Effectiveness of mutual support and psychoeducation group interventions for family caregivers of patients with schizophrenia (original) (raw)
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International Journal of Nursing Studies, 2013
Background: Positive effects on the relapse from illness and compliance with medication by patients have been observed from family intervention for schizophrenia. However, little attention has been paid to the effects on family members, particularly those in non-Western countries. Inconsistent and inconclusive findings were found on the family-related outcomes and longer-term effects of family intervention. Objective: This study tested the effects of a nine-month family-led mutual support group for Chinese people with schizophrenia, compared with a psycho-education group and standard psychiatric care over a 24-month follow-up. Design: A randomised controlled trial [registered with ClinicalTrials.gov(NCT00940394)] with repeated-measures, three-group design. Settings: Two regional psychiatric outpatient clinics in Hong Kong. Participants: One hundred and thirty-five Chinese family caregivers and their patients with schizophrenia were randomly recruited, of whom 45 family dyads received family-led mutual support group, a psycho-education group, or standard care. Methods: After completing the pre-test questionnaire, the participants were randomly assigned into one of the three study groups. The mutual support and psycho-education groups comprised 14 two-hour group sessions, with patients participating in at least 5 sessions. Those in standard care (and two treatment groups) received routine psychiatric care. Multiple patient and family-related psychosocial outcomes were compared at recruitment and at one week, 12 months, and 24 months following interventions. This is the Pre-Published Version. Results: One hundred and twenty-six of 135 family dyads completed the three post-tests and 43 (95.6%) attended at least nine group sessions (60%) of the mutual support group programme. Mean ages of the family caregivers in the study ranged from 41.2(SD=7.0) to 42.7(SD=7.6) years. About two-thirds of the caregivers were male and patients' parent or spouse. The results of multivariate analysis of variance followed by Helmert contrasts tests indicated that the participants in the mutual support group indicated significantly greater improvement in family and patient functioning[F(2,132)=5.40, p=0.005 and F(2,132)=6.88, p=0.001, respectively] and social support for families[F(2,131)=5.01, p=0.005], and in reducing patients' symptom severity[F(2,132)=4.65, p=0.01] and length of re-hospitalisations [F(2,132)=4.78,p=0.01] at 12-and 24-month follow-ups. Conclusions: Family-led mutual support group for schizophrenia produces longer-term benefits to both the patients' and families' functioning and relapse prevention for patients, compared with psycho-education and standard care. This group programme can be an effective family intervention for Chinese people with schizophrenia.
International journal of nursing studies, 2004
This randomized controlled trial examined the effectiveness of a 12-session mutual support group conducted over 3-months for Chinese family caregivers of a relative with schizophrenia compared with routine family support services in Hong Kong. Forty-eight family caregivers from two psychiatric outpatient clinics were allocated randomly to an experimental (mutual support and usual outpatient care) group (n = 24) or a control (usual outpatient care only) group (n = 24). Data were collected prior to, 1 week and 3 months after the intervention. Families allocated to the mutual support group experienced decreased levels of family burden and increased family functioning and these changes were significantly greater than those of the controls at both post-intervention time points. The experimental group also showed a significant decrease in the duration of patient re-hospitalization (the total number of days of psychiatric hospitalization) at 3 months compared with the control group. This s...
Frontiers in Psychiatry, 2018
Introduction: Recent research in Western countries has indicated that family interventions in schizophrenia and other psychotic disorders can reduce patient relapse and improve medication compliance. Few studies have addressed Chinese and Asian populations. This study tested the long-term effects of a 9-month family-led mutual support group for Chinese people with schizophrenia in Hong Kong, compared with psycho-education and standard psychiatric care. Methods: A randomized controlled trial of Chinese families of patients with recent-onset psychosis (≤5 years of illness) was conducted between August 2012 and January 2017, with a 4-year follow-up. Two hundred and one Chinese families of adult outpatients with recent-onset psychosis were randomly selected from the computerized patient lists and randomly assigned to either mutual support, psycho-education, or standard care group (n = 70 per group). Family caregivers were mainly the parent, spouse, or child of the patients. Mutual support and psycho-education group consisted of 16 two-hour group sessions and patients participated in three sessions. The standard care group and the two treatment groups received the routine psychiatric outpatient care. Results: Patients and families in the mutual support group reported consistently greater improvements in overall functioning [family functioning, F (2, 203) = 8.13, p = 0.003; patient functioning, F (2, 203) = 6.01, p = 0.008] and reductions in duration of hospitalizations [F (2, 203) =6.51, p = 0.005] over the 4-year follow-up. There were not any significant increases of medication dosages or service use by both the family support and psycho-education groups over time. Conclusions: The peer-led family support group can be an effective psychosocial intervention in early psychosis indicating long-term benefits on both patient and family functioning and re-hospitalizations. Clinical Trial Registration: NCT00940394: https://register.clinicaltrials.gov.
The British Journal of Psychiatry, 2006
Background Family intervention in schizophrenia can reduce patient relapse and improve medication adherence, but few studies on this have involved a Chinese population. Aims To examine the effects of a mutual support group for Chinese families of people with schizophrenia, compared with psychoeducation and standard care. Method Randomised controlled trial in Hong Kong with 96 families of out-patients with schizophrenia, of whom 32 received mutual support, 33 psychoeducation and 31 standard care. The psychoeducation group included patients in all the sessions, the mutual support group did not. Intervention was provided over 6 months, and patient- and family-related psychosocial outcomes were compared over an 18-month follow-up. Results Mutual support consistently produced greater improvement in patient and family functioning and caregiver burden over the intervention and follow-up periods, compared with the other two conditions. The number of readmissions did not decrease significant...
Journal of Psychiatric and Mental Health Nursing, 2013
Family members often play a vital role as caregivers in the lives of individuals with schizophrenia. Results of the studies showed that family invironment is the most important determinint of patients outcomes like as quality of life, relapse, adherence. This study aimed to determine the effect of group psychoeducational programme on attitude towards mental illness in families of patients with schizophrenia. Methods: In this quasi-experimental study, 74 families who have schizophrenic patients hospitalized in psychiatric wards during sampling were selected by convenience sampling method. Then the sample was randomly assigned to experimental and control groups. The families of experimental group received 8 continuous 90-minute 3 times a week psychoeducational sessions. Family attitude towards mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI) before and after intervention. Data analysis was conducted using 2 test, independent t-test, and paired t-test on SPSS software version 13. Results: The results showed that majority of the families had negative attitude towards mental illness (88.90%). In addition, the results showed that there was significant difference between different dimensions of attitude towards mental illness before and after psychoeducation in the experimental group. The mean score of families' post-test in the experimental group increased compared to control group 108.86 (14.9), vs. 88.86 (7.5). Conclusion: The results of this study indicate that psychoeducation improves family attitude towards mental illness. Training methods like group psych education for the families of mental patients can be effective on their attitudes towards mental illness.
Objective: Educating families and caregivers of schizophrenic patients on controlling and managing the disorder, has found particular importance in clinical psychology. The present study aims to examine the effect of Psychoeducational interventions on illness management in families of schizophrenic patients. Methods: The present study is a quasi-experimental research with pretest-posttest design, and two control groups. The study sample consisted of 30 families with a schizophrenic member. The families were selected from referrals to a psychiatric center in Tehran (during a period of 40 days) who met the inclusion criteria, and were randomly placed into three groups: an experimental group, a control group with placebo, and a control group without placebo (10 persons in each group). A researcher-made questionnaire was used to collect data. The experimental group received trainings (a training package) and attended a group discussion on schizophrenia. The placebo group attended similar meetings, but without educational content and group discussion, and the second control group were only assessed in the pretest and posttest. After finishing the training sessions, and following an interval of 3 months, the posttest was conducted for each group. The study data were analyzed using univariate analysis of variance (ANOVA). All statistics were carried out using SPSS software, version 11. Results: According to the results, the experimental group had significantly higher gain scores (α≤0.05) than the two control groups, on the following variables: an increase in the adaptability of the patient in daily functioning, from the viewpoint of both a clinical psychologist and the patient’s family, an increase in the family’s knowledge of the illness, and a reduction in the adverse effects of the illness on the family’s feeling and attitude. Conclusion: The present study showed that family education is effective in increasing patients’ adaptability and patients’ family knowledge, and in reducing the adverse effects of the illness.