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Giusti L, Mammarella S, Del Vecchio S, Salza A, Casacchia M, Roncone R. Deepening Depression in Women Balancing Work-Life Responsibilities and Caregiving during the COVID-19 Pandemic: Findings from Gender-Specific Face-to-Face Street Interviews Conducted in Italy. Behav Sci (Basel) 2023; 13:892. [PMID: 37998639 PMCID: PMC10668961 DOI: 10.3390/bs13110892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/24/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023] Open
Abstract
PURPOSE This study investigated the impact of the COVID-19 pandemic on mental health, quality of life, and family functioning in a sample of the general female population, exploring difficulties encountered in managing family and work responsibilities and burden of care when taking care of a loved one. This study was, moreover, aimed at investigating factors capable of influencing severe depressive symptomatology in the context of socio-demographics, traumatic events, individual vulnerability, and family functioning. METHOD The sampling method used in this research was non-probability sampling. The survey took place during a Hospital Open Weekend (8-10 October 2021) organized by the National Gender Observatory on Women's Health "Fondazione Onda" on the occasion of the World Mental Health Day. RESULTS A total of 211 women were interviewed (mean age = 35.6, 53% living alone, more than 15% with financial difficulties, 47% exposed to the 2009 L'Aquila earthquake). More than 50% of the sample reported a higher complexity in managing their lives during the COVID-19 pandemic compared to their previous routine, with no statistically significant differences between working women and non-workers, although the latter obtained higher scores for depressive symptomatology and poorer quality of life. Compared to non-caregivers, female caregivers (22.3%) in charge of the care of loved ones affected by physical (10.9%) or psychiatric disabilities (11.4%) complained of a poorer quality of life, especially in general health perception (p = 0.002), physical function (p = 0.011), role limitations related to physical problems (p = 0.017), bodily pain (p = 0.015), mental health (p = 0.004), and social functioning (p = 0.007). Women caring for people affected by mental disorders seemed to experience a more significant worsening in vitality (p = 0.003) and social functioning (p = 0.005). Approximately 20% of the total sample reported severe depressive symptomatology. Previous access to mental health services (O.R. 10.923; p = 0.000), a low level of education (O.R. 5.410; p = 0.021), and difficulties in management of everyday lives during the COVID-19 pandemic (O.R. 3.598; p = 0.045) were found to be the main variables predictive of severe depressive psychopathology. Old age, good problem-solving skills, and ability to pursue personal goals were identified as protective factors. CONCLUSIONS The COVID-19 pandemic underlined the need for support amongst emotionally vulnerable women with pre-existing mental health conditions, partly reflecting the cumulative effects of traumas.
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Affiliation(s)
- Laura Giusti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
| | - Silvia Mammarella
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
| | - Sasha Del Vecchio
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
| | - Anna Salza
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
| | - Massimo Casacchia
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
| | - Rita Roncone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (L.G.); (S.M.); (S.D.V.); (A.S.); (M.C.)
- University Unit for Rehabilitation Treatment, Early Interventions in Mental Health, S. Salvatore Hospital, 67100 L’Aquila, Italy
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Qin VM, Visaria A, Malhotra R. Impact of a COVID-19-Related Lockdown on the Experience of Informal Caregiving in Singapore. Gerontology 2023; 70:102-114. [PMID: 37866359 PMCID: PMC10794967 DOI: 10.1159/000534723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION Lockdowns, while limiting COVID-19 transmission, can affect provision of care by informal caregivers and their caregiving experience. We assessed, among informal caregivers in Singapore, (a) the perceived impact of a 2-month (April to May 2020) nationwide lockdown on their care provision, (b) correlates of different perceptions of the impact of the lockdown on care provision, and (c) association of different perceptions of the impact with negative and positive experiences of caregiving. METHODS In the August 2020 wave of the Singapore Life Panel (SLP; nationally representative, longitudinal monthly survey of Singapore citizens and permanent residents aged 50-70 years at baseline), 1,094 participants identified as informal caregivers reported whether their care provision became easier, remained the same, or became harder during the lockdown, compared to before the lockdown. We used multinomial logistic regression to assess the association of caregiver, care recipient, and caregiving context characteristics with their perceptions. Linear regression models examined the association of their perceptions with negative and positive experience domains of the modified Caregiver Reaction Assessment. RESULTS Just over one-third (36.1%) of the informal caregivers reported that their care provision became harder during the lockdown compared to before the lockdown. However, nearly one-fifth (18.0%) said that it became easier, and the rest (45.9%) said that it remained the same. Care provision was more likely to be perceived as having become harder among caregivers who were male, of Chinese ethnicity, in worse health, whose care recipients had functional limitations, who did not have caregiving support from cohabiting family members before the lockdown, and who had caregiving support from non-cohabiting family members before the lockdown. The perception that care provision became easier was less likely among caregivers who were of higher age, were unemployed, were socially isolated, and whose care recipients had functional limitations. Caregivers who perceived that care provision became harder during the lockdown were worse-off in negative experiences of caregiving. CONCLUSION A nationwide lockdown did not make care provision harder for all informal caregivers. However, informal caregivers for whom it did were more likely to have greater negative experiences of caregiving. The heterogeneity of the impact of lockdowns and the possibility of offering flexibility to non-cohabiting family members who support caregiving should be important considerations when planning for such disruptions.
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Affiliation(s)
- Vicky Mengqi Qin
- Centre for Research on Successful Ageing (ROSA), Singapore Management University, Singapore, Singapore
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Abhijit Visaria
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore
- Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
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Di Sarno E, Louzã MR. The burden of caregivers of schizophrenia outpatients during the COVID-19 pandemic: A same-sample comparison with the pre-pandemic burden. Int J Soc Psychiatry 2023; 69:1231-1238. [PMID: 36825654 PMCID: PMC9968889 DOI: 10.1177/00207640231156512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has affected the vulnerable Brazilian population. In this study, we investigated the burden of COVID-19 on caregivers for patients with schizophrenia. OBJECTIVE This study assessed objective and subjective burden of caregivers for patients with schizophrenia during the COVID-19 pandemic and compared the measurements obtained in the study to that before the pandemic. METHODS The study included 50 caregivers who were assessed using the Sociodemographic Questionnaire, and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). An adaptation of the Clinical Global Impression-Improvement (CGI-I) was made, in which caregivers evaluated their 'clinical' impression about the patient during the COVID-19 pandemic in comparison to pre-pandemic mental status. RESULTS Most caregivers were female, aged between 24 and 80 years, who were in contact with the patient for about 88.56 hours/week. In relation to caregiver burden, there was a significant increase in the total subjective burden (p < .001), but not in the total objective burden. The following subjective domains of the burden showed a significant increase: assistance in daily life (p < .001) and worries about patients' present and future life (p = .033). There was a decrease in the objective burden related to supervision of patients' problematic behaviors (p = .031). Although the caregiver's income did not change significantly during the COVID-19 pandemic, there was an increase in the percentage of caregivers who perceived the frequency of financial burden imposed by the patient as 'very frequent' and 'always or almost always'; conversely there was a significant decrease in the subjective perception of the caregiver that the patient imposed financially 'no burden' or a 'seldom burden' (from 34% to 4%). CONCLUSION Although the objective burden of the caregivers, during the pandemic, was similar the pre-pandemic levels, caregivers' subjective burden increased reinforcing the need for special attention to the caregiver in this global emergency.
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Affiliation(s)
- Elaine Di Sarno
- Schizophrenia Research Program (Projesq), Institute
of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de
São Paulo, Brazil
| | - Mario Rodrigues Louzã
- Schizophrenia Research Program (Projesq), Institute
of Psychiatry, Hospital das Clínicas, Faculdade de Medicina da Universidade de
São Paulo, Brazil
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Kaewwanna W, Bhatarasakoon P, Kitsumban V. Effectiveness of internet-based psychosocial interventions on psychological distress, expressed emotion, and knowledge about psychosis among family caregivers of people with schizophrenia: a systematic review protocol. JBI Evid Synth 2023; 21:789-795. [PMID: 36730284 DOI: 10.11124/jbies-22-00132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this review is to evaluate the effectiveness of internet-based psychosocial interventions versus active comparators (such as in-person interventions, bibliotherapy, or telephone interventions) and passive comparators (such as usual psychiatric care) on psychological distress, expressed emotion, and knowledge about psychosis in family caregivers of people with schizophrenia. INTRODUCTION Family caregivers of individuals with schizophrenia are at increased risk of developing mental disorders. Despite the widespread dissemination of reliable guidelines for caring for people with schizophrenia and their family caregivers, these have been poorly implemented. Hence, internet-based interventions with caregivers of people with schizophrenia could be an effective and feasible option. INCLUSION CRITERIA This review will include studies focusing on the family caregivers of individuals diagnosed with schizophrenia. Internet-based psychosocial interventions will be defined as any psychosocial intervention that is internet-based compared with active comparators (such as in-person interventions, bibliotherapy, or telephone interventions) and passive comparators (such as usual psychiatric care). The primary outcomes of this review will include psychological distress, expressed emotion, and knowledge about the psychosis of family caregivers of people with schizophrenia. The secondary outcome will be the hospitalization of people with schizophrenia. METHODS MEDLINE (PubMed), CINAHL (Ovid), Scopus, Cochrane Library, and ProQuest Dissertations and Theses will be systematically searched for published and unpublished studies from 2010 in English and Thai. Two reviewers will select studies, critically appraise them, and perform data extraction independently. Finally, when possible, the studies will be pooled through statistical meta-analysis and grading of the certainty of evidence by each outcome. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42021255318.
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Affiliation(s)
| | - Patraporn Bhatarasakoon
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- The Thailand Centre for Evidence Based Health Care: A JBI Affiliated Group, Chiang Mai University, Chiang Mai, Thailand
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Joung J, Shin S. Challenges Experienced by Family Caregivers of Individuals With Severe Mental Illness During the COVID-19 Pandemic: An Integrative Review. J Psychosoc Nurs Ment Health Serv 2023:1-8. [PMID: 36720066 DOI: 10.3928/02793695-20230110-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Family caregivers of individuals with severe mental illness (SMI) faced increasing challenges during the coronavirus disease 2019 (COVID-19) pandemic; however, empirical evidence on the general challenges they experienced is lacking. Thus, the purpose of the current integrative review was to explore family caregivers' challenges during the COVID-19 pandemic. A total of nine relevant studies were included. Family caregivers experienced greater care burdens, physical and mental health problems, and limited access to health care services due to the pandemic. It is necessary to develop mental health policies and appropriate interventions to help individuals with mental illness and their family caregivers in the event of future crises. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Nooraeen S, Bazargan-Hejazi S, Naserbakht M, Vahidi C, Shojaerad F, Mousavi SS, Malakouti SK. Impact of COVID-19 pandemic on relapse of individuals with severe mental illness and their caregiver's burden. Front Public Health 2023; 11:1086905. [PMID: 36817882 PMCID: PMC9929280 DOI: 10.3389/fpubh.2023.1086905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/05/2023] [Indexed: 02/05/2023] Open
Abstract
Background The implementation of quarantine and social distancing measures to control the COVID-19 pandemic led to restrictions at the community level and most of in-person psychiatric services were discontinued. This situation could affect the psychopathology of the patients and the burden of their caregivers. The aim of this study was to investigate the effects of COVID-19 pandemic on people with severe mental illnesses (SMIs) and their caregivers' burden. Method The study sample consisted of 86 patients with severe mental illness and 86 caregivers. The mental status, relapse rate, and rehospitalization rate of the patients and the general health status and burden of caregivers were investigated in three waves, including before and 3 and 6 months after the COVID-19 pandemic. Results The relapse rate of the patients was 14%, 33.7%, and 43% (p = 0.000) and the rehospitalization rate was 4.7%, 7%, and 10.5% in waves 0, 1, and 2, respectively (p = 0.000). Most of the psychopathological scales increased in three waves (p = 0.000). The caregivers' burden and health condition worsened during the nine months of the study as well (p = 0.000). Conclusion The COVID-19 pandemic led to the exacerbation of symptoms and increased the relapse rate in people with SMIs. It also worsened the caregivers' condition. People with severe mental illnesses (SMIs) and their caregivers are one of the most vulnerable groups on which the COVID-19 pandemic had a marked negative effect.
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Affiliation(s)
- Sara Nooraeen
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
| | - Morteza Naserbakht
- Mental Health Research Center, Psychosocial Health Research Institute, Tehran, Iran
| | - Camelia Vahidi
- Andisheh-Salamat-Ravan Mental Rehabilitation Center, Tehran, Iran
| | | | | | - Seyed Kazem Malakouti
- Mental Health Research Center, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran,*Correspondence: Seyed Kazem Malakouti ✉
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The Burnout Levels of Caregivers and Caregiver Burden of the Patients with Declined Active Participation in the Community Mental Health Center During the Covid-19 Pandemic. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1152433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim:
This study aimed to compare the burnout and caregiver burden in caregivers during Covid-19 due to the decrease in patient participation in the Community Mental Health Center (CMHC) and the inability to accept patients for a while before the Covid-19 pandemic.
Materials and Methods:
Caregivers of 47 patients registered to CMHC were included in this study. The first interview for this study was held in January 2020, before the start of the Covid-19 pandemic in Turkey. The second interview was held in June 2021, after the start of the COVID -19 pandemic and thus lockdown and restrictions. Sociodemographic data form, Maslach Burnout Inventory, and Zarit Caregiver Burden Scale were applied to caregivers.
Results:
The findings obtained in the second interview showed that Maslach Burnout Inventory (p
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Factors of Parental Preparation of Children with Mental Illnesses for Their Independent Living after Their Own Death. Healthcare (Basel) 2022; 10:healthcare10122360. [PMID: 36553884 PMCID: PMC9777822 DOI: 10.3390/healthcare10122360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Families of children with mental illnesses are often concerned about living in the community after their parents' death. The cross-sectional study aimed to examine the association between how parents prepare adult children with mental illnesses to live independently after the death of the parent(s). The participants were 1112 members of 46 family support groups for mental illnesses in Tokyo, Japan. The age of the people with mental illness was 40s, and that of their parents was 70s. Logistic regression analysis showed that mothers' support in daily living, no income or pension for disabled people, staying at home during free time, and parental livelihood being the same as the person with mental illness were factors that were negatively associated with the independent living of people with mental illness. In contrast, parental participation in the family group and creating a system for securing regular living expenses of the person with mental illness were positively associated with independent living. The results suggest that parents need to promote their children's recovery and prepare them financially by forecasting their independent living after their own death.
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Shishkova AM, Bocharov VV. The Burnout Concept as a Theoretical Framework for Investigating the Caregiving Impact of Relatives of Patients withAddictive Disorders. PSYCHOLOGY IN RUSSIA: STATE OF ART 2022; 15:111-132. [PMID: 36699138 PMCID: PMC9833605 DOI: 10.11621/pir.2022.0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background Relatives of patients withaddictive disorders often face significant difficulties in their daily lives. Although the burnout concept is currently considered a significant and promising theoretical framework for studying family members who care for chronically ill patients, its application has encountered considerable difficulties in the area of addiction treatment. Objective This article explores the methodology for studying the psychological issues arising in families affected by addictive disorders. We analyzed the social, economic, and cultural conditions of the different study models developed in this field, and identified the difficulties hindering the acceptance of the burnout concept as a theoretical construct for investigation. Results There are several main obstacles to the burnout concept's application to studying the psychology of addictive patients' families. These obstacles are: 1) a stigmatizing attitude toward the relatives, labelling them as dysfunctional/codependent, or merely passive recipients adjusting to stressful and challenging circumstances; 2) a sole focus on the destructive elements of the "informal caregiver - addicted patient" relationship dynamics; 3) underestimation of relatives' willingness, experience, and knowledge in the care of their addicted family member and failure to recognize their right to participate in treatment decision-making; and 4) lack of specialized tools for assessing burnout and its opposite pole - the engagement of addicts' relatives during the patients' care. Conclusion Application of the burnout concept as a theoretical framework allows us to reformulate many psychopathological phenomena described in the family members of addicts, and expands the perspective of psychotherapy by providing the opportunity to conduct interventions to improve relatives' functioning as caregivers. This, in turn, will contribute to the effectiveness of treatment outcomes for bothaddicts and their families.
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Affiliation(s)
- Alexandra M. Shishkova
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Saint-Petersburg, Russia,Corresponding author. E-mail:
| | - Victor V. Bocharov
- V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, Saint-Petersburg, Russia, St. Petersburg State Pediatric Medical University, Russia
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Muldrew DHL, Fee A, Coates V. Impact of the COVID-19 pandemic on family carers in the community: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1275-1285. [PMID: 34888980 DOI: 10.1111/hsc.13677] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 11/23/2021] [Accepted: 11/26/2021] [Indexed: 06/13/2023]
Abstract
The COVID-19 pandemic has led to the closure or reduction in support services for family carers, resulting in increased social isolation and stress for this population. The current scoping review aimed to identify the impact of COVID-19 upon carers and support provided for them during the pandemic. Four online databases (CINAHL, Medline, PsycINFO and PubMed) were systematically searched on 16th December 2020 and updated on 16th July 2021 for articles written in English and published after January 2020, focused on the carer and the impact of COVID-19. Google scholar and reference lists of relevant papers were checked, and key authors were contacted for further relevant information. The database searches identified 976 citations, which resulted in 670 unique articles following the removal of duplicates. Title and abstract screening identified 63 articles for full-text review, 11 of which were subsequently excluded, leaving 52 articles which were subject to inductive thematic analysis. Four key themes were identified. Whilst a number of issues were identified that were exacerbated by the pandemic, others directly resulting from it were revealed. Few studies discussed support measures for carers and only one trial evaluated an intervention. This review identifies the impact of COVID-19 on carers, but there is a dearth of evidence to inform appropriate tailored support. Governments need to identify carers as a priority group in social care reform and commission co-produced, evidence and experience informed pathways to reinstate support services, potentially modelled on pandemic plans following the example currently being considered for the paid healthcare workforce.
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Affiliation(s)
- Deborah H L Muldrew
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, UK
| | - Anne Fee
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland, UK
| | - Vivien Coates
- Institute of Nursing and Health Research, Ulster University, Londonderry, Northern Ireland, UK
- Western Health & Social Care Trust, Trust Headquarters, Altnagelvin Area Hospital, Londonderry, Northern Ireland, UK
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Miller KEM, Van Houtven CH, Smith VA, Lindquist JH, Gray K, Richardson C, Shepherd-Banigan M. Family Caregivers of Veterans Experience Clinically Significant Levels of Distress Prepandemic and During Pandemic: Implications for Caregiver Support Services. Med Care 2022; 60:530-537. [PMID: 35471419 PMCID: PMC9187587 DOI: 10.1097/mlr.0000000000001726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Of the 26.4 million family caregivers in the United States, nearly 40% report high levels of emotional strain and subjective burden. However, for the 5 million caregivers of Veterans, little is known about the experiences of caregivers of Veterans during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE The aim was to examine pandemic-related changes of caregiver well-being outcomes. RESEARCH DESIGN, SUBJECTS, AND MEASURES Using a pre/post design and longitudinal data of individual caregivers captured pre-COVID-19 and during COVID-19, we use multilevel generalized linear mixed models to examine pandemic-related changes to caregiver well-being (n=903). The primary outcome measures include Zarit Subjective Burden, Center for Epidemiologic Studies Short Depression Scale, perceived financial strain, life chaos, and loneliness. RESULTS During the pandemic, we observe slight improvements for caregivers across well-being measures except for perceived financial strain. Before the pandemic, we observed that caregivers screened positive for clinically significant caregiver burden and probable depression. While we do not observe worsening indicators of caregiver well-being during the COVID-19 pandemic, the average predicted values of indicators of caregiver well-being remain clinically significant for caregiving subjective burden and depression. CONCLUSIONS These findings illuminate pandemic-related impacts of caregivers receiving support through the Veterans Affairs (VA) pre-COVID and during the COVID-19 pandemic while caring for a population of frail, older care-recipients with a high burden of mental illness and other chronic conditions. Considering the long-term impacts of the pandemic to increase morbidity and the expected increased demand for caregivers in an aging population, these consistently high levels of distress despite receiving support highlight the need for interventions and policy reform to systematically support caregivers more broadly.
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Affiliation(s)
- Katherine E M Miller
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Courtney H Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
- Department of Population Health Sciences, Duke University Medical Center
- Duke-Margolis Center for Health Policy
| | - Valerie A Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
- Department of Population Health Sciences, Duke University Medical Center
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
| | - Jennifer H Lindquist
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
| | - Kaileigh Gray
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
| | | | - Megan Shepherd-Banigan
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC
- Department of Population Health Sciences, Duke University Medical Center
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12
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Mork E, Aminoff SR, Barrett EA, Simonsen C, Hegelstad WTV, Lagerberg TV, Melle I, Romm KL. COVID-19 lockdown - who cares? The first lockdown from the perspective of relatives of people with severe mental illness. BMC Public Health 2022; 22:1104. [PMID: 35655294 PMCID: PMC9162484 DOI: 10.1186/s12889-022-13458-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/18/2022] [Indexed: 12/03/2022] Open
Abstract
Background Informal care is vital to many people with severe mental illness under normal circumstances. Little is known about how extraordinary circumstances affect relatives with a family member with mental illness. This study investigated the consequences of the first COVID-19 lockdown in Norway from the perspective of relatives of persons with psychotic- and/or bipolar disorders: What were the challenges and for whom? Method Relatives were invited to complete an online survey shortly after the first lockdown was initiated. Both quantitative and qualitative data were collected concerning experiences of relatives’ own and their affected family members’ health and situation. Two hundred and seventy-nine relatives completed the survey, mostly mothers and partners. Results One-third of the relatives reported considerable deterioration in their family members’ mental health, and a substantial minority worried about severe self-harm or suicide. Main themes in the qualitative analyses were “Isolation and its effects on mental health”, “Worrying about the pandemic and its consequences”, “Increased symptomatology” and “Suicide”. Being a relative during the lockdown put heavy strain on the relatives’ own health, in particular disturbance of sleep, concentration, and the ability to take care of others in the family. Relatives of family members with psychotic bipolar disorder, not currently in treatment, or living with their family experienced the situation especially challenging. Conclusions Many relatives found the first lockdown hard for their family. Efforts to integrate relatives’ perspectives in health care and contingency plans under normal circumstances could potentially alleviate some of the extra burden experienced by families during extraordinary circumstances. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13458-5.
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Affiliation(s)
- Erlend Mork
- Early Intervention in Psychosis Advisory Unit for Southeast Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.O. box 4956, 0424, Oslo, Norway.
| | - Sofie R Aminoff
- Early Intervention in Psychosis Advisory Unit for Southeast Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.O. box 4956, 0424, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Nydalen, P.O. box 4956, 0424, Oslo, Norway
| | - Elizabeth Ann Barrett
- Early Intervention in Psychosis Advisory Unit for Southeast Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.O. box 4956, 0424, Oslo, Norway
| | - Carmen Simonsen
- Early Intervention in Psychosis Advisory Unit for Southeast Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.O. box 4956, 0424, Oslo, Norway
| | - Wenche Ten Velden Hegelstad
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, 4011, Stavanger, Norway.,Institute of Social Studies, Faculty of Social Sciences, University of Stavanger, P.O. box 8600, 4036, Stavanger, Norway
| | - Trine Vik Lagerberg
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PB 4956, 0424, Oslo, Norway
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Nydalen, P.O. box 4956, 0424, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, PB 4956, 0424, Oslo, Norway
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for Southeast Norway (TIPS Sør-Øst), Division of Mental Health and Addiction, Oslo University Hospital, Nydalen, P.O. box 4956, 0424, Oslo, Norway.,Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Nydalen, P.O. box 4956, 0424, Oslo, Norway
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13
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Palmeira L, Keusen A, Carim Neto E, de Cassia Ribeiro R, Barreto S, Leão O, Cavalcanti MT. Psychological Impact of the COVID-19 Pandemic on Families of People with Severe Mental Disorders Participating in Community Peer Support Groups in Brazil. TRENDS IN PSYCHOLOGY 2022. [PMCID: PMC9106325 DOI: 10.1007/s43076-022-00195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
People with severe mental disorders are at increased risk of dying from COVID-19 and more susceptible to the impacts of the pandemic. This study aims to understand how the families of patients with severe mental disorders followed up in community peer support groups experienced the beginning of the pandemic in Brazil and how they fared during the period of restricted physical contact. Family members (n = 82) and patients (n = 27) belonging to community groups in Rio de Janeiro responded to an online survey that included assessments of quality of life and well-being along with open-ended questions. Thematic analysis of the answers showed that the majority of remarks were positive, despite the concerns, fears, and feelings common at the time. Positive feelings were also mentioned significantly. These findings demonstrate that this population was adaptive and resilient in coping with the restrictions on physical contact. The main concerns and difficulties of this population are discussed.
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Affiliation(s)
- Leonardo Palmeira
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Alexandre Keusen
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Elias Carim Neto
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Rita de Cassia Ribeiro
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Silvana Barreto
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Olga Leão
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
| | - Maria Tavares Cavalcanti
- Insitute of Psychiatry, Federal University of Rio de Janeiro, 71, Ave Venceslau Brás, Botafogo, Rio de Janeiro, RJ Brazil
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14
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Caqueo-Urízar A, Urzúa A, Ponce-Correa F, Ferrer R. Psychosocial Effects of the COVID-19 Pandemic on Patients With Schizophrenia and Their Caregivers. Front Psychol 2021; 12:729793. [PMID: 34803806 PMCID: PMC8602112 DOI: 10.3389/fpsyg.2021.729793] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/18/2021] [Indexed: 12/24/2022] Open
Abstract
The aim of this study was to analyze the psychosocial effects of the COVID-19 pandemic on 120 patients with schizophrenia, and their caregivers (control group), in the city of Arica, northern Chile. The hypotheses of this study hold that (1) self-reports of the impact of the COVID-19 pandemic among patients and caregivers would be positively correlated, (2) caregivers would self-report a greater impact of the pandemic on their daily lives, and (3) patients infected with COVID-19 would experience lower levels of mental health improvement and higher levels of psychological distress. Hypotheses were tested using correlations, mean differences, and effect sizes (Cohen’s d). The results showed that patients with schizophrenia who had been in quarantine for almost a year showed similar levels of concern as their caregivers in the domains of health and social life. However, caregivers showed significant differences from patients in the areas of income, concern, and employment status. In addition, patients who were infected with COVID-19 showed lower levels of well-being and worse psychological recovery. The implications of the findings highlight the need to incorporate mental health interventions in the pandemic health context for caregivers of people with schizophrenia. Finally, the results suggest that Covid-19 infection has a significant effect on the recovery and psychological well-being of patients with schizophrenia.
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Affiliation(s)
| | - Alfonso Urzúa
- Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile
| | | | - Rodrigo Ferrer
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Arica, Chile
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15
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Yasuma N, Yamaguchi S, Ogawa M, Shiozawa T, Abe M, Igarashi M, Kawaguchi T, Sato S, Nishi D, Kawakami N, Fujii C. Care difficulties and burden during COVID-19 pandemic lockdowns among caregivers of people with schizophrenia: A cross-sectional study. Neuropsychopharmacol Rep 2021; 41:242-247. [PMID: 33764671 PMCID: PMC8249994 DOI: 10.1002/npr2.12171] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 11/10/2022] Open
Abstract
Aims The purpose of this study was to retrospectively investigate care difficulties experienced by caregivers of people with schizophrenia during COVID‐19 pandemic lockdowns in Japan (April 7‐May 25, 2020) and examine associations between these care difficulties during lockdowns and daily caregiver burden. Methods Data were collected from 132 participants of the LINE Schizophrenia Family Association using an online survey. Results Caregivers were mostly concerned about who would care for people with schizophrenia if caregivers become infected with COVID‐19. A significant association was found between higher daily caregiver burden and more difficult care experiences during COVID‐19 pandemic lockdowns (B = 0.58, 95% confidence interval, 0.40‐0.75, P < .01, adjusted R‐squared = .34). Conclusions Further studies and supports for caregivers of people with schizophrenia are needed. This study showed care difficulties experienced by caregivers of people with schizophrenia during COVID‐19 pandemic lockdowns in Japan and its association with daily caregiver burden.![]()
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Affiliation(s)
- Naonori Yasuma
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Sosei Yamaguchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Makoto Ogawa
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Makiko Abe
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Momoka Igarashi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Takayuki Kawaguchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Sayaka Sato
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Japan
| | - Chiyo Fujii
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Japan
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