1
|
Adu J, Oudshoorn A, Anderson K, Marshall CA, Stuart H. Experiences of familial stigma among individuals living with mental illnesses: A meta-synthesis of qualitative literature from high-income countries. J Psychiatr Ment Health Nurs 2023; 30:208-233. [PMID: 36031879 DOI: 10.1111/jpm.12869] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental illness stigma has been long acknowledged as a social problem that continues to persist and contribute to social exclusion of affected persons globally. Researchers have explored mental illness stigma in the general public and among health professionals, with little focus on stigma from family members and close relatives of persons with mental illnesses. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study appears to be the first meta-synthesis of familial mental illness stigma in high-income countries. Family members or close relatives of persons with mental illnesses may be perpetrators of stigma. That is, the family may enact stigma of mental illness against their relative to "save face" or by avoiding or narrowing their social contacts. Familial stigma is harmful due to the likely disaffection it brings within one's home environment. Familial mental stigma from the existing literature seems to be a by-product of public stigma and stigma by association WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further research is necessary to look at the existence of familial mental illness stigma as well as available policies to reduce its impact on affected individuals in high-income countries. Researchers in high-income countries should endeavour to examine the relationship between familial, public and associative stigma to establish baseline metrics to inform future anti-stigma programs seeking to reduce familial mental illness stigma. ABSTRACT INTRODUCTION: Familial mental illness stigma is a pervasive issue but very subtle in high-income countries. Familial mental illness stigma implies persons living with mental illnesses are discriminated against by their family members or close relatives. AIM/QUESTION This meta-synthesis explored the experiences of familial stigma among individuals living with mental illnesses in high-income countries, focusing on empirical literature, to understand the breadth of current literature and ways to reduce this form of stigma. METHOD We conducted a meta-synthesis through a structured search of qualitative data from six electronic databases (Sociological Abstract, CINAHL, Medline, PsycINFO, Google Scholar and Embase). Inclusion criteria comprised: empirical primary research, primary technique for data collection is qualitative, studies published in a peer-reviewed journal in the English language between 2000 and 2020, studies reported on experiences of familial mental illness stigma, and studies conducted in high-income countries. The exclusion criteria were as follows: all grey literature, studies not written in English and non-peer-reviewed, studies not focused on familial mental illness stigma, quantitative peer-reviewed articles on the related concept and peer-reviewed articles on the related topic before the year 2000. RESULTS The study identified only 28 peer-reviewed articles on the topic within two decades. Concealment of familial stigma was found to be detrimental due to the potential for alienation within one's home environment. Disclosure and social contact within the family system were considered as critical interventions to provide some safety nets for individuals with mental illnesses. DISCUSSION AND IMPLICATIONS FOR PRACTICE The paucity of studies over the review period highlights the need for further attention to support optimal environments for persons living with mental illnesses. Families' understanding of the difficulties of mental illness stigma is vital to supporting the development of policies and interventions towards the avoidance of social exclusion within societies. Families should make concerted efforts to reduce stigma, and this includes within the family system. Education and training approaches around mental illness-related stigma should involve individuals with lived experience and their families, as well as service providers and the general public.
Collapse
Affiliation(s)
- Joseph Adu
- Department of Health and Rehabilitation Sciences, Elborn College, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Kelly Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Department of Psychiatry and the School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
| |
Collapse
|
2
|
Forcheron V, Sacareau E, Bourgeois J, Pouchon A, Polosan M, Gaboreau Y, Dondé C. Experience, impact and needs of informal parental caregivers around the communication of a diagnosis of schizophrenia. Int J Soc Psychiatry 2023; 69:101-110. [PMID: 34991395 DOI: 10.1177/00207640211068978] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To qualitatively characterize the experience, impact and needs of informal family caregivers around the communication of a diagnosis of schizophrenia. METHODS In all, 13 informal family caregivers were recruited. All were parents. Semi-structured interviews were used to explore their experience of the diagnosis of schizophrenia, the impacts of the diagnosis and the needs related to the diagnosis around its communication. Interviews were recorded, transcribed, codes generated and mixed deductive-inductive thematic analysis undertaken. RESULTS Participants described receiving the diagnosis of schizophrenia for their relative as a devastating experience, although some nuanced the experience with a sense of relief of finally naming the disorder and getting access to care. Caregivers' experience and representations prior to hearing the diagnosis played an important role in the way the 'news' was internalized. The communication of the diagnosis constituted a starting point for acceptance of the reality of the illness in participants. Numerous unmet needs around the communication of the diagnosis were reported by participants, including personnalized support, specific explanations about the disorder and guidance on their role as caregiver. CONCLUSION A specific attention must be given to the communication of the diagnosis of schizophrenia to the informal family caregivers. Information giving must be early, comprehensive, personalized and embedded into tailored education and support programmes for caregivers to facilitate illness acceptance and adaptation.
Collapse
Affiliation(s)
- Véra Forcheron
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Elodie Sacareau
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Jérôme Bourgeois
- Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France
| | - Arnaud Pouchon
- Université Grenoble Alpes, Grenoble, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Mircea Polosan
- Université Grenoble Alpes, Grenoble, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
| | - Yoann Gaboreau
- Université Grenoble Alpes, Grenoble, France.,Department of General Practice, Faculty of Medicine, University of Grenoble, Grenoble, France.,Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications (TIMC-IMAG)
| | - Clément Dondé
- Université Grenoble Alpes, Grenoble, France.,Adult Psychiatry Department, Alpes-Isère Psychiatric Hospital, Saint-Egrève, France.,INSERM, U1216, Grenoble, France.,Adult Psychiatry Department, Grenoble Alpes University Hospital, Grenoble, France
| |
Collapse
|
3
|
Dijkxhoorn MA, Padmakar A, Bunders JFG, Regeer BJ. Stigma, lost opportunities, and growth: Understanding experiences of caregivers of persons with mental illness in Tamil Nadu, India. Transcult Psychiatry 2022; 60:255-271. [PMID: 35171067 PMCID: PMC10149884 DOI: 10.1177/13634615211059692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to address gaps in understanding of the lived experiences of caregivers of persons with mental illness in low-income countries. It was conducted among caregivers of persons with mental illness making use of a free non-governmental clinic in and around Chennai, India. The study adopted a qualitative methodology, with semi-structured interviews and life history exercises (n = 29) and six focus group discussions with caregivers (n = 21) and mental health professionals and community-based workers (n = 39). The experiences of caregivers were analyzed in the framework of "The Banyan model of caregiving," which identifies six phases. Major themes in caregivers' experience were: embarrassment and losing honor; fear; awareness; stigma and social exclusion; and reduced social interaction and loneliness. Posttraumatic growth considered as the result of caregiver experiences was found to consist mainly of personal growth and focusing on positive life experiences. Lost opportunities particular to the context of Tamil Nadu were described as the inability to get married, obtaining less education than desired, and loss of employment. Siblings faced lower levels of burden, while elderly mothers experienced especially high levels of burden and lack of happiness in life. Caregiver gains were identified as greater compassion for other people with disabilities, resulting in a desire to help others, as well as increased personal strength and confidence. Understanding the nuances of the caregiving experiences over time can provide a framework to devise more fine-tuned support structures that aim to prevent reductions in social interaction and lost opportunities, and improve a sense of meaning, in order to assist caregivers to continue providing care for their relatives with mental illness in a context with scarce mental health resources.
Collapse
Affiliation(s)
- Mirjam A Dijkxhoorn
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Archana Padmakar
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Joske F G Bunders
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Barbara J Regeer
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| |
Collapse
|
4
|
Haseley A, Wallis K, DeBrosse S. Kleefstra syndrome: Impact on parents. Disabil Health J 2020; 14:101018. [PMID: 33189624 DOI: 10.1016/j.dhjo.2020.101018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 10/01/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Kleefstra syndrome (KS) is associated with developmental delay, autism, intellectual disability, psychosis, and regression. Research has not been conducted to assess the impact of KS on parents. OBJECTIVE/HYPOTHESIS A mixed-method study was conducted to assess the impact on parental well-being by evaluating parents' well-being, identifying factors of parental experience predicting well-being, and exploring the parental experience. METHODS Parents completed an online survey containing the PedsQL™ Family Impact Module (FIM) and a questionnaire created by the researchers. One-Way T-Test compared parents of children with KS to parents of children with Prader-Willi syndrome (PWS). Multiple linear regression used parents' total scale scores on PedsQL™ FIM to identify factors influencing parental well-being. Constant comparative analysis used open-ended responses to explore the parental experience of having a child with KS. RESULTS Parents of children with KS had statistically lower scores in daily activity and social functioning, but statistically higher scores in communication and emotional functioning compared to parents of children with PWS. However, the power was below 0.80, meaning additional research needs to be completed to confirm these findings. The linear multiple regression was not significant. Most importantly, the themes of establishing the diagnosis, importance of knowledge, sense of community, KS and relationships with others, how life changed, and what the future will hold, characterized the parental experience. CONCLUSIONS Knowledge and support were important to parents who had a child recently diagnosed with KS. Therefore, parents should be provided resources about KS and support groups at diagnosis.
Collapse
Affiliation(s)
- Alexandria Haseley
- Department of Genetics and Genome Sciences, Case Western Reserve University, Biomedical Research, 2109, Adelbert Rd Building, 6th FL, Cleveland, OH, USA.
| | - Kimberly Wallis
- Center for Human Genetics, University Hospitals Cleveland Medical Center, 11100 Euclid Ave #1500, Cleveland, OH, 44106, USA; Genetic Services, Akron Children's Hospital, 215 W Bowery St, Akron, OH, 44308, USA.
| | - Suzanne DeBrosse
- Department of Genetics and Genome Sciences, Case Western Reserve University, Biomedical Research, 2109, Adelbert Rd Building, 6th FL, Cleveland, OH, USA; Center for Human Genetics, University Hospitals Cleveland Medical Center, 11100 Euclid Ave #1500, Cleveland, OH, 44106, USA.
| |
Collapse
|
5
|
Sheng Q, Zhang X, Cai C, Shi Y. Parents' Experiences of Caring for Their Only Child With Mental Illness in China: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2020; 59:29-37. [PMID: 33095263 DOI: 10.3928/02793695-20201001-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/28/2020] [Indexed: 11/20/2022]
Abstract
The current study explored Chinese parents' experiences of caring for their only child with mental illness. Face-to-face interviews with semi-structured questions were conducted to learn about the care experiences of parents whose only child had mental illness. Purposeful sampling was used to recruit parents (n = 14) and thematic analysis was used. Five themes were identified: (1) Having Responsibility to Care for Children, (2) Feeling Guilt and Self-Blame, (3) Experiencing Loneliness and Helplessness, (4) Drained by Caregiving, and (5) Worrying About the Future. Parents who cared for their only child with mental illness experienced considerable emotional and physical challenges. Professionals and health care providers should recognize and understand the experiences of these parents to identity their needs and provide adequate support. Targeted support services and appropriate professional information should be developed and provided for parents to relieve them of negative caregiving experiences and improve their psychological and physical well-being. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 29-37.].
Collapse
|
6
|
Bai XL, Luo ZC, Wang A, Guan ZY, Zhong ZY, Sun M, Tang SY. Challenge of parents caring for children or adolescents with early-stage schizophrenia in China: A qualitative study. Perspect Psychiatr Care 2020; 56:777-784. [PMID: 32147848 DOI: 10.1111/ppc.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To explore the challenges of parents caring for early-stage schizophrenia (ESS) children/adolescents in China. DESIGN AND METHODS Thirteen parents of ESS subjects completed semi-structured interviews. Thematic analysis was used to analyze data. FINDINGS Seven themes emerged from the data: psychological shock and emotional burden; lack of disease knowledge and care skill; poor treatment compliance of the patient; difficulty getting along with the patient; conflict within the family or in the workplace; financial burden; and need sufficient social support. Each challenge was produced and influenced under the Chinese special social context. PRACTICE IMPLICATIONS Professional support was needed to help patients with schizophrenia to cope with their situation promptly. Education initiatives should focus on mental health to prevent discrimination from society and enable people to recognize the early symptoms of schizophrenia in children. Telemedicine should be explored for application in the treatment of mental illness. Also, a broader nationwide healthcare policy would be needed to help to reduce the individual and societal financial burdens associated with schizophrenia.
Collapse
Affiliation(s)
- Xiao-Ling Bai
- Department of Nursing, Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Zhong-Chen Luo
- Department of Surgical Nursing, School of Nursing, Guizhou Medical University, Guiyang, Guizhou, China
| | - Anni Wang
- Department of Fundamental Nursing, School of Nursing, Fudan University, Shanghai, China
| | - Zi-Yao Guan
- Department of Community Nursing, Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Zhao-Yang Zhong
- Department of Surgical Nursing, Nursing Faculty, Fenyang College of Shanxi Medical University, Fenyang, Shanxi, China
| | - Mei Sun
- Department of Community Nursing, Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Si-Yuan Tang
- Department of Community Nursing, Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| |
Collapse
|
7
|
Stuart R, Akther SF, Machin K, Persaud K, Simpson A, Johnson S, Oram S. Carers' experiences of involuntary admission under mental health legislation: systematic review and qualitative meta-synthesis. BJPsych Open 2020; 6:e19. [PMID: 32043435 PMCID: PMC7176830 DOI: 10.1192/bjo.2019.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Carers are key providers of care and support to mental health patients and mental health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice. AIMS We aimed to synthesise qualitative evidence of carers' experiences of the assessment and detention of their family and friends under mental health legislation. METHOD We searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental health legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis. RESULTS The review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental health professionals, and of involvement as partners in care. CONCLUSIONS Research is needed to explore whether and how health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.
Collapse
Affiliation(s)
- Ruth Stuart
- Research Assistant, Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Karen Machin
- Visiting Lecturer, School of Health and Social Work, University of Hertfordshire, UK
| | - Karen Persaud
- Honorary Research Associate, NIHR Mental Health Policy Research Unit, Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Alan Simpson
- Professor of Mental Health Nursing, Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London; and Director (KCL), NIHR Mental Health Policy Research Unit, UK
| | - Sonia Johnson
- Professor of Social and Community Psychiatry, Division of Psychiatry, Faculty of Brain Sciences, University College London; Director (UCL), NIHR Mental Health Policy Research Unit; and Consultant Clinical Psychiatrist, Camden and Islington NHS Foundation Trust, UK
| | - Sian Oram
- Lecturer and Head of the Section of Women's Mental Health, Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London; Deputy Director (KCL), NIHR Mental Health Policy Research Unit, UK
| |
Collapse
|
8
|
Zhang Y, Yang M, Guo X, Chen Q. Quality of Life in Family Caregivers of Adolescents with Depression in China: A Mixed-Method Study. Patient Prefer Adherence 2020; 14:1317-1327. [PMID: 32801662 PMCID: PMC7398742 DOI: 10.2147/ppa.s265867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/12/2020] [Indexed: 02/03/2023] Open
Abstract
PURPOSE In this study, we investigated quantitatively the quality of life (QoL) and its influencing factors among Chinese family caregivers who care for adolescents with depression (AWD) and we explored qualitatively their care-giving experiences. METHODS The study was a mixed method with convergent parallel design. The sociodemographic characteristics, QoL, caregivers' burden, family functioning, positive and negative affects were assessed by using questionnaires on 240 family caregivers of AWD in China. Twelve of these family caregivers were interviewed by using a semi-structured guide to explore their care-giving experiences. RESULTS The mean score among family caregivers of AWD for physical QoL was 65.18 and 59.42 for mental QoL, which was significantly lower than the Chinese norms for QoL. Multiple regression analysis demonstrated that course of disease of AWD, caregivers' educational qualification, family functioning, positive affect and care-giving burden accounted for 57% of the variance in physical QoL. Suicide history of AWD, caregivers' educational qualification, negative affect, positive affect, care-giving burden and family functioning accounted for 54% of the variance in mental QoL. Four major themes of the care-giving experiences emerged: lack of knowledge about depression, being overwhelmed emotionally with psychological burden, the devastating impact of illness on family, and the perceived benefits of care-giving. CONCLUSION The QoL among family caregivers of AWD in China was low. It is necessary for health-care professionals to pay more attention to the QoL of family caregivers who care for AWD.
Collapse
Affiliation(s)
- Yinying Zhang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Min Yang
- Xiangya Nursing School of Central South University, Changsha, Hunan Province, People’s Republic of China
- Correspondence: Min Yang Tel/ Fax +86 731 8265 0275 Email
| | - Xin Guo
- Huashan Hospital of Fudan University, Shanghai City, People’s Republic of China
| | - Qiongni Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People’s Republic of China
| |
Collapse
|
9
|
Johansson A, Anderzén-Carlsson A, Ewertzon M. Parents of adult children with long-term mental disorder: Their experiences of the mental health professionals' approach and feelings of alienation - A cross sectional study. Arch Psychiatr Nurs 2019; 33:129-137. [PMID: 31753218 DOI: 10.1016/j.apnu.2019.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 09/09/2019] [Accepted: 10/18/2019] [Indexed: 11/25/2022]
Abstract
The aim was to describe how parents of adult children suffering from long-term mental disorder experience the mental health professionals' approach and any feelings of alienation regarding the provision of care. A further aim was to investigate any differences according to the parents' gender or the child's age. 93 mothers and 37 fathers participated. A majority experienced the mental health professionals' approach toward them as being negative and they felt alienated from the professional care. Regardless of the age of the children, parents have a considerable need for a positive approach from the professionals that can enable them to choose how they should act and what they should do, in order to help and support their adult child.
Collapse
Affiliation(s)
- Anita Johansson
- Research and Development Centre, Skaraborg Hospital, SE-541 85 Skövde, Sweden.
| | - Agneta Anderzén-Carlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE-702 81 Örebro, Sweden.
| | - Mats Ewertzon
- Ersta Sköndal Bräcke University College, Department of Health Care Sciences, P.O. Box 111 89, SE 100 61 Stockholm, Sweden.
| |
Collapse
|
10
|
Hasson-Ohayon I, Goldzweig G, Lavi-Rotenberg A, Roe D, Pijnenborg GHM. Illness representations among parents of children and adults with serious mental disorders: A systematic review and theoretical model. Eur Psychiatry 2019; 58:27-37. [PMID: 30769239 DOI: 10.1016/j.eurpsy.2019.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cognitive representations of an illness have an important impact on psychological outcomes. The current systematic review explored 1) the characteristics of illness representations held by parents of children and adults with serious mental illness (SMI), and 2) the associations of these representations with both parents' and patients' psychological outcomes. METHOD PSYINFO and PUBMED were screened for eligible studies published between January 2000 and August 2018. Selection was based on PRISMA guidelines. Reference lists of these papers were checked for additional references. Two independent coders extracted all relevant data. RESULTS The search resulted in 31 relevant studies, which were divided, by type of methodology, into three sections: quantitative, qualitative, and mixed quantitative-qualitative. In each section, findings were divided in accordance with the two research questions. CONCLUSION Parents struggle to make meaning of their child's illness, often holding stigmatizing ideas about the illness and blaming themselves for its existence. More longitudinal studies that include both of the child's parents, as well as interventional studies, are needed to expand our knowledge of ways to help parents construct more beneficial representations of their children's illnesses.
Collapse
Affiliation(s)
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel-Aviv Yaffo, Israel
| | | | - David Roe
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel; Department of Clinical Medicine, Psychiatry, Aalborg University, Denmark
| | - Gerdina Hendrika Maria Pijnenborg
- GGZ Drenthe Mental Health Institute, Department of Psychotic Disorders, Assen, the Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
11
|
Yu Y, Tang BW, Liu ZW, Chen YM, Zhang XY, Xiao S. Who cares for the schizophrenia individuals in rural China - A profile of primary family caregivers. Compr Psychiatry 2018; 84:47-53. [PMID: 29684660 DOI: 10.1016/j.comppsych.2018.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/03/2018] [Accepted: 04/05/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The present study aims to provide a comprehensive profile of the primary family caregivers of schizophrenia individuals in rural China. METHOD A cross-sectional study was conducted with a sample of 327 primary family caregivers of schizophrenia individuals recruited through a one-stage cluster sampling in Ningxiang County of Hunan province, China. The social demographic and psychological profiles of primary caregivers were measured using standard scales and self-designed scales. RESULTS The typical caregiver profile consists of a 58-year old married first degree relative (mostly parents or spouses) with a low socio-economic position. Most of them have been caregiving for over 10 years (74.3%) and have some physical illness (67.0%). The major caregiving activities were medicine management (71.6%) and hospital visit (69.4%), yet there is still 17.1% primary caregivers involved with neither of the care. Most (84%) of caregivers reported some kind of burden, with anxiety in 45.9% of caregivers and depression in 45.4%. Family caregivers also reported positive aspects of caregiving including a well-functional family (51.0%) and rewarding feelings (58.3%). CONCLUSION The findings of the present study have brought attention to a special group of family caregivers for schizophrenia, with implications for intervention on them in the future.
Collapse
Affiliation(s)
- Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China; Hospital Evaluation Office, Xiangya Hospital, Central South University, Xiangya Road 87, Changsha, Hunan 410008, China
| | - Bing-Wei Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China
| | - Zi-Wei Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China
| | - Yu-Mei Chen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China
| | - Xing-Yu Zhang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Upper Mayuanlin Road 238, Changsha, Hunan 410008, China.
| |
Collapse
|
12
|
Onwumere J, Sirykaite S, Schulz J, Man E, James G, Afsharzadegan R, Khan S, Harvey R, Souray J, Raune D. Understanding the experience of "burnout" in first-episode psychosis carers. Compr Psychiatry 2018; 83:19-24. [PMID: 29505884 DOI: 10.1016/j.comppsych.2018.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 01/23/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The first onset of psychosis can exert a significant negative impact on the functioning and positive wellbeing of family carers. Carer reports of "burnout" have recently been recorded in early psychosis carers, though the literature is scarce detailing our understanding of how burnout relates to the primary experience of caregiving. The current study investigated reports of burnout and its relationship with beliefs about caregiving and wellbeing in a large group of early psychosis carers who were routinely assessed within an early intervention team. METHODS AND MATERIALS Using a cross-sectional design, 169 early psychosis carers completed the Maslach Burnout Inventory alongside measures of caregiving experiences, affect and wellbeing. RESULTS The mean illness length for patients with psychosis was 18 months. Their mean age was 24.4 years and most was male (65%). The majority of carer participants were parental caregivers and living with their relative with psychosis. Across the three key burnout dimensions, 58% of the sample reported high levels of emotional exhaustion; 31% endorsed high levels of depersonalization; and 43% reported low levels personal accomplishment. The most severe level of burnout, reflecting elevated rates across all three dimensions, was observed in 16% of the sample. Carer burnout was positively associated with negative caregiving experiences (i.e. burden), poor affect, and reduced levels of positive wellbeing and perception of being in good health. CONCLUSIONS Reports by early psychosis carers of exhaustion, feeling inadequate and expressing negativity towards the relative they care for is not uncommon and are closely associated with their overall negative appraisals of caregiving. The results underscore the importance of developing targeted interventions during the early phase, which are designed to reduce the development and entrenchment of burnout responses in carers, but to also mitigate its negative sequelae.
Collapse
Affiliation(s)
- Juliana Onwumere
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.
| | | | - Joerg Schulz
- Department of Psychology, University of Hertfordshire, UK
| | - Emma Man
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| | - Gareth James
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| | - Roya Afsharzadegan
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| | - Sanna Khan
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| | - Raythe Harvey
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| | - Jonathan Souray
- Early Intervention in Psychosis Service, West London Mental Health NHS Trust, UK
| | - David Raune
- Early Intervention in Psychosis Service, Central and Northwest London NHS Foundation Trust, UK
| |
Collapse
|