Treatment outcomes in schizophrenia: qualitative study of the views of family carers (original) (raw)
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Neuropsychopharmacology Reports
Objective: This study investigated outcomes in community mental health research that were important to caregivers of people with schizophrenia. Using an online survey conducted from August 1-31, 2020, data were collected from caregivers belonging to the LINE Schizophrenia Family Association. Caregivers identi ed outcomes important in community mental health research. Two researchers categorized caregivers' statements into research outcomes. Results: A total of 132 caregivers completed the online self-reported questionnaire, and 296 caregiver statements were identi ed. Qualitative analysis identi ed 17 outcome categories. The caregivers tended to value having more free time, maintaining an appropriate relationship with people with schizophrenia, and being able to cope with their symptoms. This exploratory study newly demonstrates the outcomes that caregivers of people with schizophrenia consider important in community mental health research. The ndings may be useful in selecting outcomes for future studies of caregivers.
A Qualitative Study About Schizophrenia Caregiver’s Experiences and Needs
Enhancing Capacity of Healthcare Scholars and professionals in Responding to the Global Health Issues
Caregivers in schizophrenia patients have a high burden of care so they are unable to care optimally and have an impact on the high relapse. The study aimed to explore the experiences and needs of caregivers in caring for patients. This was qualitative research used a phenomenology approach. Participants were 11 caregivers who directly cared for schizophrenic. Purposive sampling technique was applied. The data collection method used in-depth interviews. The results gained four themes: caring experiences, perceived burdens, used coping mechanisms and caregivers' needs in caring for patients. Caregivers' experiences in caring for patients often encountered problems including insufficient knowledge, financial and support that created physical, emotional/psychological, and social burdens. Adaptive and maladaptive coping mechanisms were used. Caregivers' needs in caring for their family members affected by schizophrenia including knowledge, support and health services. Caring and support from people around them will reduce the risk of disruption of well-being and can improve the welfare of patients with schizophrenia. It can be concluded that caregivers' needs were some knowledge on how to care for patients and their treatment, supports and health services.
Development of a clinical version of the Carers’ Needs Assessment for Schizophrenia
neuropsychiatrie, 2017
Objective Based on the research version of the Carers' Needs Assessment for Schizophrenia (CNA-S) a shortened clinical version was developed for routine assessment of interventions needed by the caregivers of schizophrenia patients in everyday clinical work. Methods The development of this questionnaire (including a manual explaining its use) was based on results from earlier studies and suggestions from Austrian researchers involved in previous studies using the research version. Based on discussions with researchers the questionnaire and the manual were improved step by step. A clinical test version was investigated for feasibility and practicability in two waves of 15 caregivers of schizophrenia patients each. Results More than 90% of caregivers perceived the clinical version of the CNA-S as a useful instrument to assess all relevant aspects of caregivers' needs and problems. They reported feeling well during the interview for the CNA-S. Clinicians using the clinical version of the CNA-S reported similar views. Conclusion These results suggest that the clinical version of the CNA-S is both feasible and practicable in everyday clinical work.
Family Caregivers' Perspective on Factors Affecting Recovery from Schizophrenia
East Asian Archives of Psychiatry, 2020
Objective: To explore caregivers' perspective on factors affecting the recovery of their family members diagnosed with schizophrenia. Methods: A qualitative grounded theory approach was used. A convenience sample of seven male and eleven female family caregivers of patients with schizophrenia were invited from outpatient (n = 6), inpatient (n = 7), and psychiatric rehabilitation (n = 5) services in an Indian mental health institute to participate in semi-structured interviews. Interviews were recorded, transcribed, and analysed. Similar themes were grouped and the main themes identified. Results: Caregivers' perspectives on factors affecting recovery from schizophrenia were categorised to two themes: facilitators and barriers. The nine facilitators were (1) getting into a precise treatment regimen and sticking to it, (2) developing some personal attributes, (3) exercising family's role diametrically, (4) paying attention to basic needs, (5) sharing with the Almighty, (6) adapting to a supportive lifestyle, (7) not being idle… engage in something, (8) coming out, being and sharing with others, and (9) having adequate resources with a good support system. The ten barriers were (1) detrimental treatment practices, (2) hampering illness impacts, (3) off-putting personality elements, (4) unaccommodating family circumstances, (5) caregivers' limitation, (6) flaccid support system and scarce resources, (7) ambiguous treatment outcome or prognosis, (8) futile religious, health, and social belief systems, (9) situational factors, and (10) presence of troubling physical or psychological stressors. Conclusion: The recovery process is facilitated through family involvement and support by mental health professionals. Thus, giving a pre-treatment counselling to the caregivers and repeating the same content to the patients after regaining insight can be helpful.
Quality of life in caregivers of patients with schizophrenia: A literature review.
Health and quality of …, 2009
Background: A couple of decades ago, hospitals or psychiatric institutions were in charge of caring for patients with schizophrenia; however, nowadays this role is performed by one or more patient's relatives. Evidence shows that informal caregivers experience negative changes in their quality of life (QOL). The aim of this study is to review the main factors associated with the QOL of caregivers of people with schizophrenia.
Family support and quality of life of schizophrenia patients
International Journal of Public Health Science (IJPHS), 2021
Schizophrenia remains a global issue. More than half of those living with schizophrenia have yet to receive appropriate treatment that led to the impeded of their recovery and the low quality of life. This study aimed to understand the relationship between familial supports with the quality of life (QOL) of persons with schizophrenia. The cross-sectional study was conducted on randomly selected 161 outpatients at 13 community health centers (puskesmas). Family support and quality of life data were collected by interviewing the respondents with the Friedman’s family support questionnaire and WHO quality of life (WHOQOL-BREF) questionnaire. Subsequently, data was analyzed using logistic regression. The respondents have a mean age of 45 years, mostly males, have completed high school, mostly unemployed and unmarried. Instrumental (AOR=3.177; 95%CI 1.01-9.91) and appraisal support (AOR=7.620; 95%CI 2.83-20.4) were significantly associated with QOL. Conversely, no significant relationship was found between emotional (AOR=1.345; 95%CI 0.46-3.88) and informational (AOR=2.515; 95%CI 0.85-7.42) support toward QOL. Employment, being married and not experiencing relapse were significantly related to QOL. Instrumental support and appraisal support are important factors in determining the quality of life of persons with schizophrenia. Hence, the government needs to expand the roles of family and community to support these roles.
Caring for people with schizophrenia: family carers' involvement with medication
International Journal of Pharmacy Practice, 2000
Objective To investigate carers' experiences of medication, and their involvement in managing medication, when caring for an adult family member with schizophrenia. Method In-depth, semi-structured interviews were conducted with 14 family carers who were identified through voluntary care groups of the National Schizophrenia Fellowship (NSF). Interviews were audiotape recorded and transcribed. Data were analysed by comparing transcripts to generate descriptive themes. Setting All but one of the carers were interviewed in their homes; the remaining carer was interviewed in the researcher's home. Key findings Carers acknowledged the importance of medication in stabilising their care-recipients' illness. However, they had also observed their care-recipients experiencing unexpected adverse effects of medication. As a result of these observations, carers experienced feelings of guilt and fear for having encouraged medication compliance. Not all carers were involved with their ...
BMC Psychiatry, 2018
Background: Treatment-resistant schizophrenia (TRS) affects about one-third of individuals with schizophrenia. People with TRS do not experience sustained symptom relief and at the same time have the most severe diseaserelated disability and associated costs among individuals with severe mental disorders. Like caregivers of people with treatment-responsive schizophrenia, caregivers of individuals with TRS experience the disease burden along with their care recipients; however, for those providing care for individuals with TRS, the stress of the burden is unrelenting due to uncontrolled symptoms and a lack of effective treatment options. The objective of this study is to better understand the burden of TRS from the caregiver perspective and to explore their perception of available treatments. Methods: Eight focus groups with non-professional, informal caregivers of individuals with TRS were conducted in 5 US locations. TRS was defined as failure of ≥2 antipsychotics and persistent moderate-to-severe positive symptoms of schizophrenia, per caregiver report. Results: The 27 caregivers reported an average of 37 h/week providing direct care, and 21 reported being on call "24/7." Caregivers commonly reported that their care recipients exhibited symptoms of auditory hallucinations (89%), agitation/irritability/hostility (81%), suspiciousness (78%), tangentiality (74%), and cognitive impairment (74%); 70% of caregivers ranked suspiciousness/persecution as the most challenging symptom category. Caring for an individual with TRS impacted many caregivers' finances, career prospects, social relationships, and sense of freedom. Additionally, multiple medication failures led to a sense of hopelessness for many caregivers. Conclusions: Persistent positive symptoms caused significant perceived burden, feelings of being overwhelmed and having no relief, and substantial negative impacts on caregivers' emotional and physical health. To address these substantial unmet needs, policy makers should be aware of the need for practical, social, and emotional support for these caregivers and their families. Additionally, new treatment options for TRS should be developed.