Effectiveness of an Uncertainty Management Psychoeducation Program for Schizophrenia Caregivers: A Randomized Controlled Trial

BACKGROUND

The inconsistent course of schizophrenia causes a long-term experience of uncertainty for individuals and their families. In Turkey, no studies yet exist that have attempted to address this constant uncertainty that is experienced by caregivers of schizophrenic patients.

AIMS

To evaluate the effects of the Uncertainty Management Psychoeducation Program on reducing uncertainty and intolerance to uncertainty, improving psychological well-being, and coping styles in caregivers of patients with schizophrenia.

METHOD

Single-blinded randomized controlled trial. Caregivers of schizophrenia inpatients were recruited from the psychiatry clinic of a university-affiliated hospital. Data were collected between April 2019 and August 2020. Eligible individuals were randomly allocated to one of the two groups: intervention or control. The intervention group had five individual psychoeducation sessions: "Recognizing Uncertainty," "Cognitively Reframing Uncertainty," "Solving Uncertainty-Related Issues," "Dealing with Uncertainty Using Communication Skills," and the "Closing Session." Participants in the control group received the usual care. Uncertainty, intolerance to uncertainty, psychological well-being, and stress coping strategies were measured at two points: at baseline and immediately following the intervention. Hypotheses were tested using the Mann-Whitney U and Wilcoxon tests.

RESULTS

A total of 54 participants were recruited. The intervention group's ratings for "seeking social support" and "optimistic approach" were higher than the control group's ratings. Significant within-group changes in terms of "uncertainty" and "optimistic approach" were reported for the intervention group in the post-intervention. In the control group, significant changes were seen in terms of "uncertainty" and "psychological well-being" over time.

CONCLUSION

The Uncertainty Management Psychoeducation Program was found to be effective in reducing the level of uncertainty, increasing their optimistic approach, and seeking social support of caregivers of schizophrenic patients.

Perceived stigma, common mental disorders and associated factors among primary caregivers of adult patients with mental illness attending at public hospitals, Harari regional state, Eastern Ethiopia: A multicenter cross-sectional study

Background

Giving care to someone who is experiencing mental distress is a difficult and challenging task that could be detrimental to the caregiver's overall quality of life. Numerous studies show that caregivers frequently experience mental distress and feel stigmatized. However, there is limited study done on this topic in our country.

Objective

To determine the magnitude and associated factors of perceived stigma and common mental disorder among primary caregivers of adults with mental illness in public hospitals at Harari regional state, Eastern Ethiopia, 2022.

Methods

A cross-sectional study design was conducted. A total of 419 participants were recruited by a systematic random sampling technique. The data was collected by using a face-to-face interview and by reviewing patients' charts. Perceived stigma and common mental disorder were assessed by Family Interview Schedule and Self-Reporting Questionnaire, respectively. Epi-data version 4.6.2 was used to enter data, and SPSS version 20 was used to analyze. Bivariable and multivariable logistic regression were performed. P-values < 0.05 were considered statistically significant.

Result

The magnitude of perceived stigma and common mental disorder were 42.5% (95% CI, 37.7-47.3) and 39.4% (95% CI, 34.8-44.0) respectively. Age of caregiver between 26 and 33 [AOR = 3.13, 95% CI: (1.71-8.93)], no formal education [AOR = 3.85, 95% CI: (1.81-8.15)], illness duration ≥7 years [AOR = 1.93, 95% CI: (1.04-3.57)], family history of mental illness [AOR = 1.92, 95% CI: (1.09-3.39)] and poor social support [AOR = 4.87, 95% CI: (3.74-12.71)] were significantly associated with perceived stigma. Being female [AOR = 1.92, 95% CI: (1.31-3.34)], having no formal education [AOR = 4.04, 95% CI: (2.15-10.01)], having a family history of mental illness [AOR = 2.26, 95% CI: (1.29-4.00)], having comorbid other illness [AOR = 2.13, 95% CI: (1.15-3.94)], and having poor social support [AOR = 4.58, 95% CI: (2.53-8.28)] were significantly associated with common mental disorder.

Conclusion

The magnitude of perceived stigma and common mental disorder was high among primary caregivers of patients with mental illness compared with other studies. Age of caregiver between 26 and 33, no formal education, duration of illness ≥7 years, family history of mental illness and poor social support were associated with perceived stigma and being female, no formal education, family history of mental illness, comorbid other illness and poor social support were associated with common mental disorder.

Evaluation of burden felt by caregivers of patients with schizophrenia and bipolar disorder

BACKGROUND

It can be a difficult task to provide care to the patients living with mental health issues, especially with chronic diseases such as schizophrenia and bipolar disorder where the patient loses touch with reality.

AIM

The current study was aimed to assess the of burden of care that caregivers feel while giving care to the patients of schizophrenia and bipolar disorder and to compare the difference in burden between these two conditions. The study also evaluated the factors affecting the caregiver's burden.

SETTINGS AND DESIGN

This was a cross-sectional interview-based study conducted at the psychiatry department of a tertiary care hospital in Gujarat among caregivers of schizophrenia and bipolar disorder.

SUBJECTS AND METHODS

Each caregiver was given the Zarit-Burden Interview scale in vernacular language and asked to rate each statement from 0 to 4 where 0: never, 1: rarely, 2: sometimes, 3: quite frequently, and 4: nearly always. The final score was calculated and interpreted as: 0-21 - little or no burden, 41-60 - moderate to severe burden, and 61-88 - severe burden.

STATISTICAL ANALYSIS

Data of the burden score were expressed as mean and standard deviation and compared using unpaired t-test. Pearson's correlation coefficient was used for correlation between burden score and variables such as age, years of education, and duration of illness. The analysis was done using GraphPad version 3.0 and Microsoft Excel 2016.

RESULTS

A total of 210 caregivers reported the interview scale completely, of which 105 caregivers belonged to schizophrenia group and 105 were related to bipolar disorder. Average of burden score was 64.89 ± 15.7 and 59.11 ± 17.8 (maximum score: 88) in schizophrenia and bipolar group, respectively, and difference between the group was statistically significant. In both the groups, it was found that, with increase in the age of patients, caregiver's burden significantly increased.

CONCLUSION

Caregivers of schizophrenia and bipolar disorder patients feel a considerable burden of care with more burden felt by the caregivers of schizophrenia. The more vulnerable to burden are females, elderly, low-income groups, and patients in whom longer duration of care is required. The caregivers should receive an adequate support for maintaining their own mental health. they should be provided support for maintaining their mental health. Particularly, vulnerable are females, elderly, low-income groups, and longer duration of care. They should be provided with adequate support.

Determining care burden and psychiatric symptom level in caregiver of schizophrenia patient

PURPOSE

The present study was conducted to determine the care burden and psychiatric symptom levels of the caregivers of schizophrenic patients.

DESIGN AND METHODS

The caregivers of schizophrenic patients were included in this descriptive study.

FINDINGS

It was determined that there was a statistically significant difference in the care burden scores and the education, family type, and the presence of physical diseases of the caregivers (P < .05). It was determined that there was a statistically significant positive relation between age and care duration (r = .339, P = .001).

PRACTICE IMPLICATIONS

It is recommended that the family members are guided to plan activities that will allow the family members to relax and cover their own needs.

Relationship between well-being, quality of life and hope in family caregivers of schizophrenic people

OBJECTIVE

To measure and correlate the degree of psychological well-being, quality of life, and dispositional hope in family caregivers of schizophrenic people.

METHODS

Descriptive cross-sectional study conducted with 117 relatives of schizophrenic people. We applied a questionnaire of sociodemographic variables was applied, and the instruments World Health Organization 5-Item Well-Being (WHO-5), World Health Organization Quality of Life Abbreviated (WHOQOL-Bref), and Dispositional Hope Scale. We used The Kruskal Wallis, Jonckheere-Terpstra, and Spearman correlation tests at the level α <0.05.

RESULTS

It was possible to observe statistical significance when comparing schooling and age with Disposal Hope; and when comparing the scales used.

CONCLUSION

The study considered that well-being, quality of life, and hope are variables that negatively influence caregiver burden, suggesting schooling as an inverse correlation variable with Dispositional Hope.

Australian mental health caregiver burden: a smallest space analysis

OBJECTIVES

To explore Australian mental health carers' prioritisation of key elements of caregiving and establish the extent to which particular issues contribute to carer burden.

DESIGN

Cross-sectional survey.

SETTING

All Australian States and Territories.

PARTICIPANTS

Responses were received from 231 Australian mental health caregivers.

MAIN OUTCOME MEASURES

The Involvement Evaluation Questionnaire was used to assess caregiver burden.

RESULTS

Smallest space analysis identified three distinct regions, which we conceptualise as: 1) promoting the safety and health of mental health consumers; 2) impact of caring on caregivers' personal lives and 3) enabling daily living functional recovery of mental health consumers. The analysis demonstrates that carers are most concerned with enabling daily living functional recovery, for which the mean value was considerably higher than the personal impact and promoting safety and health regions. In terms of the individual questionnaire items, the issues of most importance are assisting with self-care, worrying about consumers' future, finances and general health, encouraging consumer involvement in activities and concerns over the treatment consumers are receiving.

CONCLUSION

Caregiving often came at significant personal cost. The burden that results from caring for mental health consumers could perhaps be alleviated through the expansion of psychiatric disability services, increasing government financial support and providing tailored psychosocial interventions that meet the needs of families.

What is related to the well-being of the siblings of patients with schizophrenia: An evaluation within the Lazarus and Folkman's Transactional Stress and Coping Model

BACKGROUND

Schizophrenia is a chronic mental illness that strongly affects not only the patients with schizophrenia, but also their families and close relatives. So far, family research on patients with schizophrenia has mainly focused on parents, but has neglected siblings.

AIM

This study aims to evaluate the well-being of 103 siblings of patients with schizophrenia within the Lazarus and Folkman's Transactional Coping and Stress Model.

MATERIALS

A Sociodemographic Information Form, Subjective Well-being Scale, Zarit Caregiver Burden Scale, Multidimensional Perceived Social Support Scale, Ways of Coping Scale and Shortened Perceived Parental Rearing Styles Form were administered to the siblings of patients with schizophrenia.

RESULTS

The results of this study revealed that well-being was associated with perceived mother overprotection, perceived social support, problem-focused coping and indirect coping. Social support moderated the relationship between burden and well-being as a buffering factor.

CONCLUSION

Therefore, siblings of patients with schizophrenia should be given access to social support and their problem-focused coping strategies should be strengthened. Besides, parents should be supported to provide suitable care for the siblings of patients with schizophrenia.

Predictors of burden in Australian mental health caregivers: a cross-sectional survey

BACKGROUND

The shift towards providing mental healthcare in the community has resulted in caregivers becoming more involved in the delivery of these services. Supporting mental health consumers can be burdensome which, in conjunction with the anguish that may result from observing their relative develop a mental illness, can lead to carers experiencing significant levels of distress.

AIMS

This study aimed to quantify the extent to which specific aspects of caregiving contribute to mental health burden in Australia.

METHODS

Participants were included if they were Australian mental health caregivers. An online questionnaire was distributed via email. Multivariate logistic regression was used to identify predictors of burden in mental health caregivers.

RESULTS

Completed questionnaires were collected from 231 respondents. The logistic regression analysis yielded five factors that contributed significantly to mental health caregiver burden. Of these factors, a strained atmosphere and regularly carrying out tasks for consumers were the two strongest predictors of burden.

CONCLUSION

Community health professionals could focus on interpersonal relationships between family members, access to disability and financial support services, and carers' views about the quality of healthcare provided to consumers. Addressing these issues may decrease carer burden and improve the quality of life for all family members.

Dengue research: a bibliometric analysis of worldwide and Arab publications during 1872-2015

BACKGROUND

Dengue is an important emerging and re-emerging arboviral infection globally as a rapidly growing and widespread public health problem, with transmission occurring in more than 128 countries in Asia, Americas, southeast Africa, western Pacific, and eastern Mediterranean regions. Therefore, the aim of this study was to characterize and quantify the scientific output of dengue research in Arab countries relative to that worldwide by using a bibliometric analysis.

METHODS

The standardized search approach based on the use of the the keyword "dengue" in the title, abstract, and keyword field was used to get research output related to dengue at a global level. All data related to dengue were collected from the past to December 31, 2015.

RESULTS

A total of 19,581 dengue-related documents identified in the Scopus database. The results show that the study of dengue exhibits an overall upward trend from 1872 to 2015 with peak publications in 2014. The leading countries in dengue research were the USA (4,709; 24.05 %), India (1,942; 9.92 %), Brazil (1,530; 7.81 %), Thailand (1,260; 6.43 %), the UK (1,129; 5.77 %), and France (1,087; 5.55 %). Only 226 (1.16 % of the overall global research effort in the dengue field) articles were published from the Arab region. The total number of citations for all publications was 352,710, with an average of 18.0 citations per publication. Furthermore, the h-index for all extracted data related to dengue research was 186. Kingdom of Saudi Arabia (KSA) was the most productive country in Arab region with 102 documents representing 45.1 %. Furthermore, the h-index for all extracted data related to dengue research was 27. The USA was Arab's most main cooperative partner (46, 20.4 %), followed by India (36, 15.9 %).

CONCLUSIONS

The amount of literature related to dengue research has considerably increased over the last decade. This bibliometric analysis has demonstrated the leading role that the USA, India, Brazil, Thailand, the UK, and France play in dengue research. The Arab world produced fewer publications related to dengue with lower quality than other world countries.