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Van KL, Rexhaj S, Coloni-Terrapon C, Alves M, Skuza K. Proches aidants en psychiatrie : quelle (in)adéquation entre besoins et offres de soutien ? SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2024; 36:45-56. [PMID: 38834524 DOI: 10.3917/spub.242.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Informal caregivers play a vital role in supporting people with severe mental illness. However, this role can leave informal caregivers with significant unmet needs. The aim of this qualitative study is to identify the extent to which the support offered to informal caregivers in adult psychiatry in French-speaking Switzerland meets their needs. METHOD Individual semi-structured interviews and focus groups were conducted with informal caregivers, mental health professionals, and service providers. The data were analyzed by theme. RESULTS The need for assistance and the need for information are two themes identified as prevalent among informal caregivers. Despite a consensus on the need for more support and information, informal caregivers, service providers, and health professionals do not assign the same importance to specific aspects of these themes. Suggestions for improving practices at the institutional, socio-political, and civil-society levels are put forward. Given the diversity of viewpoints on the priority needs of informal caregivers, there is a risk of offering support that only partially corresponds to the difficulties encountered by informal caregivers. CONCLUSIONS Matching support and needs remains a major challenge. Agreeing on a consensual definition of support and information needs and proposing tailored approaches could make it possible to develop support services that meet the actual needs of informal caregivers.
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Rexhaj S, Martinez D, Golay P, Coloni-Terrapon C, Monteiro S, Buisson L, Drainville AL, Bonsack C, Ismailaj A, Nguyen A, Favrod J. A randomized controlled trial of a targeted support program for informal caregivers in adult psychiatry. Front Psychiatry 2023; 14:1284096. [PMID: 38098635 PMCID: PMC10719931 DOI: 10.3389/fpsyt.2023.1284096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Background The importance of informal caregivers for persons with severe mental illness has been demonstrated. However, this role may cause a high care burden that considerably affects caregiver health. The Ensemble program is a five-session brief individual intervention designed to support informal caregivers. This trial aimed to assess the efficacy of the program versus SAU (support as usual) for participants with a high care burden. Methods A single-center randomized controlled trial including 149 participants was conducted. Caregivers in the intervention arm participated in the Ensemble program. The effects of the intervention were assessed using mixed models for repeated measures analysis of variance on improvements in informal caregivers' psychological health status, optimism levels, burden scores, and quality of life at three time points (T0 = pretest; T1 = posttest at 2 months, and T2 = follow-up at 4 months). Results Analysis of the Global Psychological Index showed no significant effect at the two endpoints in favor of the Ensemble group. However, the Brief Symptom Inventory-Positive Symptom Distress Index was significantly lower at the two-month follow-up. A significant reduction in burden on the Zarit Burden Interview was observed post-intervention, along with an increase in optimism levels on the Life Orientation Test-Revised at follow-up in the Ensemble group. No significant differences were observed in quality of life. Clinical improvements in both psychological health status and burden levels were also identified. Conclusion The Ensemble program offers an inclusive approach based on a recovery perspective that significantly reduces symptom distress and burden and increases optimism among informal caregivers.Clinical trial registration: https://clinicaltrials.gov/, NCT04020497.
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Affiliation(s)
- Shyhrete Rexhaj
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Debora Martinez
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, University Hospital, CHUV, University of Lausanne, Lausanne, Switzerland
- Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Lausanne, Switzerland
| | - Claire Coloni-Terrapon
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Shadya Monteiro
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Leslie Buisson
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Anne-Laure Drainville
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, University Hospital, CHUV, University of Lausanne, Lausanne, Switzerland
| | | | - Alexandra Nguyen
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences, Lausanne, Switzerland
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Rexhaj S, Nguyen A, Favrod J, Coloni-Terrapon C, Buisson L, Drainville AL, Martinez D. Women involvement in the informal caregiving field: A perspective review. Front Psychiatry 2023; 14:1113587. [PMID: 36741114 PMCID: PMC9889973 DOI: 10.3389/fpsyt.2023.1113587] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
The patient recovery process of individual with mental health disorder is reinforced if they are connected with their community and supported by relatives. The literature has shown that caregivers are important, although their roles can lead to alterations in their own health; and women are the most involved in this role. The present review investigated women's involvement in the informal caregiver scientific field. A literature review indicated gender differences; researchers who are women are more interested in this field than men. Even with a good representation of women in this scientific field, the results showed a statistically significant gender difference for the first and second authors, whereas there was no significant gender difference among the last authors. More efforts must be made to recognize the importance of women's involvement in research because they raise a specific important field. Family caregivers are key players in the healthcare system, but to date, there has been little recognition of their enormous contribution. Our results also indicated the informal caregiver role is filled more by women than by men, which creates social inequalities in many domains, especially in opportunities at the professional level. Tailored interventions are required to address the specific needs and issues of family caregivers. A better redistribution of unpaid work, such as informal caregiving, compared to paid work must be made to respect gender in social existence.
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Affiliation(s)
- Shyhrete Rexhaj
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Claire Coloni-Terrapon
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Leslie Buisson
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Anne-Laure Drainville
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Debora Martinez
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Monteiro S, Fournier M, Favrod J, Drainville AL, Plessis L, Freudiger S, Skuza K, Tripalo C, Franck N, Lebas MC, Deloyer J, Wilquin H, Golay P, Rexhaj S. Ability to Care for an Ill Loved One During the First COVID-19 Lockdown: Mediators of Informal Caregivers' Stress in Europe. Front Psychiatry 2022; 13:852712. [PMID: 35492725 PMCID: PMC9039127 DOI: 10.3389/fpsyt.2022.852712] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/08/2022] [Indexed: 12/04/2022] Open
Abstract
Informal caregivers are overlooked, healthcare actors. They are at particular risk of distress and suffer from poor mental health. This study aimed to investigate the perceived stress and modulating factors during the first COVID-19 lockdown in Europe, regardless of the illness that care recipients suffer from. Sociodemographic data, coping resources, and perceived stress level using the Perceived Stress Scale (PSS-10) questionnaire were assessed using a web-based survey in Switzerland, France, and Belgium with 232 informal caregivers. Mediation analyses were used to identify the factors that modulate stress. Higher perceived stress among informal caregivers was associated with a younger age for the care recipient, family relationship with the care recipient, cohabitation, and female sex of the informal caregiver. These associations were partially mediated by the fear of getting ill (age, cohabitation), the conviction that lockdowns had a negative impact on health (age, kinship), and the perceived deterioration of the care recipient's health (gender). The fear of losing the ability to cope with caregiving tasks due to an illness (COVID-19 and/or other) and the negative impact of the lockdown on care recipients' health, particularly on the mental health of young care recipients, increased the stress of informal caregivers. Our results emphasize the importance of informal caregiving support to prevent heightened stress in lockdown conditions, regardless of care recipient illness or kinship.
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Affiliation(s)
- Shadya Monteiro
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Margot Fournier
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Anne-Laure Drainville
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Léa Plessis
- Aix Marseille Université, LPCPP, Aix-en-Provence, France
| | - Sylvie Freudiger
- AVASAD, Association Vaudoise d'Aide et de Soins à Domicile Route de Chavannes, Lausanne, Lausanne, Switzerland
| | - Krzysztof Skuza
- HESAV, School of Health Sciences, HES-SO University of Applied Sciences Western Switzerland, Switzerland
| | - Charlene Tripalo
- Service de Psychiatrie Générale, Psychiatry Department, CHUV, Lausanne, Switzerland
| | - Nicolas Franck
- Pôle Centre Rive Gauche et Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Centre Hospitalier Le Vinatier, UMR 5229, CNRS, Université Claude Bernard Lyon 1, Lyon, France
| | - Marie-Clotilde Lebas
- Département des Sciences de la Santé Publique et de la Motricité, Haute Ecole de la Province de Namur, Namur, Belgium
| | | | - Hélène Wilquin
- Aix Marseille Université, LPCPP, Aix-en-Provence, France
| | - Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Shyhrete Rexhaj
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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