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Cheng M, Zhu C, Meng J, Pu C, Chen G, Liu H. Association between stigma and quality of life among chronic refractory wounds patients and informal caregivers: an actor-partner interdependence model analysis. Qual Life Res 2024:10.1007/s11136-024-03759-0. [PMID: 39162970 DOI: 10.1007/s11136-024-03759-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 08/21/2024]
Abstract
PURPOSE The co-occurrence of health impairments in patients and their informal caregivers may be particularly common in intimate care settings in China. Patients with Chronic Refractory Wounds (CRWs) and their informal caregivers constitute a dyad and exhibit dyadic effects during the caring process. Unfortunately, no study has yet explored the dyadic effects of stigma on the QoL of patients with CRWs and their caregivers. METHODS We used a convenience sampling method and recruited CRWs patient-caregiver dyads (N = 207) in China between April 2022 and October 2023. RESULTS We found that: (i) dyadic members experience varying degrees of stigma; (ii) the actor-partner effect of CRWs patients' stigma on their own and their informal caregivers' QoL was significant (Path A1: β = - 1.27, Path A2: β = - 0.37, Path P1: β = - 0.08, Path P2: β = - 0.18); (iii) informal caregivers' stigma adversely affects both their own and their patients' psychological QoL((Path A4: β = - 0.65, Path P4: β = - 0.52)). Informal caregivers' stigma can negatively impact patients' physical QoL (Path P3: β = - 0.17), whereas it does not significantly affect their own physical QoL. CONCLUSION There is a notable actor-partner effect of the CRWs patients' stigma on their own and their informal caregivers' QoL. CRWs patients' stigma should become a priority for the government to improve CRWs patients' and informal caregivers' QoL. Besides, health professionals should be addressing several assessments and interventions to decrease informal caregivers' affiliate stigma symptoms and improve CRWs patients' and informal caregivers' QoL.
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Affiliation(s)
- Ming Cheng
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China.
| | - Chenya Zhu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan Province, 250021, China
| | - Jiamin Meng
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China
| | - Chenxi Pu
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China
| | - Guoying Chen
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China
| | - Huan Liu
- Department of Nursing, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 95 Qingchun Street, Hangzhou, Zhejiang Province, 310003, China
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Lök N, Bademli K. The Effect of a Mindful Self-Compassion Intervention on Burden, Express Emotion and Mental Well-Being in Family Caregivers of Patients with Schizophrenia: A Randomized Controlled Trial. Community Ment Health J 2024; 60:997-1005. [PMID: 38393493 DOI: 10.1007/s10597-024-01253-y] [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: 10/05/2023] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
The objective of this randomized controlled trial was to examine the impact of a mindful self-compassion intervention on burden, express emotion, and mental well-being in family caregivers of patients with schizophrenia. Standardized measures, including the ZARIT Caregiving Burden Scale, Expressed Emotion Scale and Warwick-Edinburgh Mental Well-Being Scale, were administered at baseline, post-intervention. Statistical analysis was conducted to assess differences between the two groups. Significant reductions in caregiver burden, expressed emotion, and enhanced mental well-being in the intervention group compared to the control group at post-intervention. The results of this randomized controlled trial indicate that the mindful self-compassion intervention significantly reduces caregiver burden, expressed emotion, and improves mental well-being in family caregivers of patients with schizophrenia. These findings underscore the potential utility of mindful self-compassion interventions as effective support for this population, highlighting the importance of integrating such interventions into caregiver support programs.
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Affiliation(s)
- Neslihan Lök
- Faculty of Nursing, Psychiatric Nursing Department, Selcuk University, Konya, Turkey
| | - Kerime Bademli
- Faculty of Nursing, Psychiatric Nursing Department, Akdeniz University, Antalya, Turkey.
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Zhao H, Song S, Lv X, Huang S. Trait emotional intelligence and its impact on quality of life, anxiety, and depression in patients with gastric cancer. Br J Hosp Med (Lond) 2024; 85:1-10. [PMID: 38941977 DOI: 10.12968/hmed.2024.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Aims/Background Trait emotional intelligence is associated with anxiety and depression symptoms and quality of life in cancer patients. However, studies on the relationship of trait emotional intelligence with anxiety, depression, and quality of life in gastric cancer patients are limited. This study investigates the relationship of trait emotional intelligence with depression and quality of life in gastric cancer patients to provide a theoretical basis for clinical management. Methods A total of 270 patients with gastric cancer treated in our hospital from July 2020 to July 2023 were selected, of which 31 patients with missing questionnaire entries and missed visits were screened out, resulting in the enrolment of 239 gastric cancer patients in this study. In this survey, self-administered general information questionnaires, namely Trait Emotional Intelligence Short Form (TEIQue-SF), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), and Hospital Anxiety and Depression Scale (HADS) were used. Results TEIQue-SF total scores were positively correlated with QLQ-C30 scores (p < 0.001) and negatively correlated with HADS-A and HADS-D scores (p < 0.001). TEIQue-SF total score was a superior positive predictor of the QLQ-C30 score (β = 0.412, p < 0.001) and a superior negative predictor of the HADS score (β = -0.740, p < 0.001). TEIQue-SF total score (β = 0.141, p = 0.006) and HADS score (β = -0.665, p < 0.001) were good predictors of QLQ-C30 score. The direct effect of TEIQue-SF total score on QLQ-C30 score was 0.141, while HADS score between TEIQue-SF total score and QLQ-C30 score had a mediated effect value of 0.492. Conclusion Trait emotional intelligence not only directly affects the quality of life, but also indirectly affects the quality of life through anxiety and depression. Clinicians should pay attention to the anxiety, depression, and emotional intelligence of patients with gastric cancer to help them improve their quality of life.
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Affiliation(s)
- Huarong Zhao
- Department of Oncology, Hejiang County People's Hospital, Luzhou, Sichuan, China
| | - Shiqin Song
- Department of Oncology, Hejiang County People's Hospital, Luzhou, Sichuan, China
| | - Xiaobo Lv
- Department of Oncology, Hejiang County People's Hospital, Luzhou, Sichuan, China
| | - Shike Huang
- Department of Oncology, Hejiang County People's Hospital, Luzhou, Sichuan, China
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Mahomed A, Pretorius C. Giving voice to the voiceless: Understanding the perceived needs of dementia family carers in Soweto, a South African township. DEMENTIA 2024; 23:622-642. [PMID: 38354041 PMCID: PMC11059838 DOI: 10.1177/14713012241234155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
This qualitative study aimed to provide family caregivers with an independent platform to reflect on and identify their needs in the role of dementia caregiver. Thirty caregivers were interviewed using a semi-structured approach, and data analysis followed a reflective thematic analysis method. The study revealed that Black African caregivers in townships require sufficient information and orientation to dementia-specific services, psychoeducation on dementia as a disease and its behavioural manifestations, as well as practical skills to manage the disease process. Caregivers expressed the need for in-depth, accessible education to boost their confidence and resilience in handling the challenges of dementia caregiving. They also proposed community initiatives to raise awareness, promote knowledge, and facilitate early detection and diagnosis of dementia. Additional needs included informational and educational workshops, resources like transportation services and helplines, day care facilities, media campaigns, and collaboration with the government for funding and policy change. New caregivers were advised to seek comprehensive education, support, and services while preserving the dignity of their family members with dementia. Remarkably, the identified needs and community initiatives aligned with the priority areas outlined by ADI for a National Dementia Plan, which South Africa currently lacks. The study highlights the importance of developing a National Dementia Plan in South Africa through collaboration among stakeholders, including communities, policy-makers, and multidisciplinary healthcare teams, while ensuring that individuals and families affected by dementia have a voice.
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Affiliation(s)
- Aqeela Mahomed
- Department of Psychology, Stellenbosch University, South Africa
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Ferentinos P, Douki S, Yotsidi V, Kourkouni E, Dragoumi D, Smyrnis N, Douzenis A. Family in Crisis: Do Halfway Houses Perform Better Than Families with Expressed Emotion toward Patients with Schizophrenia? A Direct Adjusted Comparison. Healthcare (Basel) 2024; 12:375. [PMID: 38338260 PMCID: PMC10855104 DOI: 10.3390/healthcare12030375] [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: 01/08/2024] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Expressed emotion (EE) toward patients with schizophrenia is typically reported to be lower in psychiatric halfway houses than in families. This is the first study directly comparing EE between these settings and investigating the pathways mediating EE differences. We included 40 inpatients in halfway houses and 40 outpatients living with their families and recorded 22 psychiatric nurses' and 56 parents' EE, respectively, through Five Minutes Speech Samples. Each inpatient was rated by 2-5 nurses and each outpatient by 1-2 parents. As EE ratings had a multilevel structure, generalized linear mixed models were fitted, adjusting for patient-related confounders and caregiver demographics. Mediatory effects were investigated in multilevel structural equation models. Outpatients were younger, less chronic, and better educated, with higher negative symptoms and perceived criticism than inpatients. Nurses were younger and better educated than parents. Before adjustment, EE rates were equally high across settings. After adjusting for patient-related confounders, emotional overinvolvement was significantly higher in parents. However, after also adjusting for caregiver demographics, only criticism was significantly higher in nurses. Patients' age, negative symptoms, and perceived criticism and caregivers' age and sex significantly mediated EE group differences. Our findings highlight pathways underlying EE differences between halfway houses and families and underscore the importance of staff and family psychoeducation.
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Affiliation(s)
- Panagiotis Ferentinos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, “Attikon” University General Hospital, 12 462 Athens, Greece; (N.S.); (A.D.)
| | - Stamatina Douki
- Department of Psychiatry, “Evangelismos” General Hospital, 106 76 Athens, Greece; (S.D.); (D.D.)
| | - Vasiliki Yotsidi
- Department of Psychology, Panteion University of Social and Political Sciences, 176 71 Athens, Greece;
| | - Eleni Kourkouni
- Center for Clinical Epidemiology and Outcomes Research, 15 451 Athens, Greece;
| | - Dimitra Dragoumi
- Department of Psychiatry, “Evangelismos” General Hospital, 106 76 Athens, Greece; (S.D.); (D.D.)
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, “Attikon” University General Hospital, 12 462 Athens, Greece; (N.S.); (A.D.)
| | - Athanasios Douzenis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, “Attikon” University General Hospital, 12 462 Athens, Greece; (N.S.); (A.D.)
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Ferentinos P, Douki S, Kourkouni E, Dragoumi D, Smyrnis N, Douzenis A. Differential correlates of criticism versus emotional overinvolvement towards patients with schizophrenia living in halfway houses or with their families. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-023-02609-7. [PMID: 38296844 DOI: 10.1007/s00127-023-02609-7] [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: 10/11/2023] [Accepted: 12/22/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE This study systematically searched for differential correlates of criticism vs. emotional overinvolvement (EOI) towards patients with schizophrenia in families and halfway houses, which have only incidentally been reported in previous research. Identified patterns were compared across settings. METHODS We included 40 inpatients with schizophrenia living in halfway houses and 40 outpatients living with their families and recorded the expressed emotion (EE) of 22 psychiatric nurses or 56 parents, respectively, through Five Minutes Speech Samples. Each nurse rated 1-12 inpatients and each inpatient was rated by 2-5 nurses. Each outpatient was rated by one or both parents. As EE ratings had a multilevel structure, weighted Spearman correlations of criticism and EOI with various patient- and caregiver-related characteristics were calculated and compared with Meng's z-test. RESULTS Criticism was weakly negatively correlated with EOI in nurses but negligibly in parents. Distinct patterns of significant differential correlates arose across settings. Outpatients' aggressive behavior and parents' related burden were mainly associated with higher criticism. Inpatients' symptoms (agitation/aggression, negative and other psychotic symptoms) and nurses' burnout (Depersonalization) were mainly associated with lower EOI. Inpatients' perceived criticism and outpatients' previous suicide attempts were equally associated with higher criticism and lower EOI (mirror correlations). Finally, various inpatient attributes (older age, chronicity, unemployment and smoking) triggered higher EOI only. Inpatients' age, psychopathology (esp. agitation/aggression and negative symptoms) and perceived criticism survived adjustment for multiple comparisons. CONCLUSION Our findings suggest setting-specific pathogenetic pathways of criticism and EOI and might help customize psychoeducational interventions to staff and families.
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Affiliation(s)
- Panagiotis Ferentinos
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, "Attikon" University General Hospital, 1 Rimini Street, 124 62, Athens, Greece.
| | - Stamatina Douki
- Department of Psychiatry, "Evangelismos" General Hospital, Athens, Greece
| | - Eleni Kourkouni
- Center for Clinical Epidemiology and Outcomes Research, Athens, Greece
| | - Dimitra Dragoumi
- Department of Psychiatry, "Evangelismos" General Hospital, Athens, Greece
| | - Nikolaos Smyrnis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, "Attikon" University General Hospital, 1 Rimini Street, 124 62, Athens, Greece
| | - Athanassios Douzenis
- 2nd Department of Psychiatry, National and Kapodistrian University of Athens, "Attikon" University General Hospital, 1 Rimini Street, 124 62, Athens, Greece
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Sipowicz K, Łuczyńska K, Bąk B, Deska K, Nowakowska-Domagała K, Pietras T, Podgórska-Jachnik D, Małujło-Balcerska E, Kosmalski M. The Structure of Temperament in Caregivers of Patients with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2119. [PMID: 36767486 PMCID: PMC9916194 DOI: 10.3390/ijerph20032119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
The onset of schizophrenia symptoms usually occurs in early youth. As a result, the parents of these patients usually become their caregivers. The role of a caregiver for a person with schizophrenia is a considerable mental and physical burden. Therefore, an interesting issue is what motivates these people to take up this challenge. It is probable that, apart from the moral imperative or kinship, the factor determining this decision is the personality structure of the caregiver. The aim of our study was to compare the structure of temperament (according to the model of temperament as formal characteristics of behavior developed by Jan Strelau) in caregivers of young adults (age 18-25 years) with schizophrenia with the structure of temperament of parents of healthy young adults still living in the family home under their care. The study group consisted of 64 people (51 women), who were taking care of young adults (aged 18-25 years) with schizophrenia, while the control group (53 people, 42 women) consisted of parents of healthy adults still living in the family home. Both groups were asked to complete a questionnaire of the authors' own design on their demographic data as well as The Formal Characteristics of Behavior-Temperament Inventory to assess the temperament traits. The results were given in the number of points obtained on average in each dimension. Both groups did not differ in terms of size and age, with women predominating. Caregivers of young adults with schizophrenia had higher values of briskness (43.22 ± 4.45 vs. 42.90 ± 3.98, p = 0.032), emotional reactivity (46.02 ± 4.39 vs. 41.01 ± 3.12, p = 0.012) and activity level (44.01.89 ± 4.15 vs. 37.59 ± 4.77, p = 0.022) compared to the control group. The remaining dimensions of temperament: perseverance, sensory sensitivity, rhythmicity, and endurance did not differentiate between the two groups. The temperament structure of caregivers of young people with schizophrenia differs from the temperament structure of caregivers of healthy adults. Caregivers of sick people have higher values of briskness, emotional reactivity, and activity level compared to the control group.
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Affiliation(s)
- Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, 02-353 Warsaw, Poland
| | - Kamila Łuczyńska
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, 02-957 Warsaw, Poland
| | - Bartłomiej Bąk
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, 02-957 Warsaw, Poland
| | - Kacper Deska
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | - Katarzyna Nowakowska-Domagała
- Department of Clinical Psychology and Psychopathology, Institute of Psychology, Faculty of Educational Sciences, University of Lodz, 90-128 Lodz, Poland
| | - Tadeusz Pietras
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, 02-957 Warsaw, Poland
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
| | | | | | - Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, 90-153 Lodz, Poland
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Zhang ZJ, Lo HHM, Ng SM, Mak WWS, Wong SYS, Hung KSY, Lo CSL, Wong JOY, Lui SSY, Lin E, Siu CMW, Yan EWC, Chan SHW, Yip A, Poon MF, Wong GOC, Mak JWH, Tam HSW, Tse IHH, Leung BFH. The Effects of a Mindfulness-Based Family Psychoeducation Intervention for the Caregivers of Young Adults with First-Episode Psychosis: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1018. [PMID: 36673773 PMCID: PMC9858753 DOI: 10.3390/ijerph20021018] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE In this study, we investigated the effects of a mindfulness-based family psychoeducation (MBFPE) program on the mental-health outcomes of both caregivers and young adults with first-episode psychosis with an onset in the past three years through a multi-site randomized controlled trial. We also studied the outcomes of three potential mediating effects of interpersonal mindfulness, expressed emotions, and non-attachment on the program. METHOD We randomly assigned 65 caregivers of young adults with psychosis to MBFPE (n = 33) or an ordinary family psychoeducation (FPE) program (n = 32); among them, 18 young adults in recovery also participated in the evaluation of outcomes. RESULTS Intent-to-treat analyses were conducted. No significant time × group interaction effects of MBFPE and FPE programs were found in any of the caregivers' outcomes. However, the young adults with psychosis reported higher levels of recovery after the MBFPE program than after the ordinary FPE program (F = 8.268, p = 0.012, d = 1.484). They also reported a larger reduction in over-involvement of their caregivers (F = 4.846, p = 0.044, d = 1.136), showing that MBFPE had a superior effect to FPE in promoting recovery and reducing over-involvement. CONCLUSIONS A brief psychoeducation program may not reduce the burden on or improve the mental-health outcome of caregivers of individuals with recent-onset psychosis. However, integrating mindfulness into a conventional family psychoeducation program may reduce the expressed emotions of caregivers, especially over-involvement. Further studies should explore how psychoeducation programs can reduce the impact of psychosis on family through sustainable effects in terms of reducing their burden and expressed emotions, using a rigorous study and adequate sample size.
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Affiliation(s)
- Zoe Jiwen Zhang
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Herman Hay Ming Lo
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | | | | | | | | | | | | | | | - Edmund Lin
- Castle Peak Hospital, Hospital Authority, Hong Kong
| | | | | | | | - Annie Yip
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | | | | | | | - Hillman Shiu Wah Tam
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
- Heartfelt Listening Counselling Space, Hong Kong
| | | | - Bobby Fook Hin Leung
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
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