1
|
Zhu Y, Yin MXC. The impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients: evidence from Beijing, China. Front Psychol 2024; 15:1402159. [PMID: 38947902 PMCID: PMC11211629 DOI: 10.3389/fpsyg.2024.1402159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 06/05/2024] [Indexed: 07/02/2024] Open
Abstract
Objective To examine the impact of care-recipient relationship type on mental health burden of caregivers for schizophrenia patients in China, elucidating the underlying mechanisms. Methods A cross-sectional study was conducted using face-to-face surveys administered to caregivers of patients with schizophrenia in selected communities in Beijing, China. 1,853 samples' data was used. Descriptive statistics, logistic regression models and Sheaf coefficient method were employed to analyze the data. Results The mental health burden experienced by caregivers of schizophrenia patients has reached a high level, with 66.9% reporting a moderate or severe impact from their caregiving responsibilities. Parents and spouses were the primary providers of care for schizophrenia patients in China. Parent caregivers experienced greater suffering in their caregiving role compared to spouse caregivers, whereas the difference between child caregivers and spouse caregivers was not significant. The factors influencing caregiver's mental health burden vary according to the type of relationship with the care-recipient. For parent caregivers, the mental health burden primarily stems from personal conditions of schizophrenia patients, while for spouse or child caregivers, it mainly arises from family economic conditions. Conclusion This study reveals that caregivers having different types of care-recipient relationship with schizophrenia patients experience significantly different mental health burdens in Beijing, China, and major influencing factors are distinct according to different care-recipient relationship types.
Collapse
Affiliation(s)
- Yi Zhu
- School of Public Administration, Northwest University, Xi’an, China
| | | |
Collapse
|
2
|
Jiang Y, Cai Y, Lu Y, Wu G, Zhang XY. Relationship between anemia and its correlates and cognitive function in Chinese patients with chronic schizophrenia: A large cross-sectional study. Schizophr Res Cogn 2024; 36:100300. [PMID: 38288371 PMCID: PMC10823126 DOI: 10.1016/j.scog.2024.100300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/31/2024]
Abstract
Background Although both anemia and schizophrenia (SCZ) can cause cognitive decline, it is unclear whether anemia worsens cognitive decline in patients with SCZ. The primary objective of this study was to investigate the prevalence of anemia and the relationship between anemia, SCZ symptom severity, and cognitive function in patients with SCZ. Methods We obtained demographic and clinical data from 1690 inpatients with SCZ. All psychiatric symptoms and cognitive functioning were assessed by the Positive and Negative Syndrome Scale (PANSS), the Mini-Mental State Examination (MMSE), and the Repeated Battery for the Assessment of Neuropsychological Status (RBANS). Hemoglobin (HGB) values as well as red blood cell (RBC) counts were collected by routine blood tests. Results The proportion of anemia in patients with SCZ was 26.36 % (383/1453). Compared to SCZ patients without anemia, SCZ patients with anemia were older, had a lower bodyweight, a smaller waist circumference and lower apolipoprotein B levels, but longer QT intervals. Further logistic regression analysis revealed that anemia was associated with age, gender, and weight. In addition, there was no difference in cognitive function between SCZ patients with and without anemia. Conclusion Our findings suggest a high proportion of anemia in patients with chronic SCZ in the Han Chinese population. Several demographic and clinical variables are associated with anemia in SCZ patients.
Collapse
Affiliation(s)
- Yang Jiang
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Yi Cai
- Shenzhen Mental Health Center/Shenzhen KangNing Hospital, Department of Psychosomatic Disorders, Shenzhen, Guangdong, China
| | - Yaoyao Lu
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Guanghui Wu
- Guangxi Brain Disease Prevention & Treatment Research Center, Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou, Guangxi, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
3
|
Lohrasbi F, Maghsoudi J, Alavi M, Akbar M. Care Bermuda, families of the patients with chronic mental disorders in Iran surrounded by psychosocial problems and needs: a qualitative study. Ann Med Surg (Lond) 2024; 86:3357-3366. [PMID: 38846850 PMCID: PMC11152856 DOI: 10.1097/ms9.0000000000000626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/28/2023] [Indexed: 06/09/2024] Open
Abstract
Background A mental disorder is characterized by a clinically significant impairment of cognition, emotion regulation, or behavior. As a result of the shift in care from medical centers and hospitals to home care, we now see a change in the treatment of patients with chronic mental disorders. Consequently, families have become the main support system in the progressive care of these patients, leading to psychological and social problems. The current qualitative study investigated the social and psychological health needs and problems of family caregivers of patients with chronic mental disorders in Iran's cultural and social context. Methods This was a content analysis qualitative study. The study was conducted in three psychiatric hospitals in Farabi, Noor, Modares. Purposive sampling was done and continued until data saturation. Semi-structured, face-to-face, and individual interviews were conducted with 49 participants (15 family caregivers of patients with CMD and 34 members of the mental health care team). Data analysis was done using the conventional content analysis method. Results Eight hundred seventy-five primary codes were obtained, which were classified into 10 subcategories and 3 main categories of 'health challenges of caregiver', 'confused concept of care' and "the need for a coherent support system. Conclusion In Iranian society, after the patient is discharged from the hospital or care center, family members will change their role to the most important caregivers of these patients. The psychological and social health of these caregivers is destroyed because of the problems they have in providing care for their patients and their needs, which are not met.
Collapse
Affiliation(s)
- Fateme Lohrasbi
- Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences
| | - Jahangir Maghsoudi
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Akbar
- Nursing & midwifery care Research Center, Mental Health Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
4
|
Li Y, Qiu D, Wu Q, Ni A, Tang Z, Xiao S. Affiliate stigma and its association with family burden among family members of people living with schizophrenia in China. Schizophr Res 2024; 267:193-200. [PMID: 38569392 DOI: 10.1016/j.schres.2024.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 03/07/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Understanding affiliate stigma and its impact on family of people living with schizophrenia (PLS) in China is important for culturally informed intervention. This study aims to describe the pattern of affiliate stigma of family members of PLS in China and investigated the association between affiliate stigma and family burden. METHODS PLS and their family members dwelling in community were randomly recruited from four cities across China and completed measures of affiliate stigma and family burden. Linear regression analyses were used to determine the association between affiliate stigma and family burden. RESULTS A total of 493 dyads of family member and PLS were include in this study. The mean affiliate stigma in family members was 2.21 (SD = 0.61). The vast majority of family members reported the feeling of inferiority, helpless and sad because of their family members' schizophrenia, but few family members refusing to communicate or contact with the PLS. The mean score of overall family burden was 22.25 (SD = 14.90), with 98 % of participants reported moderate or severe burden. A higher level of affiliate stigma was associated with more family burden (b = 7.837, 95CI: 5.240 to 8.747). Affiliate stigma was significantly associated with family daily activities, entertainment activities, family relationship, physical health and mental health of family members, but not family economic burden. CONCLUSION A higher level of affiliate stigma was associated with more family burden among family with PLS. Anti-stigma intervention of mental illness should be consider not only PLS but also their family members.
Collapse
Affiliation(s)
- Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Qiuyan Wu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Anyan Ni
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zixuan Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China; National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| |
Collapse
|
5
|
Daliri DB, Afaya A, Laari TT, Abagye N, Aninanya GA. Exploring the burden on family caregivers in providing care for their mentally ill relatives in the Upper East Region of Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003075. [PMID: 38626022 PMCID: PMC11020355 DOI: 10.1371/journal.pgph.0003075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 03/13/2024] [Indexed: 04/18/2024]
Abstract
Caring for the mentally ill involves numerous challenges, including financial difficulties, stigma, and psychosocial issues, among others. Unpaid family caregivers must endure these challenges as they continue their care for their relatives with mental illness. Despite these burdens and their concomitant effects on both the patients and their caregivers, there is no evidence of this burden in the Bolgatanga municipality. This study explored the burden on family caregivers providing care for mentally ill relatives in the Bolgatanga Municipality of the Upper East Region of Ghana. The study employed a phenomenological research design. Fifteen family caregivers were purposively sampled from two secondary-level health facilities. In-depth interviews were conducted, audio-recorded, and transcribed verbatim. NVivo 12 pro software was used for data analysis. Thematic analysis was conducted following Braun and Clarke's approach. The study identified three themes including social, physical, and psychological burdens. Under social burden, financial challenges and stigma were identified, weight loss was identified as a physical burden, and poor concentration as a psychological burden. These themes represent the challenges encountered by the family caregivers as they provided care for their mentally ill relatives. There is a need to provide support for family caregivers including respite, formation of support groups, and financial support to alleviate family caregivers of the burdens they endure. Additionally, it is imperative to integrate mental health services into the national health insurance scheme to alleviate the financial burden on family caregivers.
Collapse
Affiliation(s)
- Dennis Bomansang Daliri
- Presbyterian Psychiatric Hospital, Bolgatanga, Ghana
- Department of International and Global Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | | | - Nancy Abagye
- Department of Midwifery, School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
| | - Gifty Apiung Aninanya
- Department of Health Services Policy Planning Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana
| |
Collapse
|
6
|
Pan Z, Li T, Jin G, Lu X. Caregiving experiences of family caregivers of patients with schizophrenia in a community: a qualitative study in Beijing. BMJ Open 2024; 14:e081364. [PMID: 38589261 PMCID: PMC11015265 DOI: 10.1136/bmjopen-2023-081364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVES This study aims to understand the caregiving experiences of family caregivers of people with schizophrenia in a community. DESIGN A qualitative study based on phenomenological analysis was conducted through in-depth interviews. SETTING This study was carried out from May to June 2023 in two community health service centres in urban Beijing, China. PARTICIPANTS We selected 16 family caregivers for interviews using purposive sampling method. RESULTS Four themes and 10 subthemes were identified: (1) psychosocial distress of family caregivers (feeling unprepared and helpless at the beginning, confronting negative emotions in long-term care and straying away from social life); (2) adverse impacts on the whole family (poor cooperation within the family, insufficient family involvement in professional care); (3) coping with family caregiving (accepting the reality of the patients' illness, struggling with family life balance and having realistic expectations); (4) concerns about future care (daily living support, physical health management). CONCLUSION Family caregivers experienced psychosocial distress and family stress in the process of caregiving. They had to cope with caregiving stress and were concerned about the long-term care of people with schizophrenia. These findings provide implications for intervention programmes to strengthen social support, family involvement, and active coping for caregivers and develop long-term care mechanisms for people with schizophrenia.
Collapse
Affiliation(s)
- Zhaolu Pan
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Ting Li
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Guanghui Jin
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiaoqin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| |
Collapse
|
7
|
Sun Y, Yu H, Wang Z, Zhang J, Zhou Y, Cui W, Jiang W. Relationship between medication burden and medication experience in stable patients with schizophrenia: the mediating effect of medication belief. BMC Nurs 2024; 23:197. [PMID: 38519927 PMCID: PMC10958954 DOI: 10.1186/s12912-024-01882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Individuals with schizophrenia require prolonged antipsychotic medication treatment. But more than 50% of individuals with schizophrenia experience adverse medication experiences during their antipsychotic treatments. Such individuals often adjust or discontinue medication, leading to disease relapse and impaired social functioning. Psychiatric nurses should pay close attention to the medication experiences of individuals with schizophrenia. This research explore the relationship between medication burden and medication experience, as well as the mediating effect of medication belief in stable patients with schizophrenia. METHODS A convenience sample of hospitalized stable patients with schizophrenia were selected from Daqing Third Hospital and Baiyupao Hospital from September 2023 to December 2023. A survey was conducted with them using a questionnaire consisting of general information questionnaire, The Subjective Well-being Under Neuroleptic Treatment Scale(SWN), The Living with Medicines Questionnaire(LMQ), Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). Pearson correlation analysis was used to explore the correlation between LMQ, BMQ-Specific and SWN scores, and multiple linear regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia. AMOS 24.0 was used to construct the structural equation modeling(SEM), and the mediation effect of the SEM was tested using Bootstrap method. RESULTS According to the sample size calculation requirements of structural equation model, a total of 300 samples were required in this study, and 400 effective questionnaires were actually collected in this study, which met the sample size requirements for constructing structural equation models. Bootstrap test showed that the mediation effect was significant. The total effect of medication burden on medication experience was significant (Z=-12.146, 95%CI (-0.577, -0.417), P < 0.001). The indirect effect of medication burden on medication experience, that is, the mediating effect of medication belief was significant (Z=-4.839, 95%CI (-0.217, -0.096), P < 0.001). The direct effect of medication burden on medication experience was significant (Z=-7.565, 95%CI (-0.437, -0.257), P < 0.001). This model belongs to partial mediation model. CONCLUSIONS Psychiatric nurses can enhance the patients' medication experience by reducing medication burden and strengthening medication beliefs. Therefore, the results also provide theoretical references and decision-making foundations for psychiatric nursing professionals to develop appropriate management strategies for individuals with schizophrenia.
Collapse
Affiliation(s)
- Yujing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Zhengjun Wang
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Jing Zhang
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Yuqiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China
| | - Wenming Cui
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | | |
Collapse
|
8
|
Zhang X, Wang S, Zhao R, Zhao N, Tao S, Zhang H, Wu B, Xia X, Fan H. Analysis of factors associated with family disease burden and correlation with social support among family caregivers of patients with severe mental illnesses. Int J Soc Psychiatry 2024; 70:218-226. [PMID: 37947263 DOI: 10.1177/00207640231204217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
BACKGROUND Caregivers are responsible for the home care of family members with severe mental illnesses (SMIs) and their lives are often subject to changes that can create stress and burden. The purpose of this study was to explore the current state of family disease burden and its correlation with social support among family caregivers of SMIs patients. METHODS Using a random sampling method, a total of 1,108 family caregivers of SMIs patients in community health service centers were selected. A general information questionnaire of family caregivers and patients, the Family Disease Burden Scale, and the Social Support Rating Scale were used. RESULTS The score of the Family Disease Burden Scale of 1108 family caregivers was 16.57 ± 10.65. Family disease burden was negatively correlated with social support (p < .05). The main influencing factors of family disease burden were average annual family income, duration of illness, distance to medical care, risk of unpredictable behavior, social support, caregiver-patient relationship, gender, and comorbid chronic conditions (p < .05). CONCLUSION Family caregivers of SMIs patients have a relatively low level of caregiver-perceived social support. Interventions to enhance perceived social support could help maintain the health of family caregivers and improve the quality of family care.
Collapse
Affiliation(s)
- Xia Zhang
- School of Nursing, Nanjing Medical University, P.R. China
| | - Sizhe Wang
- School of Public Health, Nanjing Medical University, P.R. China
| | - Ran Zhao
- School of Public Health, Nanjing Medical University, P.R. China
| | - Nan Zhao
- School of Nursing, Nanjing Medical University, P.R. China
| | - Shilong Tao
- Center for Disease Control and Prevention of Jiangning District, Nanjing, P.R. China
| | - Haiyang Zhang
- Center for Disease Control and Prevention of Jiangning District, Nanjing, P.R. China
| | - Baiqun Wu
- Center for Disease Control and Prevention of Jiangning District, Nanjing, P.R. China
| | - Xiaojuan Xia
- Center for Disease Control and Prevention of Jiangning District, Nanjing, P.R. China
| | - Hong Fan
- School of Nursing, Nanjing Medical University, P.R. China
- School of Public Health, Nanjing Medical University, P.R. China
| |
Collapse
|
9
|
Cham CQ, Ibrahim N, Kalaman CR, Ho MC, Visvalingam U, Ahmad Shahabuddin F, Abd Rahman FN, Halim MRTA, Harbajan Singh MK, Azhar FL, Yahya AN, Roslan S, Siau CS. Factors associated with depression, anxiety, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients: A cross-sectional study. Glob Ment Health (Camb) 2024; 11:e12. [PMID: 38390253 PMCID: PMC10882176 DOI: 10.1017/gmh.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Depression and anxiety are prevalent mental health issues worldwide, especially among parental caregivers. By expanding the family stress model, this cross-sectional study investigated the relevant factors associated with depressive symptoms, anxiety symptoms, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients. Data were collected through questionnaires (N = 207) across five major public hospitals through convenience sampling. Participants answered questionnaires measuring financial strain, caregiver burden, relationship quality, belief in mental illness, perceived COVID-19 stress, satisfaction with health services, depressive symptoms, anxiety symptoms and life satisfaction. Findings revealed that relationship quality among spouses, COVID-19 stress and caregiver burden were significantly correlated with anxiety symptoms, depressive symptoms and satisfaction with life. The multiple regression model also suggested that depressive symptoms (β = .613, p < .001), anxiety symptoms (β= .657, p < .001) and relationship quality among spouses (β = .264, p < .001) were the most influential predictors of anxiety symptoms, depressive symptoms and satisfaction with life respectively. By addressing the mental health needs of parental caregivers, this study can contribute to improving the overall quality of care and support provided to adolescent patients and their caregivers in Malaysia and beyond.
Collapse
Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson, Malaysia
| | - Uma Visvalingam
- Department of Psychiatry and Mental Health, Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | | | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Kuala Nerus, Malaysia
| | | | - Fatin Liyana Azhar
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Amira Najiha Yahya
- Department of Educational Psychology and Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
10
|
Silaule O, Casteleijn D, Adams F, Nkosi NG. Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review. Interact J Med Res 2024; 13:e48587. [PMID: 38236636 PMCID: PMC10835589 DOI: 10.2196/48587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 10/04/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND There is considerable evidence of the burden of care encountered by informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. Previous studies have highlighted the need to support these informal caregivers as key players in the care of these patients. To date, limited evidence exists on the extent and types of strategies for supporting these informal caregivers in low- and middle-income countries. OBJECTIVE This scoping review aims to identify and describe the extent and type of evidence on the existing strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. METHODS A systematic literature search was completed following the Joanna Briggs Institute methodology for scoping reviews. The participants, concept, and context framework was used to guide the search for literature sources across 5 databases: PubMed, MEDLINE, CINAHL, and PsycINFO for published literature and ProQuest for unpublished literature. This review included studies that reported on strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions, with a focus on studies that evaluated or recommended caregiver interventions and support strategies in low- and middle-income countries. The search was limited to studies conducted between 2001 and 2021, and only papers written in English were considered for inclusion. Using the Covidence software (Veritas Health Innovation), 2 reviewers independently screened the papers, applied the inclusion and exclusion criteria, and met biweekly to discuss and resolve conflicts. The relevant studies and reported outcomes were summarized, organized, and analyzed descriptively using numeric summary analysis and deductive content analysis. RESULTS Of the 18,342 studies identified, 44 (0.24%) met the inclusion criteria. The included studies were from 16 low- and middle-income countries in Asia, Africa, Europe, and South and North America. Most studies (21/44, 48%) were randomized controlled trials conducted in Asian countries. The identified strategies were grouped into 2 categories: implemented and recommended intervention strategies. Identified strategies included community-based interventions, psychoeducation interventions, support groups, cognitive behavioral therapy, spirituality-based interventions, and smartphone-based interventions. In addition, mindfulness and empowerment, collaborative interventions, standard care, financial and social support, counseling, occupation-based interventions, policy and legislature, and access to mental health care were identified. Psychoeducation and support group interventions were identified as common strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions. CONCLUSIONS This review provides evidence on the types of implemented and recommended strategies for alleviating the burden of care among informal caregivers in low- and middle-income countries. Although psychoeducational interventions were the most preferred strategy for alleviating burden, their benefits were short-lived when compared with peer-led support groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44268.
Collapse
Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, University of Pretoria, Pretoria, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula Gloria Nkosi
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
11
|
Darban F, Safarzai E, Sabzevari S, Heydarikhayat N. Schizophrenia: jinn, magic or disease? Experiences of family caregivers of patients with schizophrenia in Baloch ethnicity. BMC Psychiatry 2023; 23:827. [PMID: 37957633 PMCID: PMC10644590 DOI: 10.1186/s12888-023-05332-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Cultural and religious beliefs are effective on people's attitudes towards schizophrenia and their help-seeking behaviors. This study aimed to explain the experiences of family caregivers of patients with schizophrenia in Baloch ethnicity. METHODS This is a qualitative study with conventional content analysis approach. Purposive sampling was used and 21 participants, including family caregiver for patients with schizophrenia, a psychologist, a prayer-writer, and a normal person were interviewed in Sistan and Balochistan province in the southeast of Iran. Qualitative data were analyzed by Granheim and Lundman method. RESULTS One main theme, three categories, and 10 Sub-categories were extracted from analysis of interviews. "Immersion in the cultural beliefs" was the main theme of the study with categories of "Belief in the superstitious and supernatural nature of the psychological disease", "Superstitious beliefs, an attempt to free the patient", and "Conflict between cultural beliefs and science". CONCLUSIONS Help-seeking behaviors of family caregivers in Baloch ethnicity are influenced by their religious, superstitious, and cultural beliefs. Psycho-education should be part of all mental health education programs in these communities, as delays in treatment worsen the prognosis of people with schizophrenia. Training the medical staff to consider the culture, religion and therapeutic preferences of the Baloch people can be effective in advancing the goals. In addition, local influencers should stress the importance of health care alongside harmless local remedies.
Collapse
Affiliation(s)
- Fatemeh Darban
- Department of Nursing, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - Enayatollah Safarzai
- Department of Nursing, Ali-Ebne-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sakineh Sabzevari
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Nastaran Heydarikhayat
- Department of Nursing, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
| |
Collapse
|
12
|
Li Y, Qiu D, Wu Q, Ni A, Tang Z, Xiao S. Family caregivers' abusive behaviour and its association with internalized stigma of people living with schizophrenia in China. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:61. [PMID: 37726337 PMCID: PMC10509261 DOI: 10.1038/s41537-023-00393-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Abstract
Family caregiving of people living with schizophrenia (PLS) can be burdensome, and some family caregivers may perpetrate abusive behavior that could be harmful to PLS. This study aims to examine the association of family caregivers' abusive behavior with internalized stigma of PLS and draw attention to this problem. PLS were recruited from four cities across China and completed measures of abusive behavior and internalized stigma. Linear regression analyses were used to determine the association between family caregivers' abusive behavior and internalized stigma of PLS. A total of 693 PLS were include in this study. 22.7% of the participants had experienced one or more of the abusive behaviors perpetrated by family caregivers. The most common type of abusive behavior towards PLS was verbal abuse and 4.2% of the participants reported physical abuse. 44.6 % of participants reported a high level of internalized stigma. PLS who experienced any abusive behavior by family caregivers had significantly higher levels of internalized stigma. Family caregivers' abusive behavior is positively associated with alienation and social withdrawal but not with stereotype endorsement and discrimination of PLS. To end all forms of stigma and discrimination against PLS, more attention needs to be paid to the families of PLS.
Collapse
Affiliation(s)
- Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Qiuyan Wu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Anyan Ni
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zixuan Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
- National Clinical Research Center for Mental Disorders and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
| |
Collapse
|
13
|
Di Sarno E, Louzã MR. The burden of caregivers of schizophrenia outpatients during the COVID-19 pandemic: A same-sample comparison with the pre-pandemic burden. Int J Soc Psychiatry 2023; 69:1231-1238. [PMID: 36825654 PMCID: PMC9968889 DOI: 10.1177/00207640231156512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has affected the vulnerable Brazilian population. In this study, we investigated the burden of COVID-19 on caregivers for patients with schizophrenia. OBJECTIVE This study assessed objective and subjective burden of caregivers for patients with schizophrenia during the COVID-19 pandemic and compared the measurements obtained in the study to that before the pandemic. METHODS The study included 50 caregivers who were assessed using the Sociodemographic Questionnaire, and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). An adaptation of the Clinical Global Impression-Improvement (CGI-I) was made, in which caregivers evaluated their 'clinical' impression about the patient during the COVID-19 pandemic in comparison to pre-pandemic mental status. RESULTS Most caregivers were female, aged between 24 and 80 years, who were in contact with the patient for about 88.56 hours/week. In relation to caregiver burden, there was a significant increase in the total subjective burden (p < .001), but not in the total objective burden. The following subjective domains of the burden showed a significant increase: assistance in daily life (p < .001) and worries about patients' present and future life (p = .033). There was a decrease in the objective burden related to supervision of patients' problematic behaviors (p = .031). Although the caregiver's income did not change significantly during the COVID-19 pandemic, there was an increase in the percentage of caregivers who perceived the frequency of financial burden imposed by the patient as 'very frequent' and 'always or almost always'; conversely there was a significant decrease in the subjective perception of the caregiver that the patient imposed financially 'no burden' or a 'seldom burden' (from 34% to 4%). CONCLUSION Although the objective burden of the caregivers, during the pandemic, was similar the pre-pandemic levels, caregivers' subjective burden increased reinforcing the need for special attention to the caregiver in this global emergency.
Collapse
Affiliation(s)
- Elaine Di Sarno
- Schizophrenia Research Program (Projesq), Institute
of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de
São Paulo, Brazil
| | - Mario Rodrigues Louzã
- Schizophrenia Research Program (Projesq), Institute
of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de
São Paulo, Brazil
| |
Collapse
|
14
|
Li M, Chen Y, Hu X, Wang S. The preferences for the telemedicine and standard health care services from the perspective of the patients with schizophrenia. BMC Psychiatry 2023; 23:361. [PMID: 37226168 DOI: 10.1186/s12888-023-04885-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/18/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND With the rapid development of telemedicine, has enabled new and various ways to deliver health care services for patients with schizophrenia. However, it is not clear that the newly emerged is better than the standard or not from the perspective of patients with schizophrenia. This study aims to explore their preferences between telemedicine and standard health care services and their associated factors. METHODS The cross-sectional study was conducted at the Ningan hospital's inpatient department in Yinchuan, and collected socio-demographic and clinical information, the preferences regarding telemedicine (WeChat, telephone, and Email), and the standard health care services (community health center and home visit). The socio-demographic and clinical characteristics associated with the five-health care service delivery ways were assessed by descriptive analysis, and the associated impact factors of preferences of patients with schizophrenia were analyzed by multiple logistic regression. RESULTS Among the 300 participants, most of them chose WeChat (46.3%), some of them tended to telephone (35.4%) and community health center (11.3%), and a few of them accepted home visits (4.7%), and Email (2.3%). There are so many associated factors that affected the patients with schizophrenia to choose their favorite health care services, of which age, gender, employment, residence, and duration of illness were the independent impact factors. CONCLUSIONS The cross-sectional study surveyed the preferences between telemedicine and standard health care services in patients with schizophrenia's opinion, disclosed independent impact factors, as well as compared the advantage and disadvantages of these. According to our findings, the best health care services should be based on the preferences of the patients with schizophrenia and adapt to realistic conditions. This provides valuable evidence to improve the health care situation, facilitate the continuity of health care services, and achieve holistic rehabilitative outcomes for the patients with schizophrenia.
Collapse
Affiliation(s)
- Min Li
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Yanhan Chen
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Xuefu Hu
- Ningan mental health center, Yinchuan, Ningxia, China
| | - Shunhong Wang
- Department of Anesthesiology, The 958th Hospital of Chinese People's Liberation Army, Chongqing, China.
| |
Collapse
|
15
|
Sun X, Zhang X, Liu L, Zhang L, Zhan T, Chen Y. A qualitative of stable symptomatology for patients with schizophrenia: do they have adequate post-discharge rehabilitative resources? SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:29. [PMID: 37156777 PMCID: PMC10167338 DOI: 10.1038/s41537-023-00358-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/21/2023] [Indexed: 05/10/2023]
Abstract
Many patients diagnosed with schizophrenia face obstacles to rehabilitation and discharge into the community, particularly with regard to the way resources are structured. Clarifying the difficulties will help health care providers address rehabilitation shortcomings. Semistructured in-depth interviews and participatory observations were conducted in various locations (family home, hospital ward, outpatient clinic, and on the street) with families, social workers, doctors, nursing staff, and patients with schizophrenia. These patients met the medical facility's hospital discharge standards and either had not been discharged or had been discharged within two weeks of meeting the discharge criteria. This study explores the complex and interdependent role of social differences in the rehabilitation of patients with schizophrenia after acute treatment. The study identified five topics related to structural difficulties in resources for the rehabilitation of patients diagnosed with schizophrenia: (1) the role of policy; (2) inadequate facilities and responsibilities; (3) rejecting communities; (4) difficult families; and (5) the threat of stigma. The rehabilitation of patients diagnosed with schizophrenia is a systemic problem. Systemic rehabilitation policies and integrated social support would be more conducive to the rehabilitation of patients. Perhaps cognitive remediation therapy or the Assertive Community Treatment (ACT) Model could benefit individuals with complex disorders.
Collapse
Affiliation(s)
- Xirong Sun
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xiyan Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Liang Liu
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Lei Zhang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Ting Zhan
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yanhua Chen
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
| |
Collapse
|
16
|
Gong JW, Luo D, Liu WJ, Zhang J, Chen ZR, Wang QY, Yang XY, Yang BX, Huang HS, Wang XQ. Challenges faced when living with schizophrenia in the community: A narrative inquiry. Int J Soc Psychiatry 2023; 69:420-429. [PMID: 35943191 DOI: 10.1177/00207640221109168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia. AIMS To explore the challenges of people living with schizophrenia in the community. METHODS A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data. RESULTS Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life. CONCLUSIONS There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community.
Collapse
Affiliation(s)
| | - Dan Luo
- School of Nursing, Wuhan University, China
| | - Wen Jia Liu
- School of Nursing, Wuhan University, China.,University of Washington School of Nursing, Seattle, USA
| | - Juan Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Zi Ru Chen
- School of Nursing, Wuhan University, China
| | - Qin-Yu Wang
- Department of Psychology, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | | | - Bing Xiang Yang
- School of Nursing, Wuhan University, China.,Department of Psychiatry, Renmin Hospital of Wuhan University, China.,Population and Health Research Center, Wuhan University, China
| | - Hai-Shan Huang
- Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | |
Collapse
|
17
|
Sharifi M, Younesi SJ, Foroughan M, Safi MH, Khanjani MS. The Challenges of Caring for an Adult Child with Schizophrenia in the Family: An Analysis of the Lived Experiences of Older Parents. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580221148867. [PMID: 36752143 PMCID: PMC9909083 DOI: 10.1177/00469580221148867] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The present study aimed to investigate the lived experiences of older parents regarding the challenges in caring for adult children with schizophrenia. The current study was conducted on 16 parental (mother or father) caregivers of adult children with schizophrenia using a descriptive phenomenological qualitative approach and Colaizzi's seven-step method. This study follows the Qualitative Research Checklist (COREQ). The findings showed that the parent caregivers' experiences could be classified into two main themes: "burden of care" and "Negative attitude and inefficient performance." The former consisted of three sub-themes including "disrupted social and family interactions," "helplessness and inefficient support," and "challenges of the healthcare system," while the latter had two sub-themes including "Negative attitude and inefficient performance of the caregivers" and "Negative attitude and inefficient performance of families and society." Older parents have to tolerate a significant burden of care due to their age and physical conditions. Improving the knowledge of specialists, the government's redoubled efforts in multifaceted support for patients and caregivers, creating an integrated team of specialists, and accepting and improving public attitudes against stigma and obvious discrimination in society as important priorities in improving the condition of caregivers and patients with schizophrenia were considered.
Collapse
Affiliation(s)
- Mehdi Sharifi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Department of Counseling, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyyed Jalal Younesi
- Department of Counseling, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Seyyed Jalal Younesi, Department of Counseling, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hadi Safi
- Department of Psychology, Faculty of Humanities & Social Sciences, Ardakan University, Ardakan, Iran
| | - Mohammad Saeed Khanjani
- Department of Counseling, Faculty of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
18
|
Lök N, Bademli K, Lök S. The effect of a physical activity intervention on burden and healthy lifestyle behavior in family caregivers of patients with schizophrenia: A randomized controlled trial. Arch Psychiatr Nurs 2023; 42:33-39. [PMID: 36842825 DOI: 10.1016/j.apnu.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/21/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
AIM The aim of this study is to investigate the efficacy of a physical activity intervention on burden and healthy lifestyle behavior in family caregivers of schizophrenia. METHOD A randomized, controlled trial was conducted to evaluate the effect of physical activity program on burden and healthy lifestyle behavior in family caregivers of patients with schizophrenia. The "Physical Activity Program" consisted of 5 min of warm-up activities as the initial segment, 20 min of rhythmic exercises as the activity segment, 5 min of cool down exercises as the final segment and 30 min of free walking. The program consisted of 8 sessions. The Zarit Caregiver Burden Scale and the Healthy Lifestyle Behavior Scale were applied to the physical activity and control groups ahead of the program's implementation. A total of 60 caregivers were randomly distributed to the intervention (n = 30) and control groups (n = 30). Post-intervention measurement was completed by 60 caregivers and all the caregivers completed the intervention. RESULTS Significant differences were found on the Zarit Caregiver Burden Scale score and Healthy Lifestyle Behavior score between the groups. CONCLUSION Future research should examine with larger sample groups, carry out interventions, and apply the physical activity intervention by targeting caregivers, along with different interventions.
Collapse
Affiliation(s)
- Neslihan Lök
- Selçuk University, Faculty of Nursing, Psychiatric Nursing Department, Konya, Turkey
| | - Kerime Bademli
- Akdeniz University, Faculty of Nursing, Psychiatric Nursing Department, Antalya, Turkey.
| | - Sefa Lök
- Selçuk University, Faculty of Sports Science, Department of Coaching Education, Konya, Turkey
| |
Collapse
|
19
|
Öztürk GK, Çam MO. "Like a Pale Flower in a Dark Well": Experiences of Women Whose Spouses Have Schizophrenia. J Psychosoc Nurs Ment Health Serv 2023; 61:53-59. [PMID: 36322872 DOI: 10.3928/02793695-20221027-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current qualitative phenomenological study was performed with the aim of determining spousal, marital, and family experiences of women with spouses who have schizophrenia. Eleven women (mean age = 48 years) who were living with a spouse with schizophrenia with a disorder duration of at least 10 years were interviewed. Two main themes and six subthemes were revealed: Dark Well (anger and hate, pity beyond emotion, burnout) and Pale Flower (porter work, prison, destruction of roles). Women living with spouses with schizophrenia felt as though they had fallen into a dark well filled with problems, such as anger, hate, pity, and burnout, while they were living pale lives, which were wearing them out in many ways due to changing roles, carrying heavy burdens, and disrupted marital relationships. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 53-59.].
Collapse
|
20
|
Zabeen S, Phua D, Mohammadi L, Lawn S. Family involvement to support cardiovascular self-management care for people with severe mental illness: a systematic review. J Ment Health 2023; 32:290-306. [PMID: 32924668 DOI: 10.1080/09638237.2020.1818194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Family members play a pivotal role in supporting cardiovascular self-management-based care of community-living adults with severe mental illness (SMI). However, little is known about what strategies caregivers employ as part of their caring roles. AIM This paper aims to explore what caregiving strategies work (or not), why and how by collating and synthesising existing evidence on this issue. METHODS A systematic search of peer-reviewed qualitative and mixed-method studies published between 2000 and 2019 was employed. This comprehensive process generated only nine papers for subsequent meta-synthesis of qualitative data. RESULTS Findings suggested that caregivers have a complex yet comprehensive role to play in initiating and perpetuating self-management-based cardiovascular care. The elements of recovery such as promoting hope, normality, autonomy and identity were flagged as critical underpinning factors that motivated the person with SMI to adopt a healthy lifestyle. However, it was evident that caregivers needed to walk alongside the person, at times, to help them reach their maximum potential in sustaining improved self-management behaviours. CONCLUSION Caregivers sit in a favourable bridging position between healthcare systems and community-living individuals with SMI, to support their cardiovascular health. However, this powerful but invisible 'workforce' clearly needs further support involving finance, skill-development and acknowledgement.
Collapse
Affiliation(s)
- Sara Zabeen
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Delphine Phua
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Leila Mohammadi
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| |
Collapse
|
21
|
Sustrami D, Yusuf A, Fitryasari R, Suhardiningsih AVS, Arifin H. Determinants of Burden in Family Caregivers of Individuals With Schizophrenia: A Systematic Review. J Psychosoc Nurs Ment Health Serv 2023; 61:38-43. [PMID: 35993724 DOI: 10.3928/02793695-20220804-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The current systematic review was performed to determine the specific burdens placed on families of individuals with schizophrenia. Scopus, PubMed, and CINAHL databases were searched, resulting in 21 articles that met inclusion criteria. Results showed that treatment of individuals with schizophrenia poses a burden on families. Most caregivers experienced emotional and financial problems that affected their quality of life. Influencing factors in caregivers were age, sex, educational level, family status, income, time spent with the individual per day, knowledge regarding schizophrenia, attitude, and psychological stress. Influencing factors in individuals with schizophrenia were age, sex, severity of illness, social function, and treatment adherence. Environmental factors were stigma, social support, and professional support from health care providers. Family caregivers of individuals with schizophrenia need to be empowered to improve resilience and acceptance in caring for these individuals. [Journal of Psychosocial Nursing and Mental Health Services, 61(2), 38-43.].
Collapse
|
22
|
Deng SY, Wang YZ, Peng MM, Zhang TM, Li M, Luo W, Ran MS. Quality of life among family caregivers of people with schizophrenia in rural China. Qual Life Res 2023; 32:1759-1769. [PMID: 36715814 DOI: 10.1007/s11136-023-03349-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 01/31/2023]
Abstract
PURPOSES To investigate quality of life (QoL) of family caregivers of people with schizophrenia and examine the influencing factors of the QoL in a Chinese rural area. METHODS This study included people with schizophrenia (n = 269) and their family caregivers (n = 269) from Xinjin district, Chengdu, China. Family caregivers' QoL was measured by the World Health Organization Quality of Life-Brief Form and its influencing factors was analyzed by the multivariate regression. RESULTS Family caregivers of people with schizophrenia had very poor QoL across four domains. The regression analysis showed that physical domain of QoL was significantly associated with age, psychiatric symptoms of people with schizophrenia, and caregiving burden of family caregivers (p < 0.05). Psychological domain of QoL was significantly related to family caregivers' affiliate stigma, caregiving burden, and psychiatric symptoms of people with schizophrenia (p < 0.05). Social domain of QoL was significantly associated with age and psychiatric symptoms of people with schizophrenia, and affiliate stigma of family caregivers (p < 0.05). Environmental domain of QoL was significantly related to age and psychiatric symptoms of people with schizophrenia, and family caregivers' caregiving burden (p < 0.05). CONCLUSION Family caregivers of people with schizophrenia had poor QoL in rural China. Family caregivers' QoL is significantly impacted by age and psychiatric symptoms of people with schizophrenia, caregivers' affiliate stigma and caregiving burden. Providing social support and psychosocial interventions for family caregivers of people with schizophrenia might be crucial to improve their QoL and caregiving.
Collapse
Affiliation(s)
- Shu-Yu Deng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Yi-Zhou Wang
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, 519087, China
| | - Tian-Ming Zhang
- Department of Social Work, Shanghai University, Shanghai, China
| | - Ming Li
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | - Wei Luo
- Chengdu Xinjin Second People's Hospital, Chengdu, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China. .,Mental Health Center and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
| |
Collapse
|
23
|
Lohrasbi F, Alavi M, Akbari M, Maghsoudi J. Promoting Psychosocial Health of Family Caregivers of Patients with Chronic Mental Disorders: A Review of Challenges and Strategies. Chonnam Med J 2023; 59:31-47. [PMID: 36794251 PMCID: PMC9900218 DOI: 10.4068/cmj.2023.59.1.31] [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: 10/29/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 02/03/2023] Open
Abstract
The present study aimed to investigate the mental and social health challenges of family caregivers of the patients with chronic mental disorders (CMD) and strategies which can be helpful in this regard. This study is a narrative review conducted in PubMed, Web of Science, Scopus, Elsevier, Google Scholar, Proquest, Magiran, and Sid databases where keywords such as Family caregiver, Chronic Mental disorder, Health Promotion, Program, Psychosocial, Support, Challenge, and Problem were searched in both Persian and English. A total of 5,745 published documents were found and were screened based on inclusion and exclusion criteria. Finally, 64 studies were found which had examined the related challenges, needs and strategies. According to the results, information deficits, needs for support, community participation deficits, and psychological suffering were recognized as challenges of family caregivers of these patients. Moreover, empowerments programs for the enhancement of the knowledge and skills of caregivers and peer-centered support programs were used to improve the level of mental and social health of family caregivers of these patients. Psychosocial problems and challenges that family caregivers of the patients with CMD face affect their health, satisfaction and quality of life. Using a collaborative approach, mental health service providers and government systems can help improve the psychosocial health of caregivers. The related managers and policymakers can reduce the emotional and psychological burden of families and promote their psychosocial health through developing a comprehensive program including practical objectives and strategies and taking into account the challenges that exist for caregivers in caring for patients with CMD.
Collapse
Affiliation(s)
- Fateme Lohrasbi
- Mental Health Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing & Midwifery Care Research Center, Mental Health Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Akbari
- Nursing & Midwifery Care Research Center, Mental Health Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jahangir Maghsoudi
- Nursing & Midwifery Care Research Center, Mental Health Nursing Department, Faculty of Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
24
|
Upasen R, Saengpanya W. Combating with Compassion Fatigue: The Perspective of Family Caregivers of People with Schizophrenia. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:249-255. [PMID: 36191894 DOI: 10.1016/j.anr.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The purpose of this study was to explore the coping processes used by family caregivers of individuals with schizophrenia to deal with compassion fatigue (CF). METHODS Grounded theory was used in this study. For recruitment, purposive and theoretical samplings were used to recruit participants. Data were collected from 29 family caregivers through in-depth interviews and field notes. Data were analyzed using constant and comparative methods. RESULTS The study revealed a core process for dealing with CF as "Combating with compassion fatigue" that comprised three dynamic phases: strengthening attachment with the care recipient to increase willpower, learning how to deal with the illness, and self-empowerment to fight to the physical and mental fatigue. CONCLUSIONS Family caregivers of people with a diagnosis of schizophrenia use various strategies to fight to CF. These combine the past experiences of strategies that work and new approaches. Our research will allow mental health professionals to provide basic strategies to family caregivers of people with a diagnosis of schizophrenia to help them to cope with CF.
Collapse
Affiliation(s)
| | - Weeraphol Saengpanya
- Faculty of Education, Division of Educational Psychology, Chulalongkorn University, Thailand.
| |
Collapse
|
25
|
Issac A, Nayak SG, Yesodharan R, Sequira L. Needs, challenges, and coping strategies among primary caregivers of schizophrenia patient: A systematic review & meta-synthesis. Arch Psychiatr Nurs 2022; 41:317-332. [PMID: 36428067 DOI: 10.1016/j.apnu.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/04/2022] [Accepted: 09/03/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Deinstitutionalization and rising psychiatric care in society have led to an increase in the role of caregivers of persons diagnosed with schizophrenia. OBJECTIVE The objective of this systematic review was to identify and synthesize qualitative research findings that explored the needs, challenges, and coping strategies among the primary caregivers of a schizophrenia patient. METHODOLOGY The electronic databases namely PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Scopus, Web of Science, ProQuest, and ClinicalKey were searched to identify relevant articles published from 2005 to October 2021. The quality of the included articles was independently appraised by two reviewers using Walsh and Downe criteria and was analysed thematically. The meta-synthesis was modelled on Lucas framework. RESULTS The richness of information across 38 papers involving 543 participants was noteworthy. The needs of the primary caregivers were rehabilitation and vocational centre, information and education, self-help groups, augmented healthcare services, and communication and collaboration. The challenges reported were treatment expenses, bizarre beliefs, self and other directed harm and violence, therapeutic noncompliance, onerous caregiving task, crumbling family relations, misconception and discrimination, and self-stigmatization. The coping strategies adopted were problem-focused coping, emotional coping, behavioural coping, coping through social support, religious coping and cognitive reappraisal. CONCLUSION The primary caregivers provide unparalleled service to the health system and for the patient. The healthcare providers need to give undue attention to the unmet needs and challenges of the caregivers, which would benefit the health system by enabling the caregivers in providing long-term care for the schizophrenic.
Collapse
Affiliation(s)
- Alwin Issac
- All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Shalini Ganesh Nayak
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Renjulal Yesodharan
- Department of Mental Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Leena Sequira
- Manipal School of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| |
Collapse
|
26
|
Can Öz Y, Duran S, İncedere A. Requirements of caregivers of patients with schizophrenia: A qualitative study in Turkey. Arch Psychiatr Nurs 2022; 41:81-86. [PMID: 36428079 DOI: 10.1016/j.apnu.2022.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/04/2022] [Accepted: 07/10/2022] [Indexed: 11/30/2022]
Abstract
Caregivers have different experiences and difficulties in the patient care process during which the role of providing care is fulfilled. Understanding the requirements of caregivers may help determine the content of the country-specific psychoeducation program needed. Caregivers of patients with schizophrenia want certain needs to be met while they provide care to these patients. This qualitative study aims to determine and analyze these needs. The researchers conducted face-to-face semi-structured interviews with 15 caregivers. Themes were Themes identified included determined as managing disease behavior, gaining independent living skills, managing social-educational problems, and psychosocial support needs of the family members. Mental health and psychiatric nurses should understand, accept, and protect the needs of caregivers. It is suggested that mental health and psychiatric nurses plan group training about the determined needs and provide support for caregiving family members.
Collapse
Affiliation(s)
- Yüksel Can Öz
- Kocaeli University, Faculty of Health Sciences, Department of Psychiatric Nursing, Kocaeli, Turkey.
| | - Songül Duran
- Izmir Demokrasi University, Health Services Vocational College, Care of Elderly Program, Izmir, Turkey
| | - Aysel İncedere
- Istanbul University-Cerrahpaşa, Graduate Education Institute Mental Health and Psychiatric Nursing PhD Student, İstanbul, Turkey
| |
Collapse
|
27
|
Özgönül ML, Bademli K. Ethical problems experienced by family caregivers of patient with schizophrenia: A hermeneutic phenomenological study. Perspect Psychiatr Care 2022; 58:2127-2136. [PMID: 35102567 DOI: 10.1111/ppc.13039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to provide information on the ethical problems faced by family caregivers of patients with schizophrenia. METHOD This study was conducted using a hermeneutical approach to phenomenology. Data were obtained by means of an individual interview process using a semi-structured interview guide. RESULTS The results of this study revealed the following themes and sub-themes: higgledy-piggledy, walking on a thorny path, decision-making, subtheme, back of the mirror, victim, and dark well. PRACTICE IMPLICATIONS Expressed concerns have shown that caregivers not only face difficult challenges in the management of complicated and complicated illnesses, but also face ethical issues inherent in the role of caregivers and must take ethical decisions.
Collapse
Affiliation(s)
- Mustafa Levent Özgönül
- Department of Medical History and Ethics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Kerime Bademli
- Psychiatric Nursing Department, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| |
Collapse
|
28
|
Wang M, Chen L, Tang J, Wei Y, Jin G, Lu X. Access to family resources by families living with schizophrenia: a qualitative study of primary care workers in urban Beijing, China. BMJ Open 2022; 12:e062675. [PMID: 36691176 PMCID: PMC9454069 DOI: 10.1136/bmjopen-2022-062675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/05/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study aims to investigate the access to family resources by families living with schizophrenia from the perspective of primary care workers in Beijing, and provide evidence for appropriate and effective family resource coordination in primary care. DESIGN Qualitative research using individual in-depth interviews to identify the access to family resources by families living with schizophrenia from the perspective of primary care workers. SETTING This study was conducted from September to December 2021 in six urban community health service centres (CHSCs) in Beijing, China. PARTICIPANTS 3 general practitioners and 10 mental health doctors selected by purposive sampling method from 6 CHSCs in urban Beijing were interviewed. RESULTS Five themes emerged from the insights of the primary care workers: most family resources are non-targeted for families living with schizophrenia, the publicity of family resources is difficult, burdensome application process of family resources, limited available community-based treatment options and stigma hindering effective communication between families and society. CONCLUSIONS It is necessary to simplify the application process of family resources and provide primary care workers with systematic training regarding family resources. More family resources and improved public attitudes should be promoted for patients with schizophrenia and their caregivers.
Collapse
Affiliation(s)
- Meirong Wang
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
- General Department, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lifen Chen
- Department of Education, Xuanwu Hospital, Beijing, China
| | - Juan Tang
- General Practice, Gong He Community Health Service Center, Beijing, China
| | - Yun Wei
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Guanghui Jin
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| | - Xiaoqin Lu
- School of General Practice and Continuing Education, Capital Medical University, Beijing, China
| |
Collapse
|
29
|
Zheng SS, Zhang H, Zhang MH, Li X, Chang K, Yang FC. "Why I stay in community psychiatric rehabilitation": a semi-structured survey in persons with schizophrenia. BMC Psychol 2022; 10:213. [PMID: 36068639 PMCID: PMC9446651 DOI: 10.1186/s40359-022-00919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS Although community psychiatric rehabilitation plays an important role in returning persons with schizophrenia to the society, many patients in China stay in rehabilitation centers for longer periods of time and subsequently fail to integrate. This study is aimed to explore the underlying causes of this trend and identify possible solutions. METHODS This study used a qualitative descriptive design to examine the persons with schizophrenia who stay in rehabilitation centers for longer periods of time. The researchers conducted semi-structured telephone interviews with the patients recruited through purposeful sampling. The audio-recorded interviews were transcribed in transcripts in Chinese. Thematic analysis was performed using Colaizzi's 7-step method. RESULTS Most patients believe that they have gained knowledge, improved skills, friendship and social circles through community mental rehabilitation, with the sense of belonging and enriched life strongly attracting them to the rehabilitation centers. They felt that the difficulty of further integration into society is mainly because of social prejudice and rejection. In addition, the activities of community mental rehabilitation meet the needs of social communication, which also hinder patients from further entering the society. CONCLUSIONS Persons with schizophrenia with long-term stay in community mental rehabilitation centers meet their friendship, sense of belonging and social needs by participating in rehabilitation activities. Providing special social opportunity for these patients can get them out of the rehabilitation center. Overall, it is possible for patients to gradually return to society in a collective form.
Collapse
Affiliation(s)
- Shan-Shan Zheng
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China.,Community Health Service Center in West District of China Agricultural University, Courtyard 2, Yuan Ming Yuan West Road, Haidian District, Beijing, 100091, China
| | - Hui Zhang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Man-Hua Zhang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Xue Li
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Kuo Chang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China
| | - Feng-Chi Yang
- School of Medical Humanities, Capital Medical University, No. 10, Xitoutiao, You An Men Wai, Fengtai District, Beijing, 100069, China.
| |
Collapse
|
30
|
Al Ksir K, Wood DL, Hasni Y, Sahli J, Quinn M, Ghardallou M. Motivational interviewing to improve self-management in youth with type 1 diabetes: A randomized clinical trial. J Pediatr Nurs 2022; 66:e116-e121. [PMID: 35568602 DOI: 10.1016/j.pedn.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Effective interventions are needed to help adolescents with T1D develop independent self-management skills to prevent commonly observed deterioration of disease self-management resulting in poor health outcomes. Using a prospective RCT design, we assessed the impact of a nurse-led education program based on motivational interviewing (MI) in youth with Type 1 diabetes (T1D). DESIGN AND METHODS After parental consent and youth assent, we prospectively randomized 66 adolescents 13-18 years old with T1D to either usual care (every 3 months visit with pediatric endocrinologist) or usual care supplemented by 2 in-person and 4 follow-up phone calls with a nurse educator in a pediatric endocrinology clinic of the University Hospital Farhat Hached, Sousse, Tunisia. We used MI sessions to support youth general and disease specific self-management skills. Outcomes were change, between baseline and 6 months, in TRAQ (a validated measure of youth self-management) scores and HbA1c values. RESULTS Mean TRAQ scores (based on a 5-point Likert scale) increased by 1.44 points (s.d. = 0.56) in the Intervention Group versus 0.26 points (s.d. = 0.34) in the control group (p < 0.001). The mean HbA1C value decreased in the intervention group by 0.95 units versus a decrease of 0.12 units in the control group (p = 0.047). CONCLUSION We found that a brief, nurse-led MI-based educational intervention, integrated into specialty pediatric care, resulted in a significant improvement in both self-reported self-management skills and in HbA1c values. TRIAL REGISTRATION Registered in ClinicalTrials.gov Identifier: NCT04798937.
Collapse
Affiliation(s)
- Kawther Al Ksir
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America.
| | - David L Wood
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America; Quillen College of Medicine, East Tennessee State University, Johnson City, TN, United States of America
| | - Yosra Hasni
- Farhat Hached University Hospital Center, Endocrinology Department, Sousse, Tunisia
| | - Jihene Sahli
- Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Megan Quinn
- College of Public Health, East Tennessee State University, Johnson City, TN, United States of America
| | - Meriam Ghardallou
- Department of Family and Community Medicine, University of Sousse, Faculty of Medicine of Sousse, Sousse, Tunisia
| |
Collapse
|
31
|
Kalayci E, Uzunaslan İ, Uzunaslan Ş. Caregiver burden experiences of caregivers of patients with schizophrenia: A qualitative inquiry. Int J Soc Psychiatry 2022; 69:543-550. [PMID: 35978546 DOI: 10.1177/00207640221114564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Parents of children with schizophrenia struggle with emotional, social, and economic burdens because they do not receive adequate support and experience difficulties. AIM To determine the caregiver burden experiences of parents who care for schizophrenic patients and to provide in-depth data on their feelings, thoughts, and opinions on this issue. METHODS In this study, the phenomenological method was used. In-depth interviews were conducted with 13 parents. Maxqda 2020 was used for the analysis of the research data. RESULTS In our qualitative study, it was concluded that caregivers were stigmatized by their environment, exposed to social isolation, and stigmatized themselves. It has been determined that the social isolation experienced by the parents negatively affects them economically, socially, and emotionally. CONCLUSION The results of this study were discussed within the framework of three themes: emotional burden, social burden, and economic burden experienced by caregivers.
Collapse
|
32
|
The effect of group psychological training on the attitude of family caregivers of patients with schizophrenia. Heliyon 2022; 8:e09817. [PMID: 35874056 PMCID: PMC9304719 DOI: 10.1016/j.heliyon.2022.e09817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/09/2022] [Accepted: 06/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background and aim Mental disorders are among the most common diseases in the world. Not only the lack of social support and health services but also the social stigma surrounding individuals with mental disorders and their family members has exacerbated the difficulty of living with and caring for these patients. The present study aimed to determine the effect of group psychological training on the attitudes of family caregivers taking care of patients with schizophrenia as a common mental disorder. Materials and methods This interventional study was conducted on 60 caregivers of patients with schizophrenia who had a history of hospitalization in the psychiatric ward of Imam Reza Hospital of Birjand in 2020. The intervention group attended eight 90-minute sessions of psychological training in four weeks. However, the control group received no educational intervention during the study period. the opinions about mental illness scale (OMI) modified by Cohen and Struening was used to collect data before and after the intervention. Data were analyzed using SPSS16 by running descriptive statistics, Chi-square, independent t-test, and paired t-test at the significance level of 0.05. Results The mean scores of attitudes toward mental illness were not significantly different between the intervention (87.37 ± 15.51) and control (89.48 ± 14.08) groups before the intervention (P > 0.05). However, the mean scores of the intervention group (156.44 ± 10.09) increased significantly compared to the mean scores of the control group (88.4 ± 16.15) followed by the intervention (P < 0.05). Conclusion According to the study results, psychological group training is effective in improving the attitudes of family caregivers of schizophrenic patients. So, it can be applied method of this study as simple, low-cost, and effective in improving the life quality of schizophrenic patients and their families.
Collapse
|
33
|
Karimirad MR, Seyedfatemi N, Mirsepassi Z, Noughani F, Cheraghi MA. Barriers to Self-Care Planning for Family Caregivers of Patients with Severe Mental Illness. J Patient Exp 2022; 9:23743735221092630. [PMID: 35434285 PMCID: PMC9006375 DOI: 10.1177/23743735221092630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The chronic nature of severe mental illnesses is necessary for constant care provided by the family caregivers. Considering the significance of family caregivers in providing care, it is imperative to ensure their self-care if they are to play the role of caregiving effectively and efficiently well. The present study was conducted using the purposive sampling method and in-depth semi-structured interviews among 13 family caregivers and five health team members. The data were analyzed via a conventional content analysis approach. In the data analysis, seven main categories and 18 subcategories emerged: “A troublesome patient and me,” including “Care-induced distress,” “Caring dilemma,” “Emotional fluctuations,” and “Self-forgetfulness”; “Passive–destructive individuality,” including: “Mental stereotypes” and “Unhealthy lifestyle”; “Family turbulence,” including: “Family malfunction” and “Break in family ties”; “The conjoined influencing social factor,” including “Lack of awareness at the family and community level” and “Social stigmatization”; “lack of well-organized health care system,” including “Biomedical-oriented health system,” “Disruption in continuity of care,” and “Problems associated with the support provided by the health system”; “Disturbed economic conditions,” including “Difficulty in life with disrupted financial capability,” “Problems related to education and promoting awareness,” and “Family health care problems”; “Dysfunctional Public mental health,” including “Macro-dysfunction of mental health education,” and “Disruptive advocacy activities to support families of patients with mental disorders.” There are several barriers to family caregiver self-care planning that require health professionals to develop appropriate interventions.
Collapse
Affiliation(s)
- Mohammad Reza Karimirad
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Naiemeh Seyedfatemi
- Nursing Care Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Mirsepassi
- Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Noughani
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Cheraghi
- Department of Critical Care and Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
- Health Sciences Phenomenology Association, Ministry of Health and Medical Education, Tehran, Iran
| |
Collapse
|
34
|
Peng MM, Ma Z, Chen SY, Luo W, Hu SH, Yang X, Liu B, Chan CLW, Ran MS. Predictors of family caregiving burden of persons with schizophrenia with and without transition of primary caregivers from 1994 to 2015 in rural China. BJPsych Open 2022; 8:e78. [PMID: 35362401 PMCID: PMC9059613 DOI: 10.1192/bjo.2022.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Little is known about how sociodemographic and clinical factors affect the caregiving burden of persons with schizophrenia (PwSs) with transition in primary caregivers. AIMS This study aimed to examine the predictive effects of sociodemographic and clinical factors on the caregiving burden of PwSs with and without caregiver transition from 1994 to 2015 in rural China. METHOD Using panel data, 206 dyads of PwSs and their primary caregivers were investigated in both 1994 and 2015. The generalised linear model approach was used to examine the predictive effects of sociodemographic factors, severity of symptoms and changes in social functioning on the caregiving burden with and without caregiver transition. RESULTS The percentages of families with and without caregiver transition were 38.8% and 61.2%, respectively. Among families without caregiver transition, a heavier burden was significantly related to a larger family size and more severe symptoms in PwSs. Deteriorated functioning of 'social activities outside the household' and improved functioning of 'activity in the household' were protective factors against a heavy caregiving burden. Among families with caregiver transition, younger age, improved marital functioning, deteriorated self-care functioning, and better functioning of 'social interest or concern' were significant risk factors for caregiving burden. CONCLUSIONS The effects of sociodemographic and clinical correlates on the caregiving burden were different among families with and without caregiver transition. It is crucial to explore the caregiver arrangement of PwSs and the risk factors for burden over time, which will facilitate culture-specific family interventions, community-based mental health services and recovery.
Collapse
Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, Illinois, USA
| | - She-Ying Chen
- Center for Social Work Study, Institute on Chinese Culture, Health and Public Welfare, Tsinghua University, China
| | - Wei Luo
- Xinjin Second People's Hospital, Xinjin, Chengdu, Sichuan, China
| | - Shi-Hui Hu
- Chengdu Mental Health Center, Chengdu, Sichuan, China
| | - Xin Yang
- Guangyuan Mental Health Center, Guangyuan, Sichuan, China
| | - Bo Liu
- Jingzhou Mental Health Center, Jingzhou, Hubei, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR; and Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
35
|
Rahmani F, Roshangar F, Gholizadeh L, Asghari E. Caregiver burden and the associated factors in the family caregivers of patients with schizophrenia. Nurs Open 2022; 9:1995-2002. [PMID: 35347867 PMCID: PMC9190687 DOI: 10.1002/nop2.1205] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 02/03/2023] Open
Abstract
Aim Our study aimed to investigate the caregiving burden and its associated factors in family caregivers of patients with schizophrenia. Design Correlational study. Method Using the convenience sampling method, 215 caregivers were recruited from outpatient clinics affiliated with a tertiary referral psychiatric hospital in Iran. The caregiving burden was measured by the Zarit Burden Interview (ZBI‐22), and associations between caregiving burden and potential factors were examined using multiple regression analysis. We used the STROBE checklist to report the results. Results Family caregivers of patients with schizophrenia reported a high level of caregiving burden, with 38.2% of the caregivers perceiving severe burden relating to their role. In the regression analysis, age, gender, educational level, income, job loss due to caregiving, relationship with patient, disease duration and frequency of caregiving were statistically significant predictors of caregiving burden. The regression model explained 54.4% of the variance of caregiving burden.
Collapse
Affiliation(s)
- Farnaz Rahmani
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariborz Roshangar
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Elnaz Asghari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
36
|
Dijkxhoorn MA, Padmakar A, Bunders JFG, Regeer BJ. Stigma, lost opportunities, and growth: Understanding experiences of caregivers of persons with mental illness in Tamil Nadu, India. Transcult Psychiatry 2022; 60:255-271. [PMID: 35171067 PMCID: PMC10149884 DOI: 10.1177/13634615211059692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to address gaps in understanding of the lived experiences of caregivers of persons with mental illness in low-income countries. It was conducted among caregivers of persons with mental illness making use of a free non-governmental clinic in and around Chennai, India. The study adopted a qualitative methodology, with semi-structured interviews and life history exercises (n = 29) and six focus group discussions with caregivers (n = 21) and mental health professionals and community-based workers (n = 39). The experiences of caregivers were analyzed in the framework of "The Banyan model of caregiving," which identifies six phases. Major themes in caregivers' experience were: embarrassment and losing honor; fear; awareness; stigma and social exclusion; and reduced social interaction and loneliness. Posttraumatic growth considered as the result of caregiver experiences was found to consist mainly of personal growth and focusing on positive life experiences. Lost opportunities particular to the context of Tamil Nadu were described as the inability to get married, obtaining less education than desired, and loss of employment. Siblings faced lower levels of burden, while elderly mothers experienced especially high levels of burden and lack of happiness in life. Caregiver gains were identified as greater compassion for other people with disabilities, resulting in a desire to help others, as well as increased personal strength and confidence. Understanding the nuances of the caregiving experiences over time can provide a framework to devise more fine-tuned support structures that aim to prevent reductions in social interaction and lost opportunities, and improve a sense of meaning, in order to assist caregivers to continue providing care for their relatives with mental illness in a context with scarce mental health resources.
Collapse
Affiliation(s)
- Mirjam A Dijkxhoorn
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Archana Padmakar
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Joske F G Bunders
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Barbara J Regeer
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| |
Collapse
|
37
|
Zang DF, Zhang XT, Li YL, Li TX, Xiao SY, Tebes JK, Yu Y. WeChat use among family caregivers of people living with schizophrenia and its relationship to caregiving experiences. COMPUTERS IN HUMAN BEHAVIOR 2021. [DOI: 10.1016/j.chb.2021.106877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
38
|
Alyafei AH, Alqunaibet T, Mansour H, Ali A, Billings J. The experiences of family caregivers of people with severe mental illness in the Middle East: A systematic review and meta-synthesis of qualitative data. PLoS One 2021; 16:e0254351. [PMID: 34242343 PMCID: PMC8270161 DOI: 10.1371/journal.pone.0254351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/25/2021] [Indexed: 02/03/2023] Open
Abstract
Background There is a wealth of literature exploring the experiences of family caregivers of people with severe mental illness (SMI) in western countries, however, this topic has been neglected in the Middle East, despite families being the main source of caregiving in this context. The purpose of this review was to conduct a systematic review and qualitative meta-synthesis to explore the experiences of family caregivers living in countries in the Middle East caring for a relative with severe mental illness. Methods A systematic review and meta-synthesis were conducted, to comprehensively gain a thorough and detailed overview of what is known about family caregivers’ experiences from published qualitative research in the Middle East geographical area from inception to May 2021. The review protocol was pre-registered with PROSPERO (Ref: CRD42020165519). Results The review identified twelve qualitative studies that explored caregivers’ experiences of caring for relatives with SMI in Middle East countries. Family caregivers’ experiences were captured under seven overarching themes. The participants across all studies reported negative consequences of providing care, increased burden and emotional distress. Many experienced issues with family/marital relationships and stigmatizing attitudes and behaviours from their communities. Caregivers expressed the need for increased support which was perceived to have a critical role in improving family caregivers’ experiences. Conclusions The meta-synthesis revealed many challenges and issues that affect caregivers of people with SMI in the Middle East. Family caregivers experienced distress and burden, and reported significant impact on their psychological well-being. Their experiences highlight the urgent need to provide more support for family caregivers in Middle East countries.
Collapse
Affiliation(s)
- Aisha Hamed Alyafei
- Division of Psychiatry, University College London, London, United Kingdom
- * E-mail:
| | - Taghrid Alqunaibet
- Division of Psychiatry, University College London, London, United Kingdom
| | - Hassan Mansour
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Afia Ali
- Division of Psychiatry, University College London, London, United Kingdom
| | - Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
| |
Collapse
|
39
|
Qi L, Zhou Y, Wang R, Wang Y, Liu Y, Zeng L. Perceived quality of primary healthcare services and its association with institutional trust among caregivers of persons diagnosed with a severe mental illness in China. J Psychiatr Ment Health Nurs 2021; 28:394-408. [PMID: 32881201 DOI: 10.1111/jpm.12687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/08/2020] [Accepted: 08/11/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT Low utilization of the family-oriented community rehabilitation services is a threatening challenge facing low- and middle- income countries. Family caregiver's trust in community healthcare providers is the precondition of service utilization and is shaped by their perceived quality of primary healthcare services from previous experience. Most of the studies concerning the relationship between perceived quality and institutional trust were conducted in western countries, resulting in limited attention paid to conditions in non-western countries. Which aspect of quality predicts institutional trust in China has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE In China's context, institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Significant rural-urban disparity was observed: among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief; institutional trust was only associated with worry relief in urban respondents. WHAT ARE THE IMPLICATIONS FOR PRACTICE Mental health nurses training or working with community healthcare workers may improve their technical and communicative competence. Priorities may differ between rural and urban areas. Mental health nurses or community healthcare workers may provide more family-oriented psycho-education to rural families, and more emotional support to urban families. Wider public anti-stigma initiatives are needed to reduce the affiliated stigma of families of persons diagnosed with a severe mental illness. ABSTRACT Introduction Prior studies suggested that caregiver's trust in community healthcare providers is the precondition of the utilization of community-based rehabilitation services and is shaped by their perceived quality of primary healthcare services. Nevertheless, the research conducted in non-western countries is scarce, and which aspect of quality is associated with institutional trust in China has not been studied. Aim To explore the association between perceived quality of primary healthcare services and institutional trust in China's context. Methods This cross-sectional study was conducted with 796 family caregivers from Eastern, Central and Western China between August 2018 and October 2019. Perceived quality of primary healthcare services was measured by technical competence, communication, worry relief and risk of privacy leak. Results Institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief. Contrary finding was observed in urban respondents. Discussion and implications for practice With rural-urban disparity considered, strategies such as improving the technical and communicative competence of community healthcare workers, providing family-oriented psycho-education and emotional support, and promoting public anti-stigma initiatives may be worth consideration.
Collapse
Affiliation(s)
- Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | | | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Research Center for Rural Health Services, Hubei Province Key Research Institute of Humanities and Social Sciences, Wuhan, China
| | - Yang Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yifeng Liu
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | | |
Collapse
|
40
|
Qin L, Wang WL, Zhou YQ, Li YL. Process in medication self-management: The perspective of Chinese patients with schizophrenia. Arch Psychiatr Nurs 2021; 35:334-340. [PMID: 33966802 DOI: 10.1016/j.apnu.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/07/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
This study aimed to explore the medication self-management experience of Chinese patients with schizophrenia who are prescribed antipsychotics. Grounded theory methodology was used to guide the research. Semistructured and in-depth interviews with 17 patients with schizophrenia were conducted and analysed. The six categories identified in this study portray an evolving journey for participants, from initially obeying the orders of psychiatrists or family members to actively engaging in medication management. Six main categories emerged from the data: (i) obeying the orders; (ii) perceiving the changes; (iii) appraising the changes; (iv) making some adjustments; (v) generating insight into medication-taking; and (vi) transcending themselves. The findings from the study indicate that the participants' experience antipsychotic management is complex and that the medication self-management behaviour trajectory is a continuous, dynamic, and progressive process. Health care professionals should identify the characteristics of medication self-management behaviour changes in patients with schizophrenia according to their actual situation and provide correct, timely and adequate guidance for patients.
Collapse
Affiliation(s)
- Li Qin
- Jiangsu Vocational College of Medicine, Yancheng, Jiangsu Province, China
| | - Wei-Liang Wang
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| | - Yu-Qiu Zhou
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China.
| | - Ying-Li Li
- School of Nursing, Daqing Campus of Harbin Medical University, Daqing, Heilongjiang, China
| |
Collapse
|
41
|
Laine A, Anttila M, Hirvonen H, Välimäki M. Feasibility of a Web-Based Psychoeducation Course and Experiences of Caregivers Living With a Person With Schizophrenia Spectrum Disorder: Mixed Methods Study. J Med Internet Res 2021; 23:e25480. [PMID: 33890862 PMCID: PMC8105764 DOI: 10.2196/25480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/23/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schizophrenia is a severe mental illness that burdens both patients and caregivers. OBJECTIVE The aim of this study is to examine the feasibility of a web-based psychoeducation course targeted at caregivers of persons with schizophrenia spectrum disorders (SSDs) and to describe their experiences of living with a person with SSD based on the material caregivers produced during the web-based course. METHODS A convergent, parallel, mixed methods study design was used. First, caregivers' engagement in the course was evaluated quantitatively. Second, the overview of the course feedback was evaluated using quantitative and qualitative methods. Third, the experiences of being a caregiver to a person with SSD were analyzed qualitatively with the thematic analysis of the writings caregivers produced during the web-based course. RESULTS A total of 30 caregivers participated in the study and a web-based psychoeducation course. Less than two-thirds (18/30, 60%) completed the course. Content was most often logged for the first module, Orientation (3465 log-ins), and the lowest number of log-ins was recorded for the Daily life module (1061 log-ins). Feedback on the course varied; over half (10/17, 59%) of the caregivers considered the content to be very good or good, about half (9/17, 53%) considered the website layout to be good, only 6% (1/17) felt that the usability of the website was poor, and no one felt that it was very poor. From the reported experiences of being a caregiver to a person with SSD, 3 themes were formed: the caregiver's own well-being, relationship with the person with SSD, and experience of health care services. CONCLUSIONS The web-based psychoeducation course for caregivers living with a person with SSD seems to be especially suitable for those who have little experience as a caregiver. In the future, more planning and the consideration of aspects related to the needs of specific target groups, course content, practical arrangements, and scheduling should be taken into account. In addition, although caregivers can improve their own well-being in different ways, they need regular support and cooperation from health care professionals.
Collapse
Affiliation(s)
- Anna Laine
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Minna Anttila
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Heli Hirvonen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| |
Collapse
|
42
|
The Association of Social Support and Symptomatic Remission among Community-Dwelling Schizophrenia Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083977. [PMID: 33918873 PMCID: PMC8070210 DOI: 10.3390/ijerph18083977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 11/17/2022]
Abstract
Schizophrenia is a mental disease that often leads to chronicity. Social support could reduce the severity of psychotic symptoms; therefore, its influence on remission should be examined. This study investigated the remission rates in community-dwelling schizophrenia patients and examined the association between social support and remission status. A cross-sectional study was conducted in 129 schizophrenia patients in Taiwan. Remission rates were evaluated, and the level of social support, clinical characteristics, sociodemographic variables, and healthy lifestyle status were compared between the remission and nonremission groups. The association between social support and remission was analyzed after adjusting for confounding factors. The mean illness duration is 12.9 years. More than 95% of the participants lived with their families, 63% were unemployed, and 43% achieved remission. Higher social support was observed in the remission group, and a significant correlation was observed between family domain of social support and remission status. Family support was a protective factor of symptomatic remission in community-dwelling schizophrenia patients in Taiwan. The results reflect the effects of a family-centered culture on patients during illness. Consequently, reinforcing family relationships and the capacity of families to manage the symptoms of patients and providing support to families are recommended.
Collapse
|
43
|
Koç M, Tel H, Karakülah K. Determining care burden and psychiatric symptom level in caregiver of schizophrenia patient. Perspect Psychiatr Care 2021; 57:642-647. [PMID: 32705712 DOI: 10.1111/ppc.12588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/19/2020] [Accepted: 07/17/2020] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The present study was conducted to determine the care burden and psychiatric symptom levels of the caregivers of schizophrenic patients. DESIGN AND METHODS The caregivers of schizophrenic patients were included in this descriptive study. FINDINGS It was determined that there was a statistically significant difference in the care burden scores and the education, family type, and the presence of physical diseases of the caregivers (P < .05). It was determined that there was a statistically significant positive relation between age and care duration (r = .339, P = .001). PRACTICE IMPLICATIONS It is recommended that the family members are guided to plan activities that will allow the family members to relax and cover their own needs.
Collapse
Affiliation(s)
- Medine Koç
- Department of Nursing, Faculty of Health Sciences, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Havva Tel
- Department of Nursing, Faculty of Health Sciences, Cumhuriyet University, Sivas, Turkey
| | | |
Collapse
|
44
|
Guan Z, Cross W, Lam L, Wiley JA, Sun M, Bai X, Tang S. Feasibility of brief distress screening for family caregivers of adults diagnosed with schizophrenia in Changsha, Hunan, China. J Psychiatr Ment Health Nurs 2021; 28:174-185. [PMID: 32495993 DOI: 10.1111/jpm.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
What is known on the subject? Distress screening amongst FGs is emphasized in worldwide studies, but existing general tools were found time-consuming and sometimes inconvenient when using them amongst FGs of patients diagnosed with schizophrenia. The DT, a single-item scale, was widely used to detect distress amongst FGs of cancer patients, showing good reliability, validity and discrimination power. The 21-item Depression Anxiety and Stress Scale (DASS21) can identify distress in the general population and serve as a criterion to determine an optimal cut-off score of the DT. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The DT presented good reliability, validity and discriminatory power amongst FGs of adults diagnosed with schizophrenia. A cut-off score of six maximized sensitivity (77%) and specificity (76%). Over half of the FGs of adults diagnosed with schizophrenia reached this cut-off score and experienced significant distress. Distress was higher in FGs of male patients, when FGs were parents, and for FGs whose educational background was primary school or below. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The DT is an effective alternative to existing instruments in identifying distressed FGs of adults diagnosed with schizophrenia. It is important to provide FGs with distress screening programmes and interventions (e.g. skill-building psychoeducation) to identify and relieve distress. In addition, future research could explore brief measures to simultaneously recognize potential negative and positive impacts of caregiving in FGs.
Collapse
Affiliation(s)
- Ziyao Guan
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wendy Cross
- School of Nursing Healthcare Professions, Federation University Australia, Mount Helen, VIC, Australia
| | - Louisa Lam
- School of Nursing Healthcare Professions, Federation University Australia, Mount Helen, VIC, Australia
| | - James A Wiley
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Institute of Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China.,Hunan Women's Research Association, Changsha, Hunan, China
| | - Xiaoling Bai
- Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| |
Collapse
|
45
|
Caring for Patients with Psychosis: Mental Health Professionals' Views on Informal Caregivers' Needs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062964. [PMID: 33799346 PMCID: PMC8001319 DOI: 10.3390/ijerph18062964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 02/03/2023]
Abstract
The aim of this study was to explore the views of mental health professionals regarding the needs of the informal caregivers of patients with chronic psychotic syndrome. A qualitative research design was used. The sample consisted of 12 mental health professionals selected by a purposive sampling strategy. Data were collected through semistructured, face to face interviews. Framework analysis was used to analyze qualitative data and establish main themes and subthemes. Three main themes emerged namely, (i) impact of caring on caregivers’ lives, (ii) caregivers’ needs, and (iii) recommendations for better care. Informal caregivers’ needs were conceptualized into subthemes within the main themes. Caregivers’ increased responsibilities of caring for their relatives, the impact on their mental and physical health status and the restrictions in their social and professional life were revealed. Targeted health interventions and social policy planning are recommended for supporting informal caregivers and improving patient care.
Collapse
|
46
|
Wang M, Jin G, Wei Y, Wang F, Pan Z, Chen L, Lu X. Awareness, utilization and influencing factors of social supports for main informal caregivers of schizophrenia patients: a cross-sectional study in primary care settings in Beijing, China. BMC FAMILY PRACTICE 2020; 21:192. [PMID: 32943006 PMCID: PMC7496203 DOI: 10.1186/s12875-020-01257-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/31/2020] [Indexed: 11/21/2022]
Abstract
Background Most schizophrenia patients are supported by main informal caregivers at home in China. This study aims to investigate the further needs of social supports for main informal caregivers of schizophrenia patients and to analyze influencing factors on the awareness and utilization of social supports in Beijing. The results of this study could potentially act as reference for health professionals to implement appropriate and effective support programs. Methods A mixed-methods approach was used in this study. Awareness, utilization and influencing factors of social supports for main informal caregivers were investigated using questionnaires in 6 urban districts in Beijing. Meanwhile, individual in-depth interviews with 10 main informal caregivers from the urban districts of Beijing were conducted to identify the caregivers’ perspective on social supports and their further needs. Results Quantitative results showed that although the government provided multi-channel resources for schizophrenia patients and their families, awareness and utilization of the resources such as rehabilitation and relevant subsidies were less than 10.0 and 5.0% respectively. Most caregivers in in-depth interviews expressed that they had negative experiences with respect to obtaining social supports, and they emphasized that more support would be needed in terms of financial support, respect, and rehabilitation institutions. Conclusions The awareness and utilization of social supports are low for main informal caregivers of schizophrenia patients. More services and improved public attitudes are needed for schizophrenia patients and their caregivers.
Collapse
Affiliation(s)
- Meirong Wang
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China
| | - Guanghui Jin
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China
| | - Yun Wei
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China
| | - Feiyue Wang
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China
| | - Zhaolu Pan
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China
| | - Lifen Chen
- Xuan Wu Hospital of Capital Medical University, Beijing, China
| | - Xiaoqin Lu
- School of General Practice and Continuing Education, Capital Medical University, Fengtai district, No. 10, You An Men Wai Xi Tou Tiao, Beijing, 100069, China.
| |
Collapse
|
47
|
The Effect of Emotion Regulation Training on Stress, Anxiety, and Depression in Family Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial. Community Ment Health J 2020; 56:1095-1102. [PMID: 32056061 DOI: 10.1007/s10597-020-00574-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 02/08/2020] [Indexed: 12/15/2022]
Abstract
Schizophrenia is the most severe chronic disabling psychiatric disorder that needs long term care in various aspects. Therefore, the family's emotional atmosphere caused by the disease affects the condition of the patients' caregivers. This study aimed to investigate the effect of emotional regulation training on stress, anxiety, and depression in caregivers of patients with schizophrenia. The study was a randomized controlled trial. Seventy caregivers of patients with schizophrenia randomly assigned to a group that received emotion regulation training and a control group. The intervention group was trained about emotion regulation during eight 90-min sessions. The participants completed the Depression, Anxiety and Stress Scales-21 questionnaire before and one month after the intervention. The results showed that stress, anxiety and depression scores significantly reduced in the intervention group compared to the control group. Emotional regulation training with cognitive methods has significantly reduced the anxiety, stress, and depression of caregivers of patients with schizophrenia.
Collapse
|
48
|
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.
Collapse
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
| |
Collapse
|
49
|
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.
Collapse
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
| |
Collapse
|
50
|
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.
Collapse
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
| |
Collapse
|