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Kalra H, Tung S. Mediating Role of Social Support and Family Functioning on Quality of Life of Family Caregivers of Individuals With Alcohol Use Disorder. Indian J Psychol Med 2024:02537176241275566. [PMID: 39564270 PMCID: PMC11572329 DOI: 10.1177/02537176241275566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2024] Open
Abstract
Background Caring for persons with alcohol use disorder (AUD) significantly affects the quality of life (QoL) of caregivers. According to Lazarus and Folkman's Stress and Coping Model (1984), the severity of alcohol consumption (SAC) is a major stressor for AUD caregivers. These stressors impact well-being, with QoL linked to caregivers' coping resources, especially social support (SS) and family functioning (FF). The study aimed to investigate the mediating roles of SS and FF in the relationship between the SAC and caregivers' QoL. Material and Methods A cross-sectional study was conducted in two psychiatric hospitals in Amritsar city, Punjab. We used a purposive sampling technique to collect data from 128 family caregivers aged 18 and above who were caring for male patients with AUD aged between 20 and 65. The assessment tools used were the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), Alcohol Use Disorders Identification Test (AUDIT), Family Assessment Device (FAD), and PGI Social Support Questionnaire (PGI SSQ). Results There is a significant and partial mediation of the association between SAC and QoL by both SS and FF (P < .001, 99% CI). Moreover, SAC (r = -0.519), FF (r = -0.603), and SS (r = 0.641) showed significant correlations with caregivers' QoL (P < .001). The mean scores for SAC, SS, FF, and QoL were 22.66 (11.38), 50.88 (9.45), 127.18 (43.85), and 84.13 (18.70), respectively, suggesting moderate SAC in patients, moderate to high perceived SS levels, moderate perception of family dysfunction, and moderate to high QoL among the caregivers. Conclusion SAC detrimentally impacts caregivers' QoL both directly and indirectly through SS and FF, with the latter serving as mediators, partially mitigating SAC's negative impact. Clinical implications underscore the importance of tailored interventions, emphasizing the strengthening of support systems and consideration of diverse FF domains for personalized approaches. The findings contribute valuable insights for developing targeted interventions customized to the specific needs of AUD caregivers to enhance their overall QoL.
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Affiliation(s)
- Hunny Kalra
- Dept. of Psychology, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Suninder Tung
- Dept. of Psychology, Guru Nanak Dev University, Amritsar, Punjab, India
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2
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Wong DFK, Lau YY, Chan HS, Zhuang X. Family functioning under COVID-19: An ecological perspective of family resilience of Hong Kong Chinese families. CHILD & FAMILY SOCIAL WORK 2022; 27:CFS12934. [PMID: 35941859 PMCID: PMC9348295 DOI: 10.1111/cfs.12934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 03/01/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
This study tested an ecological model of resilience that illustrated the influence of COVID-19-related stressors (i.e., social and health stressors) and various socio-ecological factors at microsystem (i.e., parent-child conflicts and couple relationship) and exo-system levels (i.e., the utilization of community resources) on family functioning among Chinese families during COVID-19. An anonymous telephone survey was conducted using random sampling method. The sample contained 322 respondents who were co-habiting with their child(ren) and their partner. Hierarchical regression analysis and structural equation modelling were used to examine the differential impacts of various levels of factors and the model that were proposed. Results showed that 13.2% of the households were categorized as at-risk of poorer family functioning. Couple relationship and stressors significantly accounted for much of the variance in family functioning. While stressors had a significant direct effect on family functioning, couple relationship, but not parent-child conflicts or utilization of community resources, significantly mediated and moderated the impact of stressors on family functioning. The findings highlighted the impacts of both individual and ecological factors on family functioning under COVID-19. Importantly, cultural and contextual factors should be considered when adopting ecological model of resilience to examine family functioning in diverse cultural groups.
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Affiliation(s)
- Daniel Fu Keung Wong
- Department of Social Work and Social AdministrationThe University of Hong KongHong Kong
| | - Yin Yim Lau
- Department of Social Work and Social AdministrationThe University of Hong KongHong Kong
| | - Hiu Sze Chan
- Department of SociologyThe Chinese University of Hong KongHong Kong
| | - Xiaoyu Zhuang
- Sociology Research Center, School of HumanitiesJinan UniversityGuangdongChina
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3
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Zhou DHR, Chiu YLM, Lo TLW, Lo WFA, Wong SS, Luk KL, Leung CHT, Yu CK, Chang YSG. Outside-in or Inside-out? A Randomized Controlled Trial of Two Empowerment Approaches for Family Caregivers of People with Schizophrenia. Issues Ment Health Nurs 2020; 41:761-772. [PMID: 32497453 DOI: 10.1080/01612840.2020.1734992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Training-based intervention such as psychoeducational groups has become increasingly popular to empower family caregivers of people with schizophrenia, yet existing supportive programs for caregivers tend to focus more on the needs of the patients rather than the development of the caregivers. This study aimed to compare the outcomes of a skill-based empowerment psychoeducational group and an inner-resource enhancing empowerment narrative therapy group for family caregivers of people with schizophrenia. We conducted a randomized controlled trial with a longitudinal design. The sample consisted of 132 family caregivers who were randomly assigned to eight sessions of the two groups (i.e. a narrative-based group, or a psychoeducational group), or a control group with delayed treatment. Psychometric scales were administrated throughout the project. Both the psychoeducational group and the narrative group showed significant improvements in family relationships, caregiving burden, and coping skills compared with the control group across the three time points (pretest, posttest, and 2-month follow-up). A statistically significant advancement in coping skills was found in the psychoeducational group. The narrative group outperformed the psychoeducational group and the control group in the enhancement of inner resources, perceived control, and level of hope. The findings call for the need of an integrative empowerment approach that both values the inner strength and unique experiences of the caregivers and at the same time provides them with necessary skills and knowledge in taking care of their family members with schizophrenia.
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Affiliation(s)
- De-Hui Ruth Zhou
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong
| | - Yu-Lung Marcus Chiu
- Department of Applied Social Science, City University of Hong Kong, Kowloon, Hong Kong
| | | | | | - Siu-Sing Wong
- Department of Counselling and Psychology, Hong Kong Shue Yan University, North Point, Hong Kong
| | - Kwok-Leung Luk
- Department Operations Manager, Kwai Chung Hospital, Kowloon, Hong Kong
| | - Chi-Hoi Tom Leung
- East Kowloon Psychistric Center, Kwai Chung Hospital, Kowloon, Hong Kong
| | - Chui-Kam Yu
- East Kowloon Psychistric Center, Kwai Chung Hospital, Kowloon, Hong Kong
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Zumstein N, Riese F. Defining Severe and Persistent Mental Illness-A Pragmatic Utility Concept Analysis. Front Psychiatry 2020; 11:648. [PMID: 32733295 PMCID: PMC7358610 DOI: 10.3389/fpsyt.2020.00648] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/22/2020] [Indexed: 11/13/2022] Open
Abstract
The concept of severe and persistent mental illness (SPMI) lacks a consensual definition. Variations in definitions stem above all from different meanings about the constituent features of the concept and how to operationalize them. Our objective was to clarify the concept of SPMI and to explore the level of concept maturity through pragmatic utility (PU) concept analysis. Our findings suggest that SPMI is a partially mature concept that needs further clarification. We argue that the lack of a uniform definition is inherent to the problem: SPMI refers to a patient population rather than a disease entity, and the term has to be useful for different stakeholder purposes. Therefore, while an agreement on the principle three dimensions included in a definition may be possible (diagnosis, disability, and duration), their operationalization will have to be context-dependent and specific for the task at hand.
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Affiliation(s)
- Naomi Zumstein
- URPP "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.,Department of Anthropology, McGill University, Montréal, QC, Canada
| | - Florian Riese
- URPP "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.,Department of Geriatric Psychiatry, Psychiatric University Hospital Zurich, Zurich, Switzerland
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The Influence of Social Support and Care Burden on Depression among Caregivers of Patients with Severe Mental Illness in Rural Areas of Sichuan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111961. [PMID: 31159499 PMCID: PMC6603995 DOI: 10.3390/ijerph16111961] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
Depression is one of the most common psychological consequences of caregiving. Caring for patients with severe mental illness (SMI) adds significant challenges to family caregivers’ mental health. The purpose of this study was to describe the prevalence of depression among caregivers of SMI patients in rural areas of Sichuan province of China, to examine the influence of social support and care burden on depression, and to explore the intermediary effect of care burden between social support and depression among caregivers of SMI patients. Data were collected from 256 primary caregivers of SMI patients in rural Sichuan Province in China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. We found that a total of 53.5% of caregivers had depression. Both care burden (β = 0.599, 95%CI: 0.392–0.776) and social support (β = −0.307, 95%CI: (−0.494)–(−0.115)) were directly related to depression, while social support had a direct association with care burden (β = −0.506, 95%CI: (−0.672)–(−0.341)). Care burden mediated the relationship between social support and depression. For the socio-demographic variables, gender, education level and per capita annual income of household had significant correlations with depression (p < 0.05). The results strongly demonstrated that social support and care burden were predictors of depression, especially social support. Policymakers should fully recognize the role of primary family caregivers in caring for SMI patients and promote interventions to decrease care burden and reduce caregivers’ depression by improving social support and network. More attention should be given to female caregivers and caregivers with lower education and lower household income levels.
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Fauziana R, Sambasivam R, Vaingankar JA, Abdin E, Ong HL, Tan ME, Chong SA, Subramaniam M. Positive Caregiving Characteristics as a Mediator of Caregiving Burden and Satisfaction With Life in Caregivers of Older Adults. J Geriatr Psychiatry Neurol 2018; 31:329-335. [PMID: 30260715 PMCID: PMC6262596 DOI: 10.1177/0891988718802111] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Satisfaction with life is recognized to be a factor in alleviating burden in stressful caregiving duties. However, the mechanism underlying this relationship is indistinct. Positive aspects of caregiving (PAC) may help to regulate caregiving burden among caregivers of older adults. The study aims to examine whether positive caregiving characteristics mediate the effect between satisfaction with life and burden of care. METHODS Participants were 285 caregivers of older adults (aged 60 and above) in Singapore and were recruited in a cross-sectional, self-report study (mean [M] = 47.0 years; 64.6% females). Measures included in the study were the Zarit Burden Interview (ZBI), Positive Aspects of Caregiving (PAC), and the Satisfaction with Life Scale (SWLS). Mediation analyses were used to study the indirect effects of life satisfaction on caregiver burden through features of PAC. RESULTS Mean scores for the ZBI, PAC, and SWLS scales were M = 23.15 (standard deviation [SD] = 15.98), M = 34.55 (SD = 8.19), and M = 23.56 (SD = 6.62) respectively. Results from the mediation analysis revealed that the association between life satisfaction and caregiving burden was significantly mediated by the PAC ( P < .001). DISCUSSION Positive aspects of caregiving may be a mechanism that links satisfaction with life and caregiver burden. Findings may represent attempts to manage caregiving duties as well as maintaining a positive attitude toward their responsibilities.
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Affiliation(s)
- Restria Fauziana
- Institute of Mental Health, Research Division, Singapore, Singapore
| | - Rajeswari Sambasivam
- Institute of Mental Health, Research Division, Singapore, Singapore,Rajeswari Sambasivam, Institute of Mental Health, Research Division, Singapore, Singapore.
| | | | - Edimansyah Abdin
- Institute of Mental Health, Research Division, Singapore, Singapore
| | - Hui Lin Ong
- Institute of Mental Health, Research Division, Singapore, Singapore
| | - Min-En Tan
- Institute of Mental Health, Research Division, Singapore, Singapore
| | - Siow Ann Chong
- Institute of Mental Health, Research Division, Singapore, Singapore
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7
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Liu HY, Huang LH. The relationship between family functioning and caregiving appraisal of dementia family caregivers: caregiving self-efficacy as a mediator. Aging Ment Health 2018; 22:558-567. [PMID: 28001431 DOI: 10.1080/13607863.2016.1269148] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to explore caregiving self-efficacy as a mediator for the association between family functioning and caregiving appraisal of dementia family caregivers in Taiwan. METHOD This study adopted a cross-sectional correlational design. Purposive sampling was used to recruit 115 dyads of dementia patients and family caregivers from the outpatient neurological clinics of two hospitals in northern Taiwan. Data were gathered through interviews with a structured questionnaire, which included demographic characteristics for caregivers and patients, family functioning, caregiving self-efficacy, as well as positive and negative aspects of caregiving appraisal. RESULTS Family functioning, patients' activities of daily living score, Neuropsychiatric Inventory caregiver distress, and three domains of self-efficacy were significantly associated with caregiver burden. Hierarchical multiple regression analyses indicated that self-efficacy for obtaining respite (SE-OR) significantly explained 20.5% of the variance in caregiver esteem. Caregiver perceived worsened health status, family functioning, and SE-OR significantly explained 59% of the variance in caregiver burden. The mediation test only supported the partially mediating role of SE-OR on the relationship between family functioning and caregiver burden, while the mediating effect of self-efficacy for responding to disruptive behaviours and controlling upsetting thoughts were insignificant. CONCLUSION Our findings provided preliminary evidence for health professionals recommending that future studies should assess the family dynamic and health problems of caregivers, and develop appropriate family-centred interventions that focus on strengthening interfamily support and respite services to alleviate caregiver burden.
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Affiliation(s)
- Hsin-Yi Liu
- a Department of Nursing , College of Medicine, National Taiwan University , Taipei , Taiwan.,b Department of Nursing , Jen-Teh Junior College of Medicine, Nursing and Management , Miaoli , Taiwan
| | - Lian-Hua Huang
- a Department of Nursing , College of Medicine, National Taiwan University , Taipei , Taiwan
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8
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Derajew H, Tolessa D, Feyissa GT, Addisu F, Soboka M. Prevalence of depression and its associated factors among primary caregivers of patients with severe mental illness in southwest, Ethiopia. BMC Psychiatry 2017; 17:88. [PMID: 28274223 PMCID: PMC5343306 DOI: 10.1186/s12888-017-1249-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/02/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Depression is a serious mental illness that affects patients' treatment outcome and caregiver's day to day life. The prevalence of depression among caregivers of patients with severe mental illness is greater than the general population. Little is known about depression among primary caregivers of patients with severe mental illness in Ethiopia. This study is aimed at assessing prevalence of depression and associated factors among primary caregivers of patients with mental illness. METHODS A cross-sectional study was conducted among primary caregivers of patients with severe mental illness in Jimma University Teaching Hospital. Patient health questionnaire (PHQ-9) was used to assess depression. A multidimensional scale of perceived social support (MSPSS) was used to assess perceived social support; Cut down, Annoyed, Guilty, Eye opener (CAGE) scale was used to assess alcohol use disorder. After conducting descriptive analyses, logistic regression analysis was finally used for bivariate and multivariable analysis. RESULT The overall prevalence of depression among primary caregivers of patients with mental illness was 12 (19%). Out of those caregivers with depressions, 11.3, 3.5 and 4.2% had moderate, moderately severe and severe types of depression respectively. The prevalence of depression among female primary caregivers was 25% (n = 40). Being single (aOR 2.62, 95% CI = 1.07, 6.41), giving care more than six hours per day (aOR 3.75, 95% CI = 1.51, 9.33) and caring for a patient who had more than once episodes of suicidal attempts (aOR 1.48, 95% CI = 1.07, 3.42) were positively associated with depression among caregivers of patients with mental illness. CONCLUSION We found that the prevalence of depression among primary caregivers was high. Depression among caregivers was associated with giving care more than six hours per day and caring for a patient who had two or more episodes of suicidal attempts. The prevalence of depression among female caregivers was higher than that of the male caregivers. Therefore, special focus should be given to primary caregivers spending long hours for providing care, those with low perceived social support; caregivers of patients with suicidal ideation and female caregivers.
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Affiliation(s)
| | - Daniel Tolessa
- 0000 0001 2034 9160grid.411903.eDepartment of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia ,Centre for International Health, Ludwig Maxmillians University, Munich, Germany
| | - Garumma Tolu Feyissa
- 0000 0001 2034 9160grid.411903.eDepartment of Health Education and Behavioral Science, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia ,0000 0004 1936 7304grid.1010.0The Joanna Briggs Institute, The University of Adelaide, Adelaide, Australia
| | - Fikir Addisu
- 0000 0001 2034 9160grid.411903.eDepartment of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia. .,Centre for International Health, Ludwig Maxmillians University, Munich, Germany.
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9
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Care Burden and Social Support Levels of Caregivers of Patients with Chronic Obstructive Pulmonary Disease. Holist Nurs Pract 2017; 30:227-35. [PMID: 27309411 DOI: 10.1097/hnp.0000000000000153] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This descriptive study was conducted to determine the care burden and social support levels of caregivers to patients with chronic obstructive pulmonary disease (COPD). The primary caregivers of 112 patients with COPD hospitalized in the chest diseases service of a university hospital were involved in the study. Data of the study were collected by using the Patient and Caregiver Information Form, which was prepared by reviewing the literature, Katz Index of Independence in Activities of Daily Living, Zarit Burden Interview, and Multidimensional Scale of Perceived Social Support. While the care burden mean score of caregivers of patients with COPD was 40.91 ± 20.58, the mean score of Multidimensional Scale of Perceived Social Support was 54.13 ± 18.84. In this study, it was determined that female caregivers, as well as individuals stating that their physical and psychological health was affected and those having difficulty giving care and needing help, had higher levels of care burden, whereas the spouses, as well as individuals with lower levels of income and those stating that their physical and psychological health was affected, had lower levels of social support.
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10
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Pompeo DA, Carvalho AD, Olive AM, Souza MDGG, Galera SAF. Strategies for coping with family members of patients with mental disorders. Rev Lat Am Enfermagem 2016; 24:e2799. [PMID: 27627121 PMCID: PMC5048725 DOI: 10.1590/1518-8345.1311.2799] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 03/15/2016] [Indexed: 12/05/2022] Open
Abstract
Objective: 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. Method: 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. Results: 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. Conclusion: despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way.
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Affiliation(s)
- Daniele Alcalá Pompeo
- PhD, Adjunct Professor, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil
| | - Arélica de Carvalho
- Undegraduate student in Nursing, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil. Scholarship holder of the Scientific Initiation Program at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Aline Morgado Olive
- RN, student of the Obstetric Nursing of the Residency Program, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Sueli Aparecida Frari Galera
- PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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11
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Wang LJ, Zhong WX, Ji XD, Chen J. Depression, caregiver burden and social support among caregivers of retinoblastoma patients in China. Int J Nurs Pract 2016; 22:478-485. [PMID: 27325472 DOI: 10.1111/ijn.12458] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 02/25/2016] [Accepted: 05/09/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study is to examine the burden of family caregivers of patients with retinoblastoma in China and the relationships between depression, caregiver burden and social support. A descriptive and correlational survey was conducted with 117 Chinese family caregivers of outpatient patients with retinoblastoma from the Department of Ophthalmology of a tertiary hospital in Shanghai, China. Family caregivers of outpatient patients with retinoblastoma were asked to respond to four questionnaires including sociodemographic questionnaire, Becker Depression Inventory, Caregiver Burden Inventory and Social Support Rating Scale. The incidence of depression in this study was 51.3%; the average score for social support indicated moderate social support available to the caregivers, although their level of caregiver burden was heavy. Depression scores were significantly positively correlated with caregiver burden scores and significantly negatively correlated with the social support scores. Heavy caregiver burden was associated with lower monthly income, low subjective social support and less use of social support.
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Affiliation(s)
- Li-Juan Wang
- Department of Anesthesiology and Intensive Care Medicine, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen-Xiang Zhong
- Department of Neurosurgery, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xun-Da Ji
- Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiao Chen
- Department of Anesthesiology and Intensive Care Medicine, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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12
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Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord 2016; 18:183-91. [PMID: 27004622 DOI: 10.1111/bdi.12379] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.
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Affiliation(s)
- Deborah A Perlick
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Lesley Berk
- Mental Health and Wellbeing Research Centre, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Richard Kaczynski
- Veterans Affairs New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jodi Gonzalez
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Bruce Link
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, NY, USA.,Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Savannah Grier
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Hsiao CY, Tsai YF. Factors Associated With the Perception of Family Nursing Practice Among Mental Health Nurses in Taiwan. JOURNAL OF FAMILY NURSING 2015; 21:508-28. [PMID: 26410853 DOI: 10.1177/1074840715606543] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness.
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Affiliation(s)
- Chiu-Yueh Hsiao
- Chung Shan Medical University, Taichung, Taiwan Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yun-Fang Tsai
- Chang Gung University, Tao-Yuan, Taiwan Chang Gung Memorial Hospital, Keelung City, Taiwan
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Fallatah F, Edge DS. Social support needs of families: the context of rheumatoid arthritis. Appl Nurs Res 2015; 28:180-5. [DOI: 10.1016/j.apnr.2014.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 10/09/2014] [Accepted: 10/12/2014] [Indexed: 10/24/2022]
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Hsiao CY. Family demands, social support and family functioning in Taiwanese families rearing children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:549-59. [PMID: 23682672 DOI: 10.1111/jir.12052] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/15/2013] [Indexed: 05/10/2023]
Abstract
BACKGROUND Down syndrome (DS) affects not only children but also their families. Much remains to be learned about factors that influence how families of children with DS function, especially families in non-Western populations. The purpose of this cross-sectional, correlational study was to examine how family demographics, family demands and social support relate to family functioning as well as the potential mediating effect of social support on the relationship between family demands and family functioning in Taiwanese families of children with DS. METHOD One hundred and fifty-five parents (80 mothers and 75 fathers) from 83 families independently completed mailed questionnaires. Data were analysed using a principal component analysis and mixed linear modelling. RESULTS Families having older children with DS, greater parental education, higher family income, fewer family demands and greater social support contributed to healthier family functioning. Social support partially mediated the effects of family demands on family functioning. CONCLUSIONS Family demographics, family demands and social support appear to be important factors that may play a critical role in how Taiwanese families respond to the birth of a child with DS. Care of children with DS and their families is likely to be more effective if professionals working with these families are aware of factors that contribute to healthy family functioning.
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Affiliation(s)
- C-Y Hsiao
- College of Nursing, Chung Shan Medical University, Taichung, Taiwan; Department of Nursing, Chung Shan Medical University Hospital, Taichung, Taiwan
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Abstract
Recent mental illness stigma research has almost exclusively studied community and family responses to the stigmas of mental illness. Too little has been done to understand the current subjective experience of psychiatric patients. Our study explores the influence of self-stigma on the quality of life of mentally disabled people. Participating in the survey were 100 people diagnosed with schizophrenia. Using Ritsher's internalized stigma of mental illness scale, which incorporates alienation, stereotype endorsement, discrimination experience, social withdrawal, and social resistance subscales, along with the standard SF-12, helped us evaluate the subjective experience of mental illness stigma. According to our survey data, self-stigma correlates negatively with all of the quality of life measures except the Internalized Stigma of Mental Illness subscale's 'stigma resistance', which did not correlate significantly. Improved stigma resistance requires an understanding of one's sociocultural background and a strong social network to provide the sense of comfort and security that enables a fulfilling life.
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Affiliation(s)
- I-Chen Tang
- School of Medical Sociology and Social Work, Chung Shan Medical University, 110, Sec. 1, Jianguo N. Road, Taichung, 402, Taiwan.
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Hsiao CY, Hsieh MH, Tseng CJ, Chien SH, Chang CC. Quality of life of individuals with schizophrenia living in the community: relationship to socio-demographic, clinical and psychosocial characteristics. J Clin Nurs 2012; 21:2367-76. [DOI: 10.1111/j.1365-2702.2012.04067.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kulhara P, Kate N, Grover S, Nehra R. Positive aspects of caregiving in schizophrenia: A review. World J Psychiatry 2012; 2:43-8. [PMID: 24175167 PMCID: PMC3782175 DOI: 10.5498/wjp.v2.i3.43] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 06/19/2012] [Accepted: 06/20/2012] [Indexed: 02/05/2023] Open
Abstract
Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains (in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.
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Affiliation(s)
- Parmanand Kulhara
- Parmanand Kulhara, Natasha Kate, Sandeep Grover, Ritu Nehra, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Shieh SC, Tung HS, Liang SY. Social support as influencing primary family caregiver burden in Taiwanese patients with colorectal cancer. J Nurs Scholarsh 2012; 44:223-31. [PMID: 22726108 DOI: 10.1111/j.1547-5069.2012.01453.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The main purpose of this study was to describe the level of experienced burden among Taiwanese primary family caregivers (PFCs) of patients with colorectal cancer (CRC). Another purpose was to explore the relationship between demographic variables, perceived social support, and caregiver burden. DESIGN A cross-sectional study. METHODS This cross-sectional study included 100 PFCs of postsurgery colorectal cancer patients (CCPs) in one teaching hospital in the Taipei area of Taiwan. The research instruments included the Caregiver Reaction Assessment and the Medical Outcome Study-Social Support Survey. FINDINGS The caregivers' total burden mean was 3.00 (SD= 0.50, range = 2.00-4.19). Social support demonstrated a significant relationship with family caregiver burden (impact on health: r=-0.48, p < .01; impact on schedule: r=-0.58, p < .01; impact on finances: r=-0.44, p < .01; lack of family support: r=-0.54, p < .01; and impact on total scale: r=-0.64, p < .01). Higher perceived social support reported by caregivers predicted lower caregiver burden. Multivariate analysis identified social support as a significant independent influence on caregiver burden after controlling for key demographic variables. Social support accounted for 33% (R(2) increment = 0.33, p < .001) of the variance in caregiver burden. CONCLUSIONS The study highlights the importance of social support on caregiver burden in this population. Future interventions should include social support to help alleviate caregiver burden in CCPs following surgery. CLINICAL RELEVANCE Results of this study emphasize the important role of social support to enable healthcare professionals to become more effective while caring for caregivers of the patient with CRC who has undergone surgery. The findings of the present study may facilitate cross-cultural comparison and cultural-oriented management of caregiver burden.
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Affiliation(s)
- Shiouh-Chu Shieh
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Hsiao CY. Family demands, social support and caregiver burden in Taiwanese family caregivers living with mental illness: the role of family caregiver gender. J Clin Nurs 2010; 19:3494-503. [DOI: 10.1111/j.1365-2702.2010.03315.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Factors Related to Family Caregivers’ Satisfaction With Home Care for Mental Illness in Taiwan. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2010. [DOI: 10.1177/1084822310368659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In Taiwan, family caregivers play a significant role in the treatment of mentally ill patients at home because of cultural obligations. This descriptive, cross-sectional study explored factors affecting family caregivers’ satisfaction with home care services for the mentally ill and assessed the possibility of continuous use of home care and recommendation of home care to others based on the level of satisfaction of family caregivers. Data were collected using a questionnaire completed by a convenience sample of 75 primary family caregivers of mentally ill patients. Family caregiver satisfaction was significantly associated with caregiver age, marital status, support from family members to assist the caregiver during weekdays and weekends, the amount of time spent in caregiving per week, and feelings about having a mentally ill family member at home. Caregivers who had a higher level of satisfaction with home care were twice as likely as those with lower satisfaction to use the services again when needed. Home care nurses should pay close attention to the variables that support use of home care.
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