Living with psychiatric patients: Implications for the mental health of family members (original) (raw)
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Stress and satisfaction of family members and independent living skills of psychiatric outpatients
Archives of Clinical Psychiatry, 2014
Background: There are several parameters that must be included in the evaluation psychosocial rehabilitation. Objectives: To describe and correlate the degree of stress of family members who live with schizophrenic and bipolar disorder patients, their satisfaction with mental health services and the level of daily living skills of the patient. Method: Cross-sectional and correlational study, from 2012 to 2013, with a sample of 100 caregivers. The Family Satisfaction with Mental Health Services Rating Scale (SATIS-BR), the Independent Living Skills Survey (ILSS-BR), and the General Health Questionnaire (GHQ-12) were used. Data were analyzed using SPSS v.21, with the Mann-Whitney test, Jonckheere-Terpstra test, and Pearson's, Spearman's and Partial correlations, and a significance level α = 0.05. Results: The score for the SATIS-BR scale was 4.28, 1.59 for the ILSS, and 7.39 for the GHQ-12. The value of the Pearson correlation coefficient between the SATIS-BR and ILSS was r =-0.27, and r =-0.23 between the GHQ-12 and SATIS-BR. The Spearman's correlation coefficient between Education and the GHQ-12 was r =-0.24 and there was a negative linear trend between stress and the level of education (JT =-2.54, p < 0:01). Discussion: The caregivers presented a very high level of psychological distress, therefore, it is critical that mental health services perform more effective psychosocial rehabilitation actions.
International Journal of Social Psychiatry, 2005
Background: Studies that differentiate among diagnoses have detected divergent results in the experience of family burden. Aim: This study aimed to investigate differences in family burden and participation in care between relatives from subgroups of psychoses, affective disorders and`other diagnoses', and between different subgroups of relatives. Method: In a Swedish longitudinal study performed in 1986, 1991 and 1997, 455 close relatives of both committed and voluntarily admitted patients were interviewed concerning different aspects of their burden, need for support and participation in the actual care situation. Results: Relatives showed burdens in several of the aspects measured. In only one aspect of the investigated burden items was a difference found between different diagnostic subgroups. The relatives of patients with affective disorder more often had to give up leisure time. However, spouses showed more burdens and more often experienced suf®cient participation in the patient's treatment than other subgroups while siblings more seldom experienced burdens and more seldom felt that their own needs for support had been met by the psychiatric services. Within each diagnostic subgroup there were differences between subgroups of relatives. Conclusion: Being a close relative, and living together with a severely mentally ill person in an acute situation, is one factor of importance for experiencing burden and participation in care, contradicting the conventional wisdom which differentiates between diagnoses.
Caregiver burden and distress following the patient's discharge from psychiatric hospital
BJPsych bulletin, 2017
Aims and method Caring for someone with a mental illness is increasingly occurring within the community. As a result, family members who fulfil a caregiving role may experience substantial levels of burden and psychological distress. This study investigates the level of burden and psychological distress reported by caregivers after the patient's admission. Results This study found that the overall level of burden and psychological distress experienced by caregivers did not differ according to the patient's legal status. However, the caregivers of those who were voluntarily admitted supervised the person to a significantly greater extent than the caregivers of those who were involuntarily admitted. Approximately 15% of caregivers revealed high levels of psychological distress. Clinical implications This study may emphasise a need for mental health professionals to examine the circumstances of caregivers, particularly of those caring for patients who are voluntarily admitted, ...
Strategies for coping with family members of patients with mental disorders
Revista latino-americana de enfermagem, 2016
to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables. this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies. the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined. despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope wi...
Family Functioning, Coping, and Distress in Families With Serious Mental Illness
The Family Journal, 2014
It is well documented that mental illness impacts not only the person diagnosed but also the family; however, not much is known about family functioning, coping, and distress in the family of the person with the mental illness. Utilizing online surveys of members of the National Alliance on Mental Illness, the following study explored these factors in families with at least one person diagnosed with a mental illness, in order to get a closer look at how counselors and family therapists might assist these families' unique needs. Family variables such as coping style, family functioning, and distress were tested. Other factors such as race/ ethnicity, type and severity of mental illness, time and energy spent caregiving, emotional closeness, and amount of and satisfaction with mental health treatment were examined. Relationships among coping, stress and functioning were found, and meditational models were explored. A key finding was the importance of passive appraisal coping to positive family communication, functioning, and satisfaction. Families with higher levels of distress were less likely to report better family functioning, communication, or satisfaction. Mental health treatment satisfaction was related to higher levels of family support and reframing coping and lower levels of overall distress, which were then linked to more balanced family flexibility and higher family satisfaction.
Social Networks, 2016
Family relationships account for much of the support available to individuals with mental illness. Although some studies have acknowledged the importance of family support, and while others have underlined the harmful effects of negative relationships, research has seldom empirically considered the complex web of positive and negative relationships in family networks. This research hypothesised that social capital has distinct consequences for psychological health depending on the presence or absence of negative family relationships. Through a five-wave follow-up of 60 individuals undergoing psychotherapy in a private practice, the study explored the structural features of positive and negative relationships, considered jointly, in the family networks of adults with mental illness. Four patterns of relationships were found: bonding social capital, bridging social capital, overload and ego-centred conflict. Compared to individuals within a bonding or bridging social capital pattern, those experiencing overload and ego-centred conflict patterns showed higher levels of psychological distress. These results highlight the importance of considering the structural dimensions of positive and negative relationships together to understand the lasting connection between family networks and the psychological health of individuals with mental illness.
Journal of the American Psychiatric Nurses Association, 2008
BACKGROUND: Each year, 54 million American adults are affected by serious mental illness. Most of these persons depend on female family members for support or assistance, and unless these women are resourceful, they may experience considerable burden, stigma by association, depressive thoughts, and poor quality of life. OBJECTIVE: In this study, we examined the associations between characteristics of female family members (age, race, education), adults with serious mental illness (age, diagnosis), and the family situation (relationship, living arrangements, care provided) and caregivers' burden, stigma, depressive cognitions, resourcefulness, and quality of life. STUDY DESIGN: In this descriptive, cross-sectional study, a convenience sample of 60 female relatives of adults with serious mental illness provided demographic information and completed established measures of the study variables. RESULTS: We discuss associations between contextual variables and process regulators, res...
Living with mental illness: Effects of professional support and personal control on caregiver burden
Research in Nursing & Health, 1994
Families of mentally ill persons often report feeling burdened, helpless, and ignored by mental health professionals. The purpose of this study was to examine relationships among professional support, caregivers' personal sense of control, and burden. Ninety-four caregivers rated support received in 11 areas, perceptions of control. and objective and subjective burdens. General well-being measures included a depression scale (CES-D) and self-reported physical health. Controlling for the relative's disruptive behaviors and selected caregiver characteristics, hierarchical multiple regression analyses demonstrated that professional support selectively reduced burden. Practical advice on managing disruptive behaviors reduced objective burden (adjusted R2 = .16, p < ,001 ; R2 increment = .04, p < .05), in part by enhancing personal control. D 1994 John Wiley & Sons, Inc.
European Archives of Psychiatry and Clinical Neuroscience, 2005
■ Abstract In the present study, part of the Munich 5-year follow-up study on key relatives of first-hospitalized schizophrenic and depressive patients, baseline results with respect to relatives' burden and predictors of burden are presented. Basing on a transactional stress model the following hypothesis was tested: the impact of the patients' illness on their relatives' stress outcome is moderated by the psychosocial resources of the relatives. Stress outcome was measured in terms of objective and subjective burden, well-being, self-rated symptoms and global satisfaction with life. Potential moderating variables included age and gender, generalized stress response and illness-related coping strategies, beliefs of control, perceived social support, personality factors, expressed emotion and life stressors.A total of 83 relatives, whose ill family members had been hospitalized in the Department of Psychiatry of the Ludwig-Maximilians-University of Munich for the first time, participated in the study. Findings did not entirely support the hypothesis. On the one hand, relatives' stress outcome was independent of the objective stressors (severity of the illness, kind of symptoms, level of psychosocial functioning at admission). On the other hand, burden was significantly associated with several psychosocial resources and dispositions of the relatives. Multivariate linear regression analyses indicated that expressed emotion, emotion-focused coping strategies and generalized negative stress response are the most relevant predictors of burden. It is argued that a multidimensional approach in burden assessment is necessary and has relevant implications for improving family intervention strategies.