabilitation of patients living with schizophrenia in the community. The study attempts to determine the potential ways to use beneficial factors in recurrent hospitalization for improving treatment and rehabilitation efforts for patients living with long-term chronic schizophrenia. METHODS The study included 281 rehabilitations of patients living with schizophrenia in the community. A homemade general questionnaire was used to collect information about the number of previous hospitalizations and the living space of the participants. A family assessment device was used to evaluate the quality of family function of the patients. RESULTS The number of previous hospitalizations of persons living with schizophrenia in the community was negatively correlated with the quality of family function (B = 0.063), and there was no statistical difference in the number of previous hospitalizations and the quality of family function of patients in different living spaces. CONCLUSIONS The number of previous hospitalizations had a negative impact on family function in the rehabilitation of patients living with schizophrenia in the community. Living space may not have a significant positive effect on family function or the number of previous hospitalizations.
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Affiliation(s)
| | | | | | - Hongyun Qin
- Department of Psychiatry, Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
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Family Management Style Improves Family Quality of Life in Children With Epilepsy: A Randomized Controlled Trial. J Neurosci Nurs 2020; 52:84-90. [DOI: 10.1097/jnn.0000000000000497] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Carbonell Á, Navarro-Pérez JJ, Mestre MV. Risk factors associated with the family care of people with serious mental illness. Med Oral Patol Oral Cir Bucal 2019; 24:e438-e443. [PMID: 31232393 PMCID: PMC6667008 DOI: 10.4317/medoral.23133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/02/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of the present study is to analyse the variables associated with the family care of people diagnosed with serious mental illness. MATERIAL AND METHODS A cross-sectional study was carried out involving caregivers of people with serious mental illness (SMI) who were known to the mental health services in Valencia (España) and associations for those with SMI. The sample comprised 417 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview. Bivariate analyses (t-test, analysis of variance and Pearson correlation) were performed, as was a multiple linear regression model. Values of p < .05 were considered significant. The study was carried out in accordance with the recommendations of the ethics committees of the participating institutions. RESULTS The statistical analyses showed significant associations between the sociodemographic and clinical variables of the caregivers and patients and the burden felt by caregivers of people with SMI. The importance of both formal and informal social support stands out as a protective factor against the consequences of the illness's impact on the main caregiver. CONCLUSIONS The role of spaces of mutual support is crucial. The results suggest that family psychoeducational programmes should be created, applied and evaluated in all mental healthcare services so as to reinforce training in mental health matters and provide support and assessment to caregivers in order to ease their burden.
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Affiliation(s)
- Á Carbonell
- Department of Social Work and Social Services, Tarongers Avenue 4B, 46022 Valencia, Office 1D19 - University of Valencia, (Spain),
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