Family Burden and Relatives' Participation in Psychiatric Care: Are the Patient's Diagnosis and the Relation to the Patient of Importance? (original) (raw)
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The Burden of a Family in Caring For Members Who Suffer From Mental Disorders
2021
Changes and advancement of people daily living have extremely complex consequences, thereby constructive adaptation processes are necessary in dealing with it. However, not all individuals have the ability to constructively adapt to a change so that it can ultimately cause mental disorders. Exploration of the family burden as a support system for the patients is very important because of the high dependence of the patients to their family in dealing with the disease. Even though it is also a responsibility for the family members to be concerned of the patients condition. This study aims to explore the burden of a family in caring for a family member who is mentally disturbed. A phenomenological approach was applied in this qualitative research. In-depth interviews were concluded after obtaining data saturation. Data saturation was acquired after interviewing 5 families of patients. Data analysis conducted using the Collaizi method which resulted in four themes, namely: The burden ex...
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.
Indian Jl of Advanced Nursing, 2016
Among all the mental disorders Schizophrenia and Affective disorders are common disorders affecting the individual, family and society at large. Care of these patients is an enduring stress and leads to considerable amount of burden among caregivers. The aim of the present study was to asses and compare the family burden experienced by the caregivers of patients with schizophrenia and affective disorders and assess the effect of socio demographic variables of patients and care givers on family burden among these patients. A descriptive correlational design was used for the study. The sample comprised of 200 caregivers of patients (Schizophrenic patients-59 and patients with affective disorders-141) from psychiatric in patient and the outpatient clinic of Department of psychiatry, B. P. Koirala Institute of Health Sciences, Nepal.Samples were selected using purposive sampling technique.Caregivers were assessed through personal interview by nurses using 40 items (self-report) Burden Assessment Schedule (BAS) developed in SCARF, India. The result revealed that level of burden reported by caregivers of schizophrenic patients was higher than the caregivers of patients with affective disorders. Caregivers who were spouses, from joint families, with adequate social support, and with previous history of illness experienced less level of burden. Nurses play vital role in implementing family intervention in order to reduce family burden and make difference in the lives of mentally ill patients and their care givers. Key Words: Family Burden, Mental Illness, Schizophrenia, Affective Disorder
Illness-related components for the family burden of relatives to patients with psychotic illness
Social Psychiatry and Psychiatric Epidemiology, 2010
Background Previous research has shown that symptom severity often implies an increased family burden. Few other illness-related variables have, however, been investigated in this context. This study investigates how family burden is affected by symptom, function, and cognition, as well as how the patient perceives his/her illness and quality of life. Method A total of 99 relatives, to as many patients diagnosed with psychosis and with their illness at a stable level, participated in this study. The relatives estimated their perceived burden, the patients rated the distress caused by their illness as well as the quality of their lives, and the care staff rated the patients' symptom and function as well as tested their cognitive abilities. Results Increased family burden can be tied to the patients' increased symptom severity, to their impaired functioning as well as to the patients' higher self ratings regarding distress. The family burden is also connected to the patient's reduced working memory and reduced executive functioning, but this connection is not totally clear and should be further investigated. Of the variables that the patients were rated on, it was the overall functional ability measured with GAF that had the single most impact on perceived family burden. Conclusions Controlling of illness-related variables, such as symptoms, impaired functioning, impaired working memory and executive functioning, as well as the patients' own experiences of distress, is important in order to lessen the burden for the relatives. All aspects of family burden are, however, not explained by these factors, which is why further research within this realm is required.
American Journal of Nursing Research, 2020
Background: The chronic burden of care to a patient with schizophrenia which produce negative emotions. As a result of de-institutionalization, caregivers have greater burden for the care of their mentally ill relatives. Objective of this study was to explore the relationship of relatives' illness perception, expressed emotion and their burden in caring for patients with schizophrenia. Design: This study followed a correlation descriptive research design. Setting: This study conducted at inpatient and outpatient psychiatric department of Tanta University Hospital. Subject: The study subjects consist of 100 relatives of patient with schizophrenia. Tools: Tool 1 consisted of 2 parts: Part 1 Socio-demographic and general characteristics of studied participants, Part 2 Illness Perception Questionnaire-Schizophrenia Carers Version (IPQ-SCV), Tool 2 Family Questionnaire (FQ), Tool 3 Caregiver Burden Interview. Results: it was found that the studied participants had poor illness perception total score, it was found that the studied subjects (47%) had high emotional over-involvement level while it was observed that the two thirds of the studied relatives (61%) had high level of family criticism. majority of studied participants had moderate level of family burden. Conclusion: The results concluded that there was a significant positive correlation between family illness perception and family expressed emotion, also there was a significant positive correlation between family emotional expression and family burden level. Recommendations: this study recommended future studies to investigate distress and burden among caregivers with high emotion expression for intervention, reducing family stress and burden.
BMC psychiatry, 2017
Caregivers are responsible for the home care of family members with mental-health disorders often experience changes in their life that can generate stress and burden. The aim of this study was to identify factors associated with the burden of caregivers of family members with mental disorders. This cross-sectional study was conducted with a non-probability sample of family caregivers, whose patients attended a community services program, the Psychosocial Care Centers, in three cities in the southwest region of Goiás State, Central Brazil. Data collection took place from June 2014 to June 2015. The participants were 281 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview (ZBI). Bivariate analyses (t test, analysis of variance, and Pearson correlation) were performed, and variables with values of p < 0.10 and gender were included in a multiple-linear regression model. Values of p < 0.05 were considered significant. The caregivers were mostly...
The burden of caregiving in families with a mental illness: a review of 2002
Current Opinion in Psychiatry, 2003
Purpose of review With a focus on publications around 2002, this paper attempts a synthetic overview of the broad range of issues in the field of family/informal caregiver burden for all categories of mental disorders. The paper seeks to answer the following questions: how far have publications advanced the field of caregiver burden; how far have they addressed the limitations of previous studies; what more needs to be done? Recent findings Although researchers accepted 'burden' as an 'allencompassing' term, many caregivers reported positive and uplifting experiences, and hence the term 'care giving' is proposed. Care giving is associated with emotional and cognitive transformations. The most important predictors of burden are problematical behaviour, disability and the severity of symptoms. Effective treatment is thus the first step to reduce burden. High expressed emotion may indicate the family's attempts to help the patient; and is mediated by controlling behaviour, stigma, burden, and caregiver perceptions of the patient's control over their own behaviour. New questionnaire measures of expressed emotion encourage cross-cultural research. Psycho-education is the most popular family intervention treatment. Outcome indicators that include caregiver attitudes and knowledge show more positive outcomes than readmission and caregiver burden. Encounters with health professionals are frustrating. Summary There has been a paradigm shift in professionals' perceptions of the caregiver. The challenges include: how best to support the family; improving caregiver perception of professionals; comparison of caregiver costs across illness groups; crosscultural perspectives; longitudinal assessment for trait/statedependent characteristics; and practical assessment tools in the clinical setting.
Comparison of the extent and pattern of family burden in affective disorders and schizophrenia
Indian Journal of Psychiatry 1995; 37: 105 - 112. , 1995
This study sought to compare the extent and pattern of burden experienced by relatives of two different patient groups, one with affective disorders and the other with schizophrenia. Cross-sectional assessment of family burden using the Pai and Kapur's Interview Schedule was done in 78 patients with either bipolar disorder or recurrent major depression and 60 patients with schizophrenia diagnosed according to DSM-III. The inter-rater reliability of the interview schedule for burden was also undertaken prior to the assessment of burden in the main study sample. Doth groups were similar with regard to sociodemographic variables, duration of illness and dysfunction of patient except for lower mean age and greater number of single patients in schizophrenia group. The extent of both objective and subjective burden was significantly more in relatives of schizophrenics. The pattern of burden was, however, almost similar in both the groups. Burden was principally fell in the areas of family routine, family leisure, family interaction and finances. The emotional health of the family was relatively untouched and the impact on physical health of the caring relatives due to burden of care was almost negligible. Various sociodemographic and clinical variables related to burden as well as the implication of the findings of the study are discussed.
Issues in Mental Health Nursing, 2011
Relatives of persons with severe mental illness experience burden and straining changes in their lives that put their health at risk. Consequently, they need support from health professionals. The aim of this study was to describe experiences from encounters with mental health services as seen from the point of view of relatives of persons with severe mental illness. A qualitative, explorative study was performed, based on two open-ended questions in a cross-sectional study of relatives' health, burden, and sense of coherence (n = 216). A manifest qualitative content analysis was used to describe the relatives' experiences. The findings show that some relatives had experienced positive encounters with health personnel, but the majority of experiences reported were negative. The encounters can be summarized into one main category: "Left Alone with Straining but Inescapable Responsibilities." Two categories emerged: "Striving for Involvement for the Sake of the Mentally Ill Person," and "Wanting Inclusion for the Sake of Oneself." There is a gap between relatives' needs for support in order to handle their own situation in relation to their mentally ill next of kin, and what they actually receive from the mental health services. The findings suggest that health professionals should collaborate with and support these relatives.