Effects of brief family psychoeducation for caregivers of people with schizophrenia in Japan provided by visiting nurses: protocol for a cluster randomised controlled trial

Effects of brief family psychoeducation on family caregiver burden of people with schizophrenia provided by psychiatric visiting nurses: a cluster randomised controlled trial

BACKGROUND

The purpose of this study was to examine the effects of a brief family psychoeducation (BFP) programme provided by psychiatric visiting nurses on caregiver burden of family caregivers of people with schizophrenia through a cluster randomised controlled trial (cRCT).

METHODS

The study was a two-arm, parallel-group cRCT. Forty-seven psychiatric visiting nurse agencies were randomly allocated to the BFP programme group (intervention group) or treatment as usual group (TAU; control group). Caregivers of people with schizophrenia were recruited by psychiatric visiting nurses using a randomly ordered list. The primary outcome was caregiver burden, measured using the Japanese version of the Zarit Burden Interview. Outcome assessments were conducted at baseline, 1-month follow-up, and 6-month follow-up. Intention-to-treat analysis was conducted to examine the effects of the BFP programme on caregiver burden.

RESULTS

Thirty-four psychiatric visiting nurse agencies and 83 family caregivers of people with schizophrenia participated in the study. The participant attrition rate was less than 20%. Adherence to the program was 100%. Compared with TAU group, the BFP programme group had decreased caregiver burden. However, this improvement was not significant at 1-month follow-up (adjusted mean difference [aMD] = 0.27, 95% CI = - 5.48 to 6.03, p = 0.93, d = 0.01) or 6-month follow-up (aMD = - 2.12, 95% CI = - 7.80 to 3.56, p = 0.45, d = 0.11).

CONCLUSIONS

The BFP programme provided by psychiatric visiting nurses did not achieve significant decreases in caregiver burden. This result may be attributed to the difficulty in continuing the research due to the COVID-19 pandemic, which prevented us from achieving the targeted sample size necessary to meet the statistical power requirements, as well as to the participation of caregivers with relatively low burden. However, the program had the advantage of high adherence to treatment plan. Further studies should be conducted with a larger sample size and a more diverse sample that includes caregivers with a higher care burden.

TRIAL REGISTRATION

The study protocol was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000038044) on 2019/09/18.

The effectiveness of nursing psychoeducation toward family burden and quality life on caregiver of people with schizophrenia in the community

Introduction: The caregivers of people with schizophrenia have problems that include high family, burden and low quality of life at home. Therefore, this study aims to determine the effectiveness of nursing psychoeducation on family, burdens and quality of life in caregivers of schizophrenia patients in the community. Design and Methods: This study used a pre-test and post-test group control design and repeated measurement with a total of 100 respondents. The treatment group was given weekly nursing psychoeducation for seven sessions. Also, the general linear model (GLM) was used to analyze the result. Results: This study showed that before the intervention of nursing psychoeducation, the average family burden was 49,02 and 46.28 in the treatment and control groups, respectively. This decreased to 38.24 and 37.56 in the first and fourth weeks of posttreatment. Meanwhile, the control group was 44.86 in the first week and 45.62 in the fourth. The psychoeducation had an effect on decreasing the family burden with a p value < 0.001. Moreover, this study showed that before the intervention of nursing psychoeducation, the average caregiver quality of life was 75,72 and 74.24 in the treatment. After treatment, it increased to 91.22 in the first week after intervention and 92.54 in the fourth week of post-intervention. Therefore, the intervention effectively improved the caregiver quality of life with p < 0.001 Conclusions: Nursing psychoeducation can effectively reduce family burdens and improve the quality of life for caregivers.  

Stress among caregivers of schizophrenia – a pilot analysis

Caregivers of patients with schizophrenia experience a lot of stress and emotional strain, and they are frequently required to take care of them for the rest of their lives. Having a relative with mental illness can be stressful for many families.In India, the family is an important source of support for the mentally sick. Despite their incredible fortitude in caring for their relatives, Indian families face a great deal of physical and emotional suffering. The bad feelings and subsequent strain experienced as a result of caring for a chronically ill individual are referred to as caregiver’s burden. The overall response of an organism to external demands or pressure is known as stress. Any incident or occurrence that a person perceives a danger to his or her coping skills or resources can be the source of stress, and coping is a complex process. Ignorance and misconceptions among patient caregivers, deinstitutionalization policies, and a lack of resources all contribute to a high illness burden among caregivers. Many families believe they lack the required coping techniques to assist in the management of their relatives’ mental illness. Serious mental illnesses, such as schizophrenia, have catastrophic consequences for both sufferers and their families. A pilot study was done among 28 careers of schizophrenia to examine the study’s viability and feasibility. This study advocated for a true experimental research design .Conclusion: This pilot study concludes by demonstrating the efficacy of psychosocial therapies on stress in schizophrenia careers.