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Shokrgozar S, Abdollahi E, Abedrad M, Asadi P, Rouzbehan V, Nazari Z, Zare R. Investigating gender differences in quality of life and social support in patients with severe mental illnesses. Int J Soc Psychiatry 2024; 70:750-762. [PMID: 38439517 DOI: 10.1177/00207640241227366] [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: 03/06/2024]
Abstract
BACKGROUND Severe mental illnesses (SMIs), including schizophrenia and bipolar disorder affect patients significantly. Gender has been identified as a key factor influencing the experience of SMIs with notable disparities in prevalence, symptoms, and treatment outcomes. Additionally, the quality of life (QoL) and social support for patients with SMIs can vary based on gender. AIMS This study examined gender differences in QoL and social support of patients with SMIs. METHOD Participants include 170 outpatients with schizophrenia and bipolar disorder at Shafa Hospital (2021). QoL and social support were assessed using World Health Organization QoL (WHOQOL-BREF) questionnaire and Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Group differences were analyzed using t-test or Mann-Whitney U test, and two-way multivariate analyses of variance explored the effect of gender and disease type. RESULTS It was indicated that females with schizophrenia reported higher QoL than males, but the opposite was observed for bipolar disorder. Gender differences in social support were not significant among schizophrenia patients, nor between the two patient groups. However, women with bipolar disorder and multiple hospitalizations experienced lower social support and QoL compared to men. Additionally, more hospitalizations were associated with decreased QoL in both genders with schizophrenia. CONCLUSIONS Findings suggest the need for gender- specific interventions and support policies to enhance QoL and social support in patients with SMI.
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Affiliation(s)
- Somayeh Shokrgozar
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abdollahi
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Morvarid Abedrad
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parham Asadi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Vida Rouzbehan
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Nazari
- Department of Psychology, Lahijan Branch, Islamic Azad University, Iran
| | - Roghayeh Zare
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Iswanti DI, Nursalam N, Fitryasari R, Sarfika R, Saifudin IMMY. Effectiveness of an Integrative Empowerment Intervention for Families on Caring and Prevention of Relapse in Schizophrenia Patients. SAGE Open Nurs 2024; 10:23779608241231000. [PMID: 38333904 PMCID: PMC10851764 DOI: 10.1177/23779608241231000] [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: 08/01/2023] [Revised: 12/06/2023] [Accepted: 01/16/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Patients with schizophrenia require extended treatment and recovery, leaving their families and support systems feeling helpless. Integrative empowerment is a strategy that utilizes outside-in and inside-out empowerment to increase the ability of families to care for their loved ones and prevent relapse. Objective This study aimed to investigate the impact of integrative empowerment intervention on enhancing the family's ability to care for and prevent relapse in patients with schizophrenia. Methods The study employed a quasi-experimental with a pre-test and post-test control group design. The research sample was comprised of 70 individuals from nuclear families residing in Semarang, all of whom were responsible for the care of individuals with schizophrenia. The participants were divided into two groups: the treatment group, consisting of 35 individuals, and the control group, also comprising 35 individuals. Participant selection was carried out using purposive sampling. Module and booklet were produced as an intervention tools. The integrative empowerment intervention program spanned a period of 5 weeks, involving one session per week, each lasting approximately 60-90 min. Data analysis was conducted through the utilization of the Wilcoxon and Mann-Whitney tests. The significance level for the study was set at p<.05. Results There was a significant change in the family's ability to care for patients with schizophrenia before and after the integrative empowerment intervention (p<.001), while there was no change in the control group's ability to care for patients with schizophrenia (p>.05). Integrative empowerment had a significant impact on increasing the family's ability to care for and prevent relapse in patients with schizophrenia (p<.001). Conclusions Nurses can help families strengthen their positive caregiving experiences through the home visit program by utilizing integrative empowerment. This study's findings highlight the importance of integrative empowerment in enhancing the family's ability to care for and prevent relapse in patients with schizophrenia.
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Affiliation(s)
- Dwi Indah Iswanti
- Department of Mental Health and Community, Faculty of Nursing and Health Science, Universitas Karya Husada Semarang, Semarang, Indonesia
| | | | | | - Rika Sarfika
- Department of Mental Health and Community, Faculty of Nursing, Universitas Andalas, Padang, West Sumatra, Indonesia
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Stanley S, Balakrishnan S. Informal caregivers of people with a diagnosis of schizophrenia: determinants and predictors of resilience. J Ment Health 2023; 32:198-205. [PMID: 34282713 DOI: 10.1080/09638237.2021.1952945] [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: 01/06/2023]
Abstract
BACKGROUND The extant literature portrays informal caregiving by family members who care for a person with a diagnosis of schizophrenia, as one that involves a tremendous amount of stress and burden. AIM This investigation sought to assess informal caregiving experience with regard to variables such as perceived positive aspects, preparedness, resilience, and life satisfaction. METHOD Data was collected from two groups of respondents accessing services at the Thanjavur Medical College Hospital, Tamil Nadu, India. The study group consisted of 75 family caregivers of persons with a diagnosis of schizophrenia and the reference group had an equal number of caregivers of people with minor physical ailments. The two groups were matched on important background factors, ensuring their comparability. Standardised instruments were administered to all respondents to collect data pertaining to the key variables and analysed using appropriate statistical procedures. RESULTS Results indicated that caregivers of people with a diagnosis of schizophrenia, while manifesting higher levels of resilience, perceived lesser positive aspects in their caring role. A significant statistical difference between both groups of respondents in terms of their life satisfaction and resilience. Regression analyses extracted preparedness and life satisfaction as significant contributors to the manifestation of resilience in the caregivers. CONCLUSIONS The study highlights the importance of caregiver preparedness and life satisfaction in enhancing their resilience.
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Affiliation(s)
- Selwyn Stanley
- Social Work Faculty of Health, Social Care and Medicine Edge Hill University, Ormskirk, UK
| | - Sujeetha Balakrishnan
- Psychology and Clinical Psychologist, Thanjavur Medical College Hospital, Thanjavur, India
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Şahin Altun Ö, Asi Karakas S, Öztürk Z, Polat H. An analysis of the relationship between social support levels and treatment compliance of individuals diagnosed with schizophrenia. Perspect Psychiatr Care 2022; 58:578-583. [PMID: 33904170 DOI: 10.1111/ppc.12813] [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: 06/22/2020] [Revised: 03/05/2021] [Accepted: 03/27/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to determine the relationship between social support levels and treatment compliance of individuals with schizophrenia. DESIGN AND METHODS A descriptive and correlational research design was used in the study. The sample was not selected from the universe and the study was completed with 110 patients. FINDINGS There was a significant positive correlation between the total score of family subscale and total score of the Morisky compliance scale (p < 0.05). Morisky adherence scale (p < 0.05), suggesting that family support can favor the treatment adherence of patients. PRACTICE IMPLICATIONS Psychiatric professionals should carefully evaluate the family support perceived from the patients with schizophrenia to improve their adherence to treatment.
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Affiliation(s)
- Özlem Şahin Altun
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Sibel Asi Karakas
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Zeynep Öztürk
- Department of Psychiatric Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey
| | - Hatice Polat
- Malatya Education and Research Hospital Psychiatry Clinic, Malatya, Turkey
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Chinneimawi E, Nagarajan P, Menon V. Caregiver Burden and Disability in Somatoform Disorder: An Exploratory Study. Indian J Psychol Med 2021; 43:500-507. [PMID: 35210678 PMCID: PMC8826199 DOI: 10.1177/0253717620957563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Very few Indian studies have explored disability among patients with somatoform disorder and the burden experienced by their caregivers. We aimed to assess the levels of disability among patients with somatoform disorder and the levels of burden among their caregivers and compare these parameters against patients with schizophrenia. METHODS Participants included adults with a diagnosis of somatoform disorders (F45.0-F 45.9) (n = 28) or schizophrenia (F20.0-F20.9) (n = 28) diagnosed as per the International Classification of Diseases, Tenth Revision (ICD-10), clinical descriptions, and diagnostic guidelines, as well as their caregivers. The WHO Disability Assessment Schedule 2.0 and Family Burden Interview Schedule were used to assess patient disability and caregiver burden, respectively. Independent Student's t-test or chi-square test was used to compare relevant sociodemographic and clinical parameters. RESULTS Out of 56 patients, the mean (±SD) age of the sample was 38.6 (±10.5) years. Females constituted a slender majority of the sample (n = 29, 51.8%). The mean disability score of patients with somatoform disorders was slightly higher (83.6 ±20.9) than that of patients with schizophrenia (82.3 ±16.7). Similarly, the mean burden score of caregivers of patients with somatoform disorders was nominally higher (18.96 ±9.9) than that of caregivers of patients with schizophrenia (15.7 ±9.7). Neither of these differences approached statistical significance (P > 0.05). CONCLUSION Patients with somatoform disorders experience considerable levels of disability, and their caregivers go through various levels of burden in their daily life that is comparable to schizophrenia.
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Affiliation(s)
| | - Padmavathi Nagarajan
- Dept. of Psychiatric Nursing, College of Nursing, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pudhucherry, India
| | - Vikas Menon
- Dept. of Psychiatry, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Pudhucherry, India
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Kim JY, Jun WH. The effect of gratitude and self-encouragement on depression in psychiatric inpatients in Korea. Arch Psychiatr Nurs 2021; 35:323-328. [PMID: 33966800 DOI: 10.1016/j.apnu.2020.12.004] [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: 06/01/2020] [Revised: 09/14/2020] [Accepted: 12/12/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the effect of gratitude and self-encouragement on depression in psychiatric inpatients in South Korea. A cross-sectional and correlational research design was used. The participants were 112 psychiatric inpatients recruited from the psychiatric units of four general hospitals in South Korea. Data were collected using the Korean version of the Gratitude Questionnaire-6, the Self-Encouragement Inventory, and the Korean version of Beck's Depression Inventory II. Data were analyzed using two-stage hierarchical regression analysis. The results showed that emotional self-encouragement (β = -0.43, p = .004) and gratitude (β = -0.22, p = .029) were factors significantly influencing depression. The regression model explained 28.0% of depression. Therefore, it is recommended that mental health nurses provide intervention to psychiatric inpatients to help them foster gratitude and emotional self-encouragement so that they can decrease depression.
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Affiliation(s)
- Ju Yeon Kim
- College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, South Korea
| | - Won Hee Jun
- College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, South Korea.
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Phadsri S, Shioji R, Tanimura A, Jaknissai J, Apichai S, Sookruay T. Nonpharmacological Treatment for Supporting Social Participation of Adults with Depression. Occup Ther Int 2021; 2021:8850364. [PMID: 34007254 PMCID: PMC8102128 DOI: 10.1155/2021/8850364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 03/16/2021] [Accepted: 04/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Social withdrawal is predominantly seen among adults with depression. However, a dearth of reviews exists that explore nonpharmacological treatments, especially occupational therapy (OT) interventions and their effect in promoting social participation. The aim of this research was to review what intervention programs are conducted to support the social participation of adults with depression and their effectiveness. METHOD A systematic review was performed wherein relevant articles were searched in PubMed, CINAHL, Wiley Online Library, PsycINFO, and OTseeker databases and AJOT, BJOT, SJOT, and OTMH journals. Only English articles published from January 2010 to December 2018, which tackled intervention for adults aged 20-60 years with depression, were considered. Ten out of 918 studies met the screening criteria. RESULT Among the ten studies, the effective intervention programs were categorized as either occupation-based intervention (OBI) or cognitive behavioral therapy-based intervention (CBT-BI). These programs sought the following outcomes: behavioral change in social participation (n = 4), reduction of depression or depressive symptoms (n = 13), life satisfaction (n = 4), and quality of life (QoL) (n = 1). Studies showed moderate (n = 3) to strong (n = 7) level of certainty, whereas they also revealed high to unclear (n = 3) and low (n = 7) risk of bias. CONCLUSION Both OBI such as animal-assisted therapy and CBT-BI such as behavioral change program and health education have a strong level of certainty and low risk of bias in promoting social participation by supporting positive behavioral change and reducing depressive symptoms. Furthermore, the sport and exercise program of OBI was popular in encouraging participation and engagement with other people. Other programs were suggested for combined interventions to support social participation, life satisfaction, and QoL.
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Affiliation(s)
- Supaluck Phadsri
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
- Department of Occupational Therapy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Rieko Shioji
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Atsuko Tanimura
- Department of Occupational Therapy, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Jeerawit Jaknissai
- Occupational Therapy Unit, Thanyarak Khon Kaen Hospital, Khon Kaen 40000, Thailand
| | - Sopida Apichai
- Department of Occupational Therapy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Tippawan Sookruay
- Chiang Mai University Library, Chiang Mai University, Chiang Mai 50200, Thailand
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Nguyen T, Tran T, Green S, Hsueh A, Tran T, Tran H, Fisher J. Proof of concept of participant informed, psycho-educational, community-based intervention for people with severe mental illness in rural Vietnam. Int J Soc Psychiatry 2020; 66:232-239. [PMID: 31902271 DOI: 10.1177/0020764019898234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is a lack of an intervention model that empowers people with severe mental illness (SMI) and their families and addresses the mental health gap in low- and middle-income countries. There is a significant gap in care for people with SMI in rural Vietnam due to the low quality of care in the formal mental health system and the lack of access to an evidence-informed informal approach to care. OBJECTIVES To assess acceptability, feasibility, preliminary evidence of impact and potential cost savings of a mental health support group intervention for people with SMI in the community. METHODS The proof of concept used a pre-post design with qualitative assessment, impact evaluation and cost analysis. RESULTS A mental health support group intervention facilitated by Women's Union staff using a positive deviance approach was conducted among 68 people with SMI. Qualitative evaluation showed that the approach was highly acceptable and feasible. There was a significant improvement in personal functioning and a reduction in stigma and discrimination experienced by intervention participants. The intervention was found to reduce significantly the financial burden on the families having members with SMI. CONCLUSION The proof of concept of the mental health support group intervention delivered by informal community care providers for people with SMI provides promising evidence to address the mental health gap with high acceptability, feasibility and low-cost for low- and middle-income countries.
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Affiliation(s)
- Trang Nguyen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Tuan Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Sally Green
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Arthur Hsueh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Thach Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ha Tran
- Research and Training Centre for Community Development (RTCCD), Hanoi, Vietnam
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Triyaspodo K, Daulima NHC, Wardani IY. History of violence performed by family on people with mental illness following hospitalization. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Managing family burden through combined family psychoeducation and care decision without pasung therapies. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Handi A, Gultom DP, Husada MS, Loebis B, Effendy E, Amin MM, Camellia V, Nasution NM. The Comparison of Hospital Anxiety and Depression Scale-Anxiety Scores between Female Caregivers of People with Schizophrenia According to Gender Difference. Open Access Maced J Med Sci 2019; 7:2630-2633. [PMID: 31777621 PMCID: PMC6876818 DOI: 10.3889/oamjms.2019.472] [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: 06/30/2019] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Caregiver plays an important role for a better outcome in people with schizophrenia, although it usually causes emotional distress for the caregiver. Anxiety is one of the emotional distress. Gender of schizophrenic patients is associated with the emotional distress of caregiver. The differences in HADS-A scores between female caregivers of people with schizophrenia according to gender in Indonesia remain unclear. AIM: To determine whether HADS-A scores are higher in a male group compare with the female group. METHODS: This study was an analytical study with a cross-sectional approach to determine the comparison of HADS-A score between 27 female caregivers of male schizophrenic patients (male group) and 27 female caregivers of female schizophrenic patients (female group) in Prof. Dr M. Ildrem Mental Hospital Medan, using a HADS rating scale. RESULTS: There is no difference between the male and female group in caregivers age, marital status, employment status, family income/month, education time, the relationship with people with schizophrenia, caring time, time spent / weeks, and the patients age, employment status, education time, PANSS score and number of relapses. The comparison between total HADS-A score between the male group and the female group is not significant with 9.52 ± 4.90 v 8.70 ± 4.49 (p = 0.53). CONCLUSION: HADS-A scores are not higher in caregivers of male with schizophrenia compared with caregivers of a female with schizophrenia.
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Affiliation(s)
- Andrew Handi
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dapot Parulian Gultom
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Muhammad Surya Husada
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Bahagia Loebis
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Elmeida Effendy
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Mustafa Mahmud Amin
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Vita Camellia
- Department of Psychiatry, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Mittendorfer-Rutz E, Rahman S, Tanskanen A, Majak M, Mehtälä J, Hoti F, Jedenius E, Enkusson D, Leval A, Sermon J, Taipale H, Tiihonen J. Burden for Parents of Patients With Schizophrenia-A Nationwide Comparative Study of Parents of Offspring With Rheumatoid Arthritis, Multiple Sclerosis, Epilepsy, and Healthy Controls. Schizophr Bull 2019; 45:794-803. [PMID: 30184197 PMCID: PMC6581137 DOI: 10.1093/schbul/sby130] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The study aimed to (1) compare the risk of health care use, adverse health status, and work productivity loss of parents of patients with schizophrenia to parents of patients with multiple sclerosis (MS), rheumatoid arthritis (RA), epilepsy, and healthy controls; and (2) evaluate such outcome measures while considering disease severity of schizophrenia. METHODS Based on linkage of Swedish registers, at least one parent was included (n = 18215) of patients with schizophrenia (information 2006-2013, n = 10883). Similarly, parental information was linked to patients with MS, RA, epilepsy, and matched healthy controls, comprising 11292, 15516, 34715, and 18408 parents, respectively. Disease severity of schizophrenia was analyzed. Different regression models yielding odds ratios (OR), hazard ratios (HR), or relative risks (RR) with 95% confidence intervals (CI) were run. RESULTS Psychiatric health care use, mainly due to anxiety and affective disorders, showed a strongly increasing trend for parents of patients with schizophrenia throughout the observation period. During the follow-up, these parents had an up to 2.7 times higher risk of specialized psychiatric health care and receipt of social welfare benefits than other parents. Parents of the moderately severely ill patients with schizophrenia had higher risk estimates for psychiatric health care (RR: 1.12; 95% CI: 1.07-1.17) compared with parents of least severely ill patients. CONCLUSIONS Parents of patients with schizophrenia have a considerably higher risk of psychiatric health care and social welfare benefit receipt than other parents. Psychiatric health care use worsens over time and with increasing disease severity of the offspring.
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Affiliation(s)
- Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,To whom correspondence should be addressed; tel: +46-8-524-820-25, fax: +46-8-524-832-05, e-mail:
| | - Syed Rahman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Antti Tanskanen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland,The Impact Assessment Unit, National Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | | | | | - Amy Leval
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Heidi Taipale
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Jari Tiihonen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
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Mathias K, Kermode M, San Sebastian M, Davar B, Goicolea I. An asymmetric burden: Experiences of men and women as caregivers of people with psycho-social disabilities in rural North India. Transcult Psychiatry 2019; 56:76-102. [PMID: 30141376 DOI: 10.1177/1363461518792728] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Caring for a family member with a psycho-social disability can be both rewarding and burdensome. This study analyses the experiences of caregivers of people with psychosocial disabilities (PPSDs) in rural communities in North India using relational gender theory. In-depth interviews with 18 female and male caregivers of PPSDs probed the social, emotional and health impacts of their caregiving role. Nine themes were identified that were grouped under three meta-themes: intra-personal, inter-personal and institutional impacts. Under the intra-personal meta-theme, all caregivers experienced high tension, with women describing almost overwhelming stress. Women minimised their role as caregivers, and felt negative and hopeless about their futures, while men had a more positive view of the future and themselves. Embodied experiences of psychological and social distress were consistently described by women, but not by men. Within the interpersonal meta-theme, men experienced opportunity for social connection and social support that was seldom available to women. Interpersonal violence with other household members was described by both men and women. Within the institutional meta-theme, both men and women described strength in unity, and gestures leading to the reordering of gender relations. These findings underline the significant and diffuse impacts of a gender order that values males and disadvantages females as caregivers of PPSDs, with the asymmetry of a greater burden for women. The findings point to the urgent need for global mental health policies that support and empower caregivers and that strengthen gender equality.
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Attepe Özden S, Tuncay T. The experiences of Turkish families caring for individuals with Schizophrenia: A qualitative inquiry. Int J Soc Psychiatry 2018; 64:497-505. [PMID: 29862853 DOI: 10.1177/0020764018779090] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Turkey, individuals with schizophrenia usually live with their families. Therefore, families are main caregivers and face psychological, financial and social problems. AIM The aim of this study is to understand the personal burdens and coping strategies, and social support affecting the families that provide care to the individuals with schizophrenia. METHODS In-depth interviews were conducted with 31 members of 12 families. RESULTS Four themes were formed: learning and accepting the disorder, caregiving, social dimensions and service dimensions. Families have a problem with accepting this order and caregiving affects their quality of life both financially and socially. As schizophrenia is one of the reasons for being isolated from community, families prefer hiding it. Although families are satisfied with community-based systems, they need long-term solution, training and financial aid. CONCLUSIONS To reduce the burden, family therapies, education and psychological support should be provided for families, and job opportunities, long-term caregiving services and psychological support should be provided for individuals with schizophrenia.
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Affiliation(s)
- Seda Attepe Özden
- 1 Department of Social Work, Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Tarık Tuncay
- 2 Department of Social Work, Hacettepe University, Ankara, Turkey
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Arun R, Inbakamal S, Tharyan A, Premkumar PS. Spousal Caregiver Burden and Its Relation with Disability in Schizophrenia. Indian J Psychol Med 2018; 40:22-28. [PMID: 29403125 PMCID: PMC5795674 DOI: 10.4103/ijpsym.ijpsym_204_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Schizophrenia, a chronic psychiatric disorder, can affect one's productivity and psychosocial functioning. In Indian context, the responsibility of caring persons with schizophrenia is increasingly on their spouses. Spousal caregiver experience and its relation with disability in schizophrenia need to be studied. MATERIALS AND METHODS We conducted a cross-sectional study among 52 outpatients with schizophrenia and their spouses attending a tertiary psychiatric center. The objectives were: (a) to explore spousal caregiver burden in schizophrenia and (b) to assess the relation between disability and spousal caregiver burden. The study adopted recommended ethical principles. Scales such as Burden Assessment Schedule, Indian Disability Evaluation and Assessment Scale (IDEAS), and Positive and Negative Syndrome Scale were used to collect appropriate data. Descriptive analysis, bivariate analysis, and multivariate analysis were done in SPSS software version 16.0. RESULTS The mean spousal caregiver burden score was 73.5 (standard deviation: 14.0). In bivariate analysis, disability, duration of schizophrenia, severity of schizophrenia, place of residence, and socioeconomic status had statistically significant relation with spousal caregiver burden. Adjusted for spouses' age, gender, and other significant factors in bivariate analysis, the IDEAS global disability score (2.6, [confidence interval 0.5-3.8, P = 0.013]) retained statistically significant association with spousal caregiver burden. CONCLUSION Spouses of persons with schizophrenia experience significant caregiver burden. Disability was found to be the most powerful determinant of spousal caregiver burden in the sample. Focus on disability alleviation in the management of schizophrenia may help reduce spousal caregiver burden.
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Affiliation(s)
- R Arun
- Department of Psychiatry, Psychosocial Rehabilitation Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - S Inbakamal
- Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anna Tharyan
- Department of Psychiatry, Psychosocial Rehabilitation Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prasanna S Premkumar
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
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Abstract
We aim to assess the level of family burden of schizophrenia patients and identify its predicting factors in a rural community sample of China. A sample of 327 primary caregivers was recruited through a one-stage cluster sampling in Ningxiang County of Hunan province, China. Family burden was assessed using the Family Burden Interview Schedule (FBIS) of Pai and Kapur. Our results showed that the mean score of FBIS was 23.62±9.76 (range, 0–48), with over half (52%) caregivers reported their family burden being moderate and severe. Among the six domains of family burden, financial burden (76%) was the commonest burden, while disruption of family interactions (37%) was the least mentioned. A multivariate analysis of family burden revealed that patient being admitted for over 3 times, caregiver being female, having a middle school education, and with additional dependents, as well as higher care network function were positive predictors of family burden, while higher patient function and family function, and increasing patient age were negative predictors of family burden. Intervention to decrease family burden may be best served by improving family function and exploring alternative care model instead of hospitalization.
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17
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Hidru TH, Osman MH, Lolokote S, Li X. Extent and pattern of burden of care and its associated factors among Eritrean families of persons living with schizophrenia: a cross-sectional study. BMJ Open 2016; 6:e012127. [PMID: 27683516 PMCID: PMC5051495 DOI: 10.1136/bmjopen-2016-012127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess the caregiving burden and its associated factors among Eritrean families of persons living with schizophrenia. METHODS A cross-sectional study was conducted for 146 caregivers with their respective known patients with schizophrenia of Saint Mary's Neuropsychiatric National Referral Hospital (SMNNRH). Data were collected using Pai and Kapur's Family Burden Interview Schedule (FBIS), the Positive and Negative Syndrome Scale (PANSS) and self-prepared sociodemographic sheet. Data were analysed using SPSS V.21. Descriptive statistics, independent t-tests, one-way analysis of variance (ANOVA) and multiple regression analysis was employed to analyse the data. RESULTS In this study, 84 (57.5%) were males and 62 (42.5%) were females. The mean age was 33.96+10.37 (median=31) for the patients and 46.76+13.96 (median=48) for the caregivers. Total mean objective score was 29.47+6.67. Family caregivers who were single (F=3.224, p<0.005, effect size (ES)=0.064), had educational level at elementary (F=5.647 p=0.001, ES=0.11), had low monthly income (t=7.727, p<0.001, ES=0.01) and were dissatisfied with family support (t=2.889, p<0.01, ES=0.01) experienced greater burden relative to the counterparts. Caregiver's age (β=0.156; p<0.05), duration of caregiving (β=0.131; p<0.05), monthly household family income (β=-0.298; p<0.001), history of self-injury (β=0.151; p=0.05), positive scale (β=0.344; p<0.001), negative scale (β=0.278; p<0.001) and general psychopathological scale (β=0.146; p<0.01) emerged as significant predictors of objective burden. CONCLUSIONS Family caregivers of a person living with schizophrenia experience a significant burden of care. Our findings highlight that there is a need of strengthening social and psychological support to reduce the caregiving burden.
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Affiliation(s)
| | | | - Sainyugu Lolokote
- Department of Epidemiology and Biostatistics, Dalian Medical University, Dalian, Liaoning, PR China
| | - Xiaofeng Li
- Department of Epidemiology and Biostatistics, Dalian Medical University, Dalian, Liaoning, PR China
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Ong HC, Ibrahim N, Wahab S. Psychological distress, perceived stigma, and coping among caregivers of patients with schizophrenia. Psychol Res Behav Manag 2016; 9:211-8. [PMID: 27574475 PMCID: PMC4993414 DOI: 10.2147/prbm.s112129] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Nowadays, family members are gradually taking on the role of full-time caregivers for patients suffering from schizophrenia. The increasing burden and tasks of caretaking can cause them psychological distress such as depression or anxiety. The aim of this study was to measure the correlation between perceived stigma and coping, and psychological distress as well as determine the predictors of psychological distress among the caregivers. Results showed that 31.5% of the caregivers experienced psychological distress. “Community rejection” was found to be positively associated with psychological distress. In case of coping subscales, psychological distress had a positive correlation with substance use, use of emotional support, behavioral disengagement, venting, and self-blame, while it was negatively correlated with “positive reframing”. Behavioral disengagement was the best predictor of psychological distress among caregivers of patients with schizophrenia, followed by positive reframing, use of emotional support, self-blame, and venting. Health practitioners can use adaptive coping strategies instead of maladaptive for caregivers to help ease their distress and prevent further deterioration of psychological disorders.
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Affiliation(s)
| | - Norhayati Ibrahim
- Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia
| | - Suzaily Wahab
- Department of Psychiatry, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
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Ibanez G, Mercedes BPDC, Vedana KGG, Miasso AI. [Adherence and difficulties related to drug treatment in patients with depression]. Rev Bras Enferm 2016; 67:556-62. [PMID: 25271579 DOI: 10.1590/0034-7167.2014670409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 06/30/2014] [Indexed: 11/22/2022] Open
Abstract
This research verified adherence and knowledge of people with depression regarding prescribed pharmacotherapy, satisfaction with the health team and difficulties related to drug treatment. This is descriptive and cross-sectional study, with quail-quantitative approach. The study included 27 people assisted in an outpatient clinic in the interior of the state of São Paulo - Brazil. Data were collected through semi-structured interviews and review of medical records and analyzed using descriptive statistics and content analysis. It was found that 29.6% of patients were no adherent to medication and 51.9% were unaware of the dose of prescribed drugs. Impact of drug therapy in depressive symptoms on self-care, dissatisfaction with effects of psychoactive drugs, lack of support, use of multiple medications and lack of knowledge about the disorder and treatment were reported as difficulties in following drug therapy. This study shows critical factors to the promotion of patient safety in following drug therapy.
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Burden of caregivers of adult patients with schizophrenia in a predominantly African ancestry population. Qual Life Res 2015. [DOI: 10.1007/s11136-015-1077-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Kumar CN, Suresha KK, Thirthalli J, Arunachala U, Gangadhar BN. Caregiver burden is associated with disability in schizophrenia: results of a study from a rural setting of south India. Int J Soc Psychiatry 2015; 61:157-63. [PMID: 24948613 DOI: 10.1177/0020764014537637] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Taking care of patients with schizophrenia is a major source of burden to the family. Research on burden experienced by family members of patients living in rural communities is sparse. METHODS Data were obtained from a community intervention program for psychoses in a rural community of south India, where persons with severe mental disorders were identified, treated and followed up. As part of the program, caregivers of 245 schizophrenia patients were interviewed using the Burden Assessment Schedule. Psychopathology (Positive and Negative Syndrome Scale; PANSS), treatment status and disability (Indian Disability Evaluation and Assessment Scale; IDEAS) experienced by the patients were also assessed. Univariate and multivariate analyses were used to study the influence of different factors on the caregiver burden. RESULTS Level of burden had a significant direct correlation with disability (Pearson's r = .35; p < .01) and severity of psychopathology (r = .21; p < .01). Duration of treatment had an inverse correlation with burden (Pearson's r = -.16; p < .01). Multivariate analysis revealed that total IDEAS score (Beta = .28; t = 4.37; p ≤ .01), duration of treatment (Beta = -.17; t = -2.58; p = .01), age of the family caregiver (Beta = .15; t = 2.4; p = .02) and gender of the patient (Beta = -.13; t = -2.1; p = .04) were significant predictors of burden. The model including total IDEAS score explained 14% of variance (adjusted R (2) = .139; p < .01). CONCLUSION Burden experienced by family caregivers of schizophrenia patients depends on the level of disability experienced by the patient, age of the family caregivers and gender of the patient. Interventions to reduce disability of the patients may reduce the caregiver burden.
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Affiliation(s)
- Channaveerachari N Kumar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Kudumallige K Suresha
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | | | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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