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Nkomo T, Kekana MP. The Realities of Caring for a Person with a Mental Disorder in Rural and Remote Capricorn District of South Africa: A Qualitative Study. Community Ment Health J 2025; 61:531-543. [PMID: 39313738 PMCID: PMC11868129 DOI: 10.1007/s10597-024-01360-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 09/05/2024] [Indexed: 09/25/2024]
Abstract
In rural African communities, family caregivers shoulder the responsibility of caring for loved ones with mental disorders, often without professional support. This qualitative explorative study, conducted in Limpopo Province, South Africa, aimed to explore the realities of caring for a family member with a mental disorder in rural and remote Capricorn District, in order to uncover insights that can inform support systems, the academic community, interventions, and policies. Non-probability purposive sampling was used to ensure the reproducibility and validity of the results by focusing on participants who are actively involved in caregiving, living in the rural and remote of Capricorn District, in order to provide a comprehensive understanding of their experiences, and this resulted in 15 participants (13 females, 2 males). Data saturation determined the sample size, with data collected through in-depth interviews and analyzed using Tesch's open-coding method. The findings revealed that cultural and spiritual beliefs strengthen caregivers, who exhibit resilience and resourcefulness, yet face financial strain, career setbacks, social isolation, and health declines. The study underscores the critical role of healthcare professionals in recognizing and addressing the challenges faced by family caregivers, while also advocating for the academic community to prioritize the development and dissemination of educational programs focused on safe and ethical coping strategies for caregivers and for policymakers to develop comprehensive mental health services that are accessible and culturally sensitive to rural and remote communities. This is essential because the well-being of caregivers directly influences the rehabilitation and community integration outcomes for individuals with mental disorders.
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Affiliation(s)
- Thembi Nkomo
- University of Limpopo, C/O R71 Tzaneen Road, Sovenga, 0727, South Africa.
- University of the Free State, 205 Nelson Mandela Dr, Park West, Bloemfontein, 9301, South Africa.
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Huang Z, Yi Q, Yao H, Li K, Li C, Shi Y, Hu S, Chen J, Xu Y. Care Tasks and Caregiver Burden Among Family Caregivers of Patients With Mental Disorders in China: Illness Perception as a Mediator and Social Support as a Moderator. J Psychiatr Ment Health Nurs 2025. [PMID: 39968743 DOI: 10.1111/jpm.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Revised: 01/18/2025] [Accepted: 02/05/2025] [Indexed: 02/20/2025]
Abstract
INTRODUCTION Caring for a family member with mental disorders is burdensome, which may not only damage the caregivers' well-being and health, but also hinder patients' recovery. It is critical to investigate the underlying mechanisms for caregiver burden. AIM To examine the mediating effect of illness perception and the moderating function of social support on the association between care tasks and caregiver burden. METHOD A total of 1169 family caregivers of patients with mental disorders were recruited via convenience sampling across China. Data were collected using acceptable reliability scales (Cronbach's α > 0.6). The relationships among care tasks, illness perception, social support and caregiver burden were examined in the SPSS PROCESS macro. RESULTS Illness perception partially mediates the relationship between care tasks and overall caregiver burden, personal strain and role strain, while social support only alleviates the impact of care tasks on personal strain but not on role strain. DISCUSSION Care tasks could positively predict caregiver burden. As a mediating moderating mechanism, illness perception and social support could further explain how care tasks affect caregiver burden. IMPLICATIONS FOR PRACTICE Psychiatric nurses should provide psychoeducation for family caregivers of patients with mental illness to improve their negative illness perception, as well as increase their social support.
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Affiliation(s)
- Zhuoer Huang
- Department of Nursing, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Qifeng Yi
- Department of Nursing, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Hao Yao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Brain Health Institute at National Center for Mental Disorder, Shanghai, China
| | | | - Chuan Li
- Shanghai Hongkou Mental Health Center, Mental Health Center Affiliated to Shanghai University School of Medicine, Shanghai, China
| | - Yimeng Shi
- School of Law and Sociology, Yunnan Normal University, Kunming, China
| | - Shuang Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Brain Health Institute at National Center for Mental Disorder, Shanghai, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Research Center for Mental Health, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- Brain Health Institute at National Center for Mental Disorder, Shanghai, China
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Holmbom M, Andréasson F, Grundström H, Bernild C, Fålun N, Norekvål TM, Kikkenborg Berg S, Strömberg A. Young Spouses' Experiences of Having a Partner With Heart Disease and Adolescents Living at Home. Health Expect 2024; 27:e14129. [PMID: 38970211 PMCID: PMC11226407 DOI: 10.1111/hex.14129] [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] [Received: 12/08/2023] [Revised: 06/02/2024] [Accepted: 06/19/2024] [Indexed: 07/08/2024] Open
Abstract
AIM To describe the life situation of spouses having a partner with heart disease and adolescents living at home. DESIGN Qualitative inductive design. METHOD Participants (n = 22) were included from three Scandinavian countries. Semi-structured interviews were analysed using thematic analysis with an inductive and latent approach. RESULTS Three themes were derived. 'Being in spousal and parental role transition' described how daily life had been affected and parental responsibilities had been doubled due to their partner's heart disease. 'Living with unpredictability and insecurity' included how the unpredictable illness trajectory caused worries and affected the well-being of the family. 'Managing a challenging life situation' highlights how spouses coped with their partners' heart disease and adapted to a new life situation. CONCLUSION Young spouses' life situation was greatly affected by their partner's heart disease, resulting in increased responsibilities and double parenthood. Having a positive attitude and mindset towards life was used as a strategy to cope with the changed life situation and find a new way of life. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE All family members are affected by heart disease. Spouses needed additional professional support and guidance on how to involve the children when a parent is ill. IMPACTS This study highlights how young spouses, with adolescents living at home, experience their life situation. The life situation is unpredictable due to the partner's heart disease, as they must handle both caring for their partner and taking on double parenthood. Research involving family members can improve person- and family-centred care and treatment outcomes in health care and society. REPORTING METHOD COREQ checklist was used preparing the manuscript. PATIENT OR PUBLIC CONTRIBUTION Data collection included interviews with spouse. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: By highlighting the spouses changed life situation due to heart disease and the importance of including them in health care.
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Affiliation(s)
- Matilda Holmbom
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
| | | | - Hanna Grundström
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of Obstetrics and GynecologyNorrkopingSweden
- Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
| | - Camilla Bernild
- The Heart Center, RigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | - Nina Fålun
- Haukeland University HospitalBergenNorway
| | - Tone Merete Norekvål
- Haukeland University HospitalBergenNorway
- Department of Clinical ScienceUniversity of BergenBergenNorway
| | | | - Anna Strömberg
- Department of Health, Medicine and Caring SciencesLinköping UniversityLinköpingSweden
- Department of CardiologyLinköping UniversityLinköpingSweden
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Petrova I, Pipere A. Caregivers' experience of caring for family members with complex health needs in Latvia. Health Promot Int 2024; 39:daae070. [PMID: 38934478 DOI: 10.1093/heapro/daae070] [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] [Indexed: 06/28/2024] Open
Abstract
The article examines the experiences of family caregivers engaged in the provision of long-term care for their relatives with complex health needs within the Latvian context. Semi-structured interviews were conducted with seven caregivers who provide care in cases of dementia, depression, schizophrenia, opioid use, Down syndrome and mild cognitive impairment. A thematic analysis of interview transcripts revealed common themes, such as the initial experiences when encountering a family member's disorder and the subsequent reactions, as well as the quest for support and resources. Variations mainly centered around differences in formal aspects and childhood experiences of care. Caregivers reported risk factors such as guilt, lack of support from family and friends, financial difficulties, deficiency of professional care and ignoring the caregiver's own needs. Awareness of personal resources, values and limits, coping with personal stigma and improved overall quality of life were identified as protective factors. The findings underscore several preventive measures that social and mental health services could implement to mitigate the adverse effects of caregiving on caregivers' lives.
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Affiliation(s)
- Indra Petrova
- Daugavpils University, Institute of Humanities and Social Sciences, Vienības iela 13, Daugavpils, LV 5400, Latvia
| | - Anita Pipere
- Daugavpils University, Institute of Humanities and Social Sciences, Vienības iela 13, Daugavpils, LV 5400, Latvia
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Antonio G, Kwakye IN, Essel C. Experiences of relatives caring for psychiatric patients in the Greater Accra Region of Ghana. Br J Health Psychol 2024; 29:317-332. [PMID: 37844916 DOI: 10.1111/bjhp.12701] [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: 03/02/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE The study aimed at examining the lived experiences of relatives caring for family members with mental illness in Ghana. METHODS Interpretative Phenomenological Analysis (IPA) was adopted to explore caregivers' in-depth experiences. Fifteen caregivers were purposefully selected from four hospitals within the Greater Accra Region of Ghana, and they were engaged in face-to-face interview sessions through the semi-structured guided interviews. Interviews were transcribed into text formats and analysed using the IPA approach. RESULTS Three superordinate themes and their respective sub-themes were identified. Theme 1: Being with the mentally ill (time consuming; financial burden; healer shopping); Theme 2: Psychosocial effect (stigmatization; stress and depression; changes in social/work life); Theme3: Coping resources (prayers/spirituality; psychological capital - ignoring, self-encouragement, acceptance, routinization; social/family support; reading). CONCLUSION It was recommended that healthcare professionals ought to prepare family members for the emotional challenges by providing them with constant therapeutic service to help reduce their emotional strain associated with the burden of care. Public education should be intensified for people to understand the need for accepting people with mental illness in order to reduce the issue of stigmatization. Again, government should institute policies through its agencies (Ministry of Health, Ghana Health Service) to assist the caregivers in the discharge of responsibilities. This could take the form of reducing cost of drugs, and establishing community mental health care to provide immediate support.
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Affiliation(s)
| | - Isaac Nyarko Kwakye
- Department of Built Environment, University of Environment and Sustainable Development, Somanya, Ghana
| | - Cynthia Essel
- Salvation Army Hospital/West End University College, Accra, Ghana
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Monari EN, Booth R, Forchuk C, Csiernik R. Black family members' cultural beliefs and experiences regarding substance use and misuse by relatives: A focused ethnography. J Ethn Subst Abuse 2024:1-31. [PMID: 38557270 DOI: 10.1080/15332640.2024.2331634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Research explored substance use in Black communities in Canada, but a gap exists about the experiences of Black family members, caring for relatives with substance misuse within the Canadian context. Black family members are defined as African Canadians, Caribbean Canadian or Caribbean Blacks. This paper explores Black family members' beliefs and experiences regarding their relatives' psychoactive substance use and misuse. A focused ethnography was conducted with 26 Black family members with 17 participants originated from various parts of Africa, and nine participants originated from parts of the Caribbean. Participants comprised of mothers (n = 5), fathers (n = 2), step-fathers (n = 1), husbands (n = 1), wives (n = 2), uncles (n = 5), aunties (n = 2), siblings (n = 5), in-laws (n = 2), and guardians (n = 1). Three themes were generated: cultural beliefs and perceptions regarding substance use and misuse of family relatives; "When he starts drinking, hell breaks loose": Perceived impact of substance misuse on family safety and stability; and, the experiences of stigma and the keeping of secrets. Prioritizing public health approaches, such as public policies and campaigns that dismantle stigma and systemic barriers, and increase awareness about substance use and harm reduction interventions among Black communities.
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Affiliation(s)
- Esther N Monari
- Memorial University of Newfoundland, St. John's, Canada
- Western University, London, Canada
| | | | - Cheryl Forchuk
- Western University, London, Canada
- Lawson Health Research Institute, London, Canada
- Parkwood Institute Research, London, Canada
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Mabunda NF, Mangena-Netshikweta ML, Lebese RT, Olaniyi FC. Family Perspectives Related to Caring for Mental Health Care Users: A Case Study in the Long-Term Mental Health Institutions of Limpopo Province, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10511. [PMID: 36078227 PMCID: PMC9518157 DOI: 10.3390/ijerph191710511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Family involvement in long-term mental health care is a significant therapeutic aspect in managing mentally ill patients. This study aimed to determine the perspectives of family members about caring for mental health care users at selected long-term mental health institutions in Limpopo Province. A qualitative explorative and contextual descriptive design was used. Purposive sampling was used to select family members with mental health care users admitted in long-term health institutions in Limpopo Province. Data were collected with in-depth individual interviews aided by an audio recorder and field notes. Data were qualitatively analysed. Trustworthiness and ethical considerations were ensured. Two themes yielded from the interviews: Perspectives of family members about their involvement in the care of mental health care users and difficulties in caring for mental health care users at home when granted leave of absence or discharged. Sub-themes: Caring for mental health care users leads to an understanding of mental illness; Lack of skill and inability to monitor mental health care users at home; Mental health care users abuse substances during leave of absence which makes family reluctant to request them for visit; Caring for mental health care users at home viewed as a difficult task and stigma from the community. The challenges experienced by family members contribute to poor interaction with mentally ill patients. We recommend that family members of mental health care users be educated about mental illnesses and encouraged to participate in the care of the patients.
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Affiliation(s)
- Nkhensani F. Mabunda
- Department of Advanced Nursing Science, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | | | - Rachel T. Lebese
- Research Department, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
| | - Foluke C. Olaniyi
- Department of Public Health, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
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