Caregiver psychoeducation for schizophrenia: is gender important? Comments on the study by McWilliams et al., 2007

Knowledge about schizophrenia test: the Chinese Mandarin version and its sociodemographic and clinical factors

BACKGROUND

Schizophrenia is a chronic, complex, and severe mental disorder and caregivers having knowledge about it can help improve patient adherence to treatment. This study aims to translate the Knowledge About Schizophrenia Test (KAST) into a Chinese Mandarin version and test it among caregivers to validate its reliability and reproducibility, as well as to determine its associated sociodemographic factors and clinical factors.

METHODS

The project surveyed 160 patients with schizophrenia and their caregivers at four community health facilities in Beijing, China, from January 2022 to February 2022. All patients and caregivers completed the sociodemographic questionnaire, and caregivers also completed the Chinese-version KAST, and 143 of these caregivers completed the Chinese-version KAST again 2-4 weeks later.

RESULTS

The mean (SD) of the caregiver score was 11.49 (± 3.13). After item analysis, there was acceptable internal consistency among the 17 items in the Chinese version (KR-20 coefficient 0.702). The intraclass correlation coefficient in the retest (0.686) was statistically significant. Gender, educational attainment, marital status, relationship with the patient, and occupational status were associated with the KAST score.

CONCLUSION

The findings demonstrate that the Chinese-version KAST is a reliable and reproducible instrument that can measure knowledge about schizophrenia and is valid to be applied in schizophrenia research.

Gender differences in patient and caregiver psychoeducation for schizophrenia

Objective:

The aim of this research is to detect gender-related differences in patients and caregivers regarding knowledge about schizophrenia and attitudes towards drugs as well as gender as predictor for changes in these variables during psychoeducation.

Methods:

Data sets of one randomised-controlled (study 1) and one naturalistic psychoeducation study (study 2) were reanalysed. Main outcome measures (knowledge about schizophrenia, drug attitude, confidence in medication) were assessed at baseline, post-intervention and 12 months after index discharge.

Results:

The reanalysed samples consisted in total of 1002 patients and 176 caregivers. In study 2, baseline knowledge was significantly better in male patients and female caregivers. All participants improved significantly their knowledge. The amount of knowledge gain did not differ between genders in either study or either group. Gender was not a major predictor of baseline knowledge or knowledge gain. Only in study 1 did gender significantly impact the knowledge gain from baseline to follow-up. Regarding improvement of drug attitude, females seemed to benefit significantly better from psychoeducation. In both studies, however, changes in drug attitudes respectively confidence in medication were best explained by lower corresponding baseline scores, not gender. Patients’ gender did not influence outcomes of their caregivers.

Conclusion:

Our findings suggest that psychoeducational programs might be better adapted to males in order to improve their drug attitude. Concerning knowledge, gender-related changes do not seem to be necessary.

The Effects of Psychoeducation on the Expressed Emotion and Family Functioning of the Family Members in First-Episode Schizophrenia

The aim of this study was to determine the effects of the psychoeducation received by the family members of the patients with first-episode schizophrenia on the expressed emotion (EE) and the family functioning of the family members. This study has a quasi-experimental design with a control group. The sample of the study was 60 family members (30 experimental -30 control) of the patients with first-episode schizophrenia. The experimental group received 9 weeks of psychoeducation as a group. EE and family functioning were assessed at the beginning and at the end of the psychoeducation program. EE criticism/hostility and over involvement-protecting-intervention levels of the family members have decreased at the end of the psychoeducation (p < 0.05). Family functioning has changed too at the end of the psychoeducation (p < 0.05), and assessed as more healthy. Consequently, early psychoeducational groups may be effective in decreasing EE level and improving the family functioning for a family member of patient with first-episode schizophrenia.

Knowledge in schizophrenia: The Portuguese version of KAST (Knowledge About Schizophrenia Test) and analysis of social-demographic and clinical factors' influence

Schizophrenia is a complex disorder, and the knowledge about it can have a positive impact. The purpose of this study was to make the translation and cultural adaptation of the Knowledge About Schizophrenia Test (KAST) into Portuguese and determine the influence of clinical and socio-demographic factors on knowledge. The test was applied to 189 caregivers of patients enrolled in Schizophrenia Program of the Federal University of São Paulo, 30 caregivers of clinical patients of the General Outpatient Clinic of the same University, and 30 health professionals. The face and content validity of the test was established. The mean value (SD) obtained with the application of the final version to caregivers of schizophrenic patients was 12.96 (2.45) - maximum 17. Level of knowledge increased considering the following order: caregivers of clinical patients, caregivers of patients with schizophrenia and mental health professionals. The intraclass correlation coefficient (0.592) obtained in the test-retest was statistically significant. An influence of social class, race, gender and education of the caregiver on the test was observed, and the last two factors were more relevant. The KAST translated and adapted into Portuguese is a valid instrument and can be used as an evaluation tool on psychoeducational interventions.

Gender aspects of parents' needs of schizophrenia patients

BACKGROUND

Most studies about the problems and needs of schizophrenia carers included only one care-giving relative, usually the patients' mothers.

METHODS

101 mothers and fathers of the same patients suffering from schizophrenia were included into this study. Their needs were assessed by means of the "Carers' Needs Assessment for Schizophrenia".

RESULTS

Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Overall, mothers reported higher numbers of problems and needs for intervention than fathers. The number of mothers' problems was predicted by not living with a partner and by a shorter duration of the patients' illness. The number of mothers' needs was predicted by more psychiatric symptoms, not living with a partner and a shorter duration of the patients' illness. Among fathers we could not identify any predictors, neither for the number of problems nor for the number of needs.

CONCLUSIONS

Fathers and mothers often report problems and frequently need professional support. Overall, mothers exhibited more problems and needs for interventions than fathers. The differences between mothers and fathers indicate the importance of considering the carer's gender in clinical work.