1
|
Carroll D, Wales M, Rintell LS, Hojlo M, Gonzalez-Heydrich J, Berbert L, Fitzpatrick M, D'Angelo E, Reed MP. Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis. J Am Psychiatr Nurses Assoc 2024; 30:518-531. [PMID: 36475411 DOI: 10.1177/10783903221141883] [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: 12/13/2022]
Abstract
BACKGROUND Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). AIM This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver-child relationship, severity of illness, and frequency of psychiatric hospitalizations. METHODS A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire-Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression-Severity scale. RESULTS The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years (SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support (r = -.408, p = .002), lower levels of parenting confidence (r = -.514, p < .001), higher levels of relational frustration (r = .612, p < .001), and higher severity of illness (r = .316 p = .025). CONCLUSIONS These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.
Collapse
Affiliation(s)
- Devon Carroll
- Devon Carroll, PMHNP-BC, MSN, Boston Children's Hospital, Boston, MA, USA; University of Rhode Island, Providence, RI, USA
| | - Meghan Wales
- Meghan Wales, RN, BA, Boston Children's Hospital, Boston, MA, USA
| | | | - Margaret Hojlo
- Margaret Hojlo, BA, Boston Children's Hospital, Boston, MA, USA
| | - Joseph Gonzalez-Heydrich
- Joseph Gonzalez-Heydrich, MD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Laura Berbert
- Laura Berbert, MS, Boston Children's Hospital, Boston, MA, USA
| | - Molly Fitzpatrick
- Molly Fitzpatrick, MA, Boston Children's Hospital, Boston, MA, USA; William James College, Newton, MA, USA
| | - Eugene D'Angelo
- Eugene D'Angelo, PhD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Mary P Reed
- Mary P. Reed, PhD, RN, ANP, CNRN, NEA-BC, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Manesh AE, Dalvandi A, Zoladl M. The experience of stigma in family caregivers of people with schizophrenia spectrum disorders: A meta-synthesis study. Heliyon 2023; 9:e14333. [PMID: 36938397 PMCID: PMC10015248 DOI: 10.1016/j.heliyon.2023.e14333] [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] [Received: 03/17/2022] [Revised: 02/15/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023] Open
Abstract
Introduction Schizophrenia is a chronic disabling and the most stigmatizing mental disorder worldwide. The stigma experienced by family caregivers impacts their lives in different ways. This study reports the results of qualitative synthesis to understand the perceptions and experiences of stigma in families of people with schizophrenia spectrum disorders across various socio-cultural contexts. Methods An initial comprehensive search was performed in databases like Web of Science, PsycINFO, CINAHL, Scopus, and Ovid-based MEDLINE. By searching, 3560 studies were found, of which 16 articles were included in the present study. A meta-synthesis was done according to the meta-ethnographic approach. Result Three themes were generated: perpetuated stigma by general misunderstandings about schizophrenia, mental health inequality contributes to structural stigma, and long-term family caregiving stigmas, attitudes, and coping strategies. These themes indicated the essential experiences of stigma in families of people with schizophrenia, which appeared due to unknown and socio-cultural misconceptions of schizophrenia that led to emotional challenges for family caregivers. Conclusion This study addresses stigma-related issues, and coping strategies used almost exclusively by family caregivers. Health policymakers and healthcare professionals working in mental health institutions should consider this data. Substantial steps must be taken to combat stigma, with education initiatives topping the list.
Collapse
Affiliation(s)
- Azadeh Eghbal Manesh
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Asghar Dalvandi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Science, Islamic Azad University, Tehran, Iran
- Corresponding author.
| | - Mohammad Zoladl
- Associate Professor of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| |
Collapse
|
3
|
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
|
4
|
Zhou W, Ouyang F, Yu Y, Li Y, Bi F, Xiao S, Khoshnood K. Knowledge of mental health diagnosis among patients and their family members: an inpatient survey in China. J Ment Health 2023; 32:234-240. [PMID: 35770867 DOI: 10.1080/09638237.2022.2091753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/03/2022] [Accepted: 05/03/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Patient-oriented information disclosure has been advocated by the National Mental Health Law (NMHL) in China since 2012; however, reporting on diagnostic disclosure to patients with mental disorders after the NMHL is limited. AMIS This study aims to investigate and compare the knowledge of mental health diagnosis among patients and their family members in China. METHODS An inpatient survey was conducted among 205 patients with mental disorders and their family members. Group differences of the correctness of self-reported mental health diagnosis were compared, and logistic regression was performed to investigate correlates among both patients and their family members. RESULTS Overall, 76.7% patients and 80.6% of their family members reported a correct diagnosis. Only 46.2% patients with psychotic disorders correctly knew their diagnosis, significantly lower than their family members and patients with non-psychotic disorders. Multivariate regression analysis found that the diagnosis of psychotic disorders was a risk factor of patients' diagnostic knowledge (AOR = 0.137; 95% CI = 0.044-0.429), while family members' diagnostic knowledge was associated with their employment (AOR = 6.125, 95% CI = 1.942-19.323) and parent-child relationship with patients (AOR = 3.719; 95% CI = 1.057-13.086). CONCLUSIONS The majority of patients with non-psychotic disorders know their diagnosis correctly and informing family members of patients' diagnosis remains a common practice in psychiatric setting after the implementation of China's NMHL.
Collapse
Affiliation(s)
- Wei Zhou
- Research Center for Public Health and Social Security, School of Public Administration, Hunan University, Changsha, China
| | - Feiyun Ouyang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Yu
- Division of Prevention and Community Research and The Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Fengying Bi
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Zibo Central Hospital, Zibo, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
5
|
Rexhaj S, Nguyen A, Favrod J, Coloni-Terrapon C, Buisson L, Drainville AL, Martinez D. Women involvement in the informal caregiving field: A perspective review. Front Psychiatry 2023; 14:1113587. [PMID: 36741114 PMCID: PMC9889973 DOI: 10.3389/fpsyt.2023.1113587] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/05/2023] [Indexed: 01/19/2023] Open
Abstract
The patient recovery process of individual with mental health disorder is reinforced if they are connected with their community and supported by relatives. The literature has shown that caregivers are important, although their roles can lead to alterations in their own health; and women are the most involved in this role. The present review investigated women's involvement in the informal caregiver scientific field. A literature review indicated gender differences; researchers who are women are more interested in this field than men. Even with a good representation of women in this scientific field, the results showed a statistically significant gender difference for the first and second authors, whereas there was no significant gender difference among the last authors. More efforts must be made to recognize the importance of women's involvement in research because they raise a specific important field. Family caregivers are key players in the healthcare system, but to date, there has been little recognition of their enormous contribution. Our results also indicated the informal caregiver role is filled more by women than by men, which creates social inequalities in many domains, especially in opportunities at the professional level. Tailored interventions are required to address the specific needs and issues of family caregivers. A better redistribution of unpaid work, such as informal caregiving, compared to paid work must be made to respect gender in social existence.
Collapse
Affiliation(s)
- Shyhrete Rexhaj
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Alexandra Nguyen
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Claire Coloni-Terrapon
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Leslie Buisson
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Anne-Laure Drainville
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Debora Martinez
- La Source, School of Nursing Sciences, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| |
Collapse
|
6
|
Alreshidi SM. Correlation Between Symptoms of Depression and Obesity in Caregivers of Patients With Chronic Illness: A Gender Difference Analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231219590. [PMID: 38102847 PMCID: PMC10725106 DOI: 10.1177/00469580231219590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
This study involved gender-stratified analysis and total-sample analysis to assess the extent to which symptoms of depression correlate with the body mass index (BMI) of a population of 112 people responsible for caring for others diagnosed with a chronic illness. The majority of the participants (caregivers) of this study were female (57.1%). All participants were recruited from an urban medical city hospital. The Patient Health Questionnaire-9 (PHQ-9) was employed to assess the extent to which caregivers exhibited symptoms of depression, and BMI was calculated by the researcher using the subject's height and weight. Regressions were executed on the entire dataset spanning male and female participants to generate insights into demographic factors, after which the PHQ-9 was administered. After taking into account the possible confounding factors, the findings of the regression showed that there was a significant correlation between the BMI and PHQ-9 scores (β = .25, P = .042). The correlation between BMI and PHQ-9 persisted among females (β = .37, P = .023). Furthermore, there is a noteworthy correlation among the participants who were morbidly obese (BMI > 30 kg/m2). The correlation between BMI and PHQ-9 caregivers of patients with chronic illness remained after taking demographic factors into account. These findings could be utilized to enhance the outcomes for caregivers of patients with chronic illness. They may be particularly pertinent for caregivers who are experiencing depression or are overweight.
Collapse
|
7
|
Tingleff EB, Rowaert S, Vinding S, Vestphal TK, Wilson R, Gildberg FA. "It's still our child". A qualitative interview study with parent carers in forensic mental health. Arch Psychiatr Nurs 2022; 41:124-131. [PMID: 36428040 DOI: 10.1016/j.apnu.2022.07.017] [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: 03/21/2022] [Revised: 06/21/2022] [Accepted: 07/09/2022] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to explore the experiences and perceptions of parents in forensic mental health services with regard to their cooperation with healthcare professionals and their role as parent carers. 15 participants were interviewed using qualitative, in-depth interviews and transcripts were analysed thematically. The identified themes were 'Medical dominance', 'Interactions with healthcare professionals', and 'Advocating for their daughter/son'. The themes were associated with the overall theme 'perceived impact on the parents' everyday lives'. The results suggest that parent carers perceive a malalignment between the institutional medicalised treatment focus and the need for an integrated holistic approach, which would include them as partners.
Collapse
Affiliation(s)
- Ellen Boldrup Tingleff
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark; Nursing Education, Vejle, and Health Sciences Research Center, UCL University College, Denmark; OPEN, Odense Service user data Explorative Network, Odense University Hospital/Department of Clinical Research, University of Southern Denmark, Denmark.
| | - Sara Rowaert
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - Stinne Vinding
- Nursing Education, Vejle, and Health Sciences Research Center, UCL University College, Denmark
| | - Tina Kirstine Vestphal
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark
| | - Rhonda Wilson
- School of Nursing and Midwifery, College of Health, Medicine, and Wellbeing, The University of Newcastle, Australia; School of Nursing, Massey University, New Zealand
| | - Frederik Alkier Gildberg
- Forensic Mental Health Research Unit Middelfart (RFM), Department of Regional Health Research, Faculty of Health Science, University of Southern Denmark, Denmark; Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, Denmark
| |
Collapse
|
8
|
Peng MM, Ma Z, Ran MS. Family caregiving and chronic illness management in schizophrenia: positive and negative aspects of caregiving. BMC Psychol 2022; 10:83. [PMID: 35361263 PMCID: PMC8973811 DOI: 10.1186/s40359-022-00794-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/24/2022] [Indexed: 02/08/2023] Open
Abstract
Background We aimed to explore the long-term caregiving experiences of family caregivers of people with schizophrenia (PwS) in terms of both positive and negative aspects. Method Utilising a purposive sampling method, we conducted in-depth interviews with 20 family caregivers of persons who had suffered from schizophrenia for more than 20 years. We empirically investigated their retrospective experiences of caregiver-patient interactions during a long period of family caregiving. We audio-recorded and transcribed the interviews into text. We thematically coded and analysed the transcribed text using a four-phase method of theme development. Findings Schizophrenia might not only generate a caregiving burden, affect caregivers’ psychological status, and accordingly influence their coping strategies, but also have short- or long-term patient-related consequences. Discussion Family caregivers should develop their stress management skills to cope with relevant life changes and increase their knowledge of the potential psychological consequences for care recipients resulting from negative caregiving strategies during home-based practice. Care recipients with schizophrenia in a relatively stable status should be empowered to take care of themselves. More effective family-based interventions for psychiatric nursing or individualised training for symptom management should be tailored to serve families’ diverse needs.
Collapse
Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, 519087, China.
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, IL, USA
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China. .,Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
9
|
Lin HC, Chen CC. Disease Prevention Behavior During the COVID-19 Pandemic and the Role of Self-Esteem: An Extended Parallel Process Model. Psychol Res Behav Manag 2021; 14:123-135. [PMID: 33603513 PMCID: PMC7882452 DOI: 10.2147/prbm.s291300] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/31/2020] [Indexed: 12/20/2022] Open
Abstract
Objective The COVID-19 outbreak has become a serious public health problem worldwide. The purpose of this study was to use an extended parallel process model (EPPM) to understand factors in COVID-19 prevention behaviors. Methods This cross-sectional and analytical study was conducted on 1012 participants in Taiwan. A structured questionnaire and an online survey were used to collect data. Results The EPPM revealed that the severity of the COVID-19 threat perceived by respondents directly affected the arousal of fear in the respondents (β=0.268, t=9.007, p<0.001), but perceived efficacy did not (β=−0.019, t=−0.619, p>0.05); additionally, fear arousal was significantly associated with COVID-19 prevention behaviors (β=0.119, t=4.603, p<0.001). Regarding personal characteristics, self-esteem moderated the relationship between perceived threat and fear arousal. However, the moderating effect of self-esteem was stronger in people with low self-esteem compared to those with high self-esteem (β=0.606, −0.472; t=26.303, −17.694; p<0.001, p<0.001; respectively). The results of this study also indicated that two demographic characteristics (age and gender) affect COVID-19 prevention behaviors. Conclusion When developing healthcare policies and community interventions for improving COVID-19 prevention behaviors during an outbreak, healthcare administrators should carefully consider the main constructs of the EPPM, particularly personal characteristics (ie, self-esteem) and demographic characteristics (ie, age and gender).
Collapse
Affiliation(s)
- Hsien-Cheng Lin
- Business College, Taizhou University, Taizhou, Zhejiang Province, People's Republic of China
| | - Chia-Chen Chen
- Department of Anesthesiology, China Medical University Hsinchu Hospital, Zhubei, Taiwan, Republic of China
| |
Collapse
|
10
|
Zhou W, Liu Q, Yu Y, Xiao S, Chen L, Khoshnood K, Zheng S. Proxy reliability of the 12-item world health organization disability assessment schedule II among adult patients with mental disorders. Qual Life Res 2020; 29:2219-2229. [PMID: 32388787 DOI: 10.1007/s11136-020-02474-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Despite the wide usage of World Health Organization Disability Assessment Schedule II (WHODAS 2.0) in psychiatry research and clinical practice, there was limited knowledge on its proxy reliability among people with mental disorders. This paper aimed to compare the 12-item WHODAS 2.0 responses of adult patients with mental disorders to their family caregivers. METHODS In this study, 205 pairs of patients with mental disorders and primary family caregivers were consecutively recruited from one inpatient mental health department in a large hospital in China. All participants completed the 12-item version WHODAS 2.0 to assess patients' functioning in the 30 days prior to the hospitalization. Measurement invariance, including configural, metric and scalar invariance, was tested across patient and proxy groups, using multi-group confirmatory factor analysis. Agreement between patients and proxies was examined by paired Wilcoxon tests and intraclass correlation coefficients (ICC). Subgroup analyses for proxy reliability were conducted within strata of proxy kinship and patient psychiatric diagnosis. RESULTS The 12-item WHODAS 2.0 achieved configural, metric and partial scalar invariance across patient and proxy groups. Unsatisfactory consistency was found for most items (ICC < 0.75, P < 0.05), especially for items on Cognition, Getting along, Life activities, and Participation in society (ICC < 0.4, P < 0.05). Spouses agreed with patients more often than parents (ICC ≥ 0.4, P < 0.05). The paired Wilcoxon tests found that impairment of patients with psychotic disorders tended to be overestimated by proxies while proxies tended to underestimate impairment of patients with mood disorders. CONCLUSION Our study reveals inconsistency between self and proxy reports in the 12-item WHODAS 2.0 among adult patients with mental disorders. When proxy reports is needed, spouses are preferred than parents. We should be aware of proxies' impairment overestimation among patients with psychotic disorders and underestimation among patients with mood disorders.
Collapse
Affiliation(s)
- Wei Zhou
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Qian Liu
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yu Yu
- Division of Prevention and Community Research & The Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Shuiyuan Xiao
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Lizhang Chen
- Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Shimin Zheng
- Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| |
Collapse
|
11
|
Yu Y, Liu ZW, Li TX, Li YL, Xiao SY, Tebes JK. Test of the stress process model of family caregivers of people living with schizophrenia in China. Soc Sci Med 2020; 259:113113. [PMID: 32646627 DOI: 10.1016/j.socscimed.2020.113113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
Across the world, people living with schizophrenia (PLS) are often cared for by family caregivers. This is especially true in China where community-based systems of care for PLS are underdeveloped. Thus, family caregivers of PLS may experience emotional distress and burden in the absence of community-based services. Pearlin (1990) proposed a highly influential model for understanding the stress process and its relationship to health and wellbeing. Although the model has been examined worldwide, it has yet to be studied in China for caregivers of PLS. In the present study, we use Pearlin's stress process model to examine the mediating effect of perceived caregiver burden, family functioning, and caregivers' positive feelings about caregiving on PLS global functioning and caregiver depressive symptoms. We also examine whether the model differs for parent and spouse caregivers. A total of 327 primary family caregivers of PLS in Hunan province, China, were assessed cross-sectionally using culturally-validated measures. Bootstrap methods with Hayes's PROCESS Macro were used to test multiple mediation models of global functioning scores of PLS and caregiver depressive symptoms. In this first study of the stress process model of family caregivers of PLS in China, the results generally support the model. Caregiver perceived burden, family functioning, and positive caregiver feelings about caregiving all mediate the relationship between PLS global functioning and caregiver depression, with perceived caregiver burden having the strongest indirect effect. Analyses also show that the stress process differs between parent and spouse caregivers, with perceived caregiver burden a mediator for both groups but family functioning only a mediator for parent depressive symptoms. We discuss implications of these findings for extending the stress process model cross-culturally; suggest hypotheses for future research to examine parent and spouse differences; and discuss fruitful directions for intervention.
Collapse
Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China; Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
| | - Zi-Wei Liu
- Department of Preventive Medicine, School of Medicine, Hunan Normal University, Tongzipo Road 172, Changsha, Hunan, 410008, China.
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Yi-Lu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China
| | - Shui-Yuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan, 410008, China.
| | - Jacob Kraemer Tebes
- Division of Prevention & Community Research, Department of Psychiatry, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.
| |
Collapse
|
12
|
Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: a cross-sectional study. Qual Life Res 2020; 29:2745-2757. [PMID: 32394137 DOI: 10.1007/s11136-020-02518-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aimed to examine correlates of caregiver burden and health-related quality of life (HRQoL) among primary family caregivers of individuals with schizophrenia in inpatient psychiatric rehabilitation facilities. METHODS A cross-sectional study was conducted with 157 Taiwanese primary family caregivers of individuals with schizophrenia residing in inpatient psychiatric facilities. Measures included socio-demographic questionnaires and clinical information, Mutuality Scale, Family Crisis-Oriented Personal Evaluation Scales, Zarit Burden Interview, and World Health Organization Quality of Life-brief version. To describe the degree of caregiver burden and domains of HRQoL, descriptive statistics were computed. Independent sample t test, one-way analysis of variance, and Pearson's correlation analysis followed by multiple regression analyses were performed to determine correlations and relationships between characteristics of patients and primary family caregivers with caregiver burden and domains of HRQoL. RESULTS Primary family caregivers experienced mild to moderate caregiver burden and poor HRQoL. Primary family caregivers who were older and unemployed, caring for patient's severe psychiatric symptoms, and had low monthly incomes, decreased mutuality, and fewer family coping strategies were associated with greater caregiver burden and poor HRQoL. Greater mutuality and family coping strategies of reframing and seeking spiritual support were the most significant factors in improving caregiver burden and all domains of HRQoL, respectively. CONCLUSION Family-focused interventions for caregivers of institutionalized persons with schizophrenia that include psychological support and peer support groups are recommended to enhance mutuality and family coping strategies, reduce caregiver burden, and improve HRQoL.
Collapse
|
13
|
Yu Y, Xiao X, Yang M, Ge XP, Li TX, Cao G, Liao YJ. Personal Recovery and Its Determinants Among People Living With Schizophrenia in China. Front Psychiatry 2020; 11:602524. [PMID: 33362611 PMCID: PMC7759546 DOI: 10.3389/fpsyt.2020.602524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022] Open
Abstract
Objective: The past few decades have seen an evolution in the understanding of recovery from a clinical-based view that focuses on symptoms and functioning to a more consumer-oriented perspective that focuses on personal recovery. The present study aimed to assess personal recovery among people living with schizophrenia and determine its predictors. Methods: This cross-sectional study recruited a random sample of 400 people living with schizophrenia (PLS) from twelve community health centers of Hunan, China. Recovery was assessed using the short-form 8-item Recovery Assessment Scale (RAS-8). PLS disability and functioning were assessed using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and the Global Assessment of Functioning (GAF), respectively. Results: Participants had a mean personal recovery score of 20.29 (SD: 9.31, Range: 8-40). Personal recovery was predicted by both socio-demographic and clinical characteristics. Older age (r = -0.17, p < 0.001), being female (r = -2.29, p = 0.019), and higher disability (r = -0.22, p < 0.001) were independently associated with worse personal recovery, while having a college education (r = 5.49, p = 0.002), and higher functioning (r = 0.09, p = 0.017) were independently associated with better personal recovery. Conclusion: Interventions to improve recovery among PLS may be best served by reducing the impact of disability and improving functioning, with targeted interventions for individuals who are older, female and less educated in order to increase their likelihood of recovery.
Collapse
Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Xi Xiao
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, China
| | - Min Yang
- Department of Psychiatry, Changsha Psychiatric Hospital, Changsha, China
| | - Xiao-Ping Ge
- Department of Geriatrics, Changsha Psychiatric Hospital, Changsha, China
| | - Tong-Xin Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Gui Cao
- Department of Health Insurance and Long Term Care, Chinese Academy of Labor and Social Security, Beijing, China
| | - Ying-Jun Liao
- Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
14
|
Daily intake of soft drinks is associated with symptoms of anxiety and depression in Chinese adolescents. Public Health Nutr 2019; 22:2553-2560. [PMID: 31097051 DOI: 10.1017/s1368980019001009] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The association of soft drink consumption with mental problems in Asian adolescents has not been reported. The present study aimed to investigate the association of soft drink consumption and symptoms of anxiety and depression in adolescents in China. DESIGN A cross-sectional study to investigate the association of intake of soft drinks and sugars from soft drinks with symptoms of anxiety and depression measured by the two-item Generalized Anxiety Disorder (GAD-2) and the Patient Health Questionnaire (PHQ-2), respectively. SETTING A comprehensive university in Changsha, China. PARTICIPANTS Newly enrolled college students in 2017. RESULT In total, 8226 students completed the investigation and 8085 students with no systemic disorders were finally analysed. Students consuming soft drinks ≥7 times/week had significantly higher (mean difference; 95 % CI) GAD-2 (0·15; 0·07, 0·23) and PHQ-2 (0·27; 0·19, 0·35) scores compared with those barely consuming soft drinks, adjusted for demographic and behavioural factors. Those consuming >25 g sugar/d from soft drinks had significantly higher GAD-2 (0·11; 0·04, 0·18) and PHQ-2 (0·22; 0·15, 0·29) scores compared with non-consumers. The mediation effect of obesity in the associations was not clinically significant. CONCLUSIONS Adolescents consuming soft drinks ≥7 times/week, or >25 g sugar/d from soft drinks, had significantly higher levels of anxiety and depression. Dietary suggestion is needed to prevent anxiety and depression in adolescents.
Collapse
|
15
|
Liu Q, Zhou W, Niu L, Yu Y, Chen L, Luo B, Xiao S. Comparison Of Expectations For Health Services Between Inpatients From Mental Health Department And Endocrinology Department In China. Patient Prefer Adherence 2019; 13:1851-1860. [PMID: 31749611 PMCID: PMC6818530 DOI: 10.2147/ppa.s224071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/12/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient expectations for health services refer to the anticipation or the belief about what should be encountered in the healthcare system. Understanding patient expectations can improve patient satisfaction and healthcare compliance. It is particularly important for patients with mental disorders, as greater healthcare compliance is required for them due to the chronic and relapsing nature of their diseases. However, little is known about expectations among Chinese patients with mental disorders. OBJECTIVE To examine expectations for healthcare among patients with mental disorders and to compare them with those of patients with chronic physical diseases. PATIENTS AND METHODS A cross-sectional survey was conducted among two inpatient groups, consecutively recruited from the Mental Health Department (MHD) and Endocrinology Department (ED) in one tertiary general hospital in Changsha, China. Patient expectations were measured by eight translated and modified vignettes of health system responsiveness. Group differences were compared using Chi-square tests for socio-demographic and clinical characteristics and Z-test for expectation rating. Logistic regression was performed to test whether group differences of expectations remained statistically significant after controlling for socio-demographic and clinical variables. RESULTS Most patients from MHD rated scenarios in vignettes on communication, choice of provider, autonomy, and social support as "meeting expectations", and rated scenarios in vignettes on prompt attention, dignity, confidentiality, and quality of basic amenities as "below expectations". In comparison, patients from MHD had similar expectations with their counterparts from ED, for prompt attention, dignity, confidentiality, communication, choice of provider, and social support; however, patients from MHD had significantly lower expectations in quality of basic amenities and higher expectations in autonomy, after adjusting for socio-demographic and clinical factors. CONCLUSION Like their counterparts with physical diseases, patients with mental disorders also expect prompt attention, dignity, confidentiality, communication, choice of provider, and social support in their interaction with the healthcare system. Moreover, extra attention to autonomy is needed for patients with mental disorders to meet their expectations and improve patient satisfaction.
Collapse
Affiliation(s)
- Qian Liu
- Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
| | - Wei Zhou
- Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
- Correspondence: Wei Zhou; Shuiyuan Xiao Xiangya School of Public Health, Central South University, No. 87 Xiangya Street, Changsha, Hunan410087, People’s Republic of ChinaTel/fax +86 731 8480 5459 Email ;
| | - Lu Niu
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, People’s Republic of China
| | - Yu Yu
- Division of Prevention and Community Research and the Consultation Center, Yale School of Medicine, New Haven, CT, USA
| | - Lizhang Chen
- Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Bihua Luo
- Department of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| | - Shuiyuan Xiao
- Xiangya School of Public Health, Central South University, Changsha, Hunan, People’s Republic of China
- Hospital Administration Institute, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China
| |
Collapse
|