Academic journal article Central European Journal of Public Health

Quality of Life of Key Caregivers of Schizophrenia Patients and Association with Kinship

Academic journal article Central European Journal of Public Health

Quality of Life of Key Caregivers of Schizophrenia Patients and Association with Kinship

Article excerpt

SUMMARY

Introduction: Reports on the quality of life (QOL) of family caregivers of schizophrenia patients are uncommon. Relations of different degree of kinship to caregivers' QOL are unexplored, but may be relevant. The purpose of this study was to assess the subjective QOL of caregivers of stable outpatients with diagnosis of schizophrenia compared with controls, and to assess factors associated with QOL in this population.

Methods: Responses of 138 schizophrenia outpatient' family caregivers to the Quality of Life, Enjoyment and Satisfaction Questionnaire (QLESQ-SF) were compared with those of a sex- and age-matched control group. Patients were assessed with the Positive and Negative Symptom Scale (PANSS) and the Global Assessment of Functioning (GAF) and data were collected for kinship relationship and hospitalization.

Results: Group of caregivers had significantly lower QOL compared with controls (t=11.347; df=271; p=0.0001). Caregivers' QOL correlated significantly with their age and differed according to the degree of kinship and marriage status. ANCOVA, with age as covariate, performed to asses the differences in QOL according to kinship, showed that parents and own children had significantly lower QOL than patients' siblings who were also caregivers.

Conclusion: QOL of the schizophrenia patients' caregivers is lower in comparisons to controls. It depends on the degree of kinship and caregivers' age. Parents and own children have lower QOL than siblings. Psycho-educational intervention programmes should target specific needs of the family as a whole, depending also on their age and kinship relationship.

Key words: QOL, schizophrenia, key caregivers, family, kinship

INTRODUCTION

Owing to inadequacy of community-based services, family of origin remains the most important social contact and source of support for the majority of schizophrenia patients. The impact of caring for a relative with a mental disorder on the quality of life (QOL) of family caregivers has been acknowledged in previous reports (1-3). It has been shown that schizophrenia patients' family caregivers have lower scores on measures of quality of life comparing to caregivers of the patients with other psychiatric diagnoses (4, 5). Their low QOL derives from emotional reactions to the illness, the stress of coping with relatives' disturbed behaviour, the disruption of household routine, stigma they are also confronted with, restriction in social and leisure activities, and economic difficulties (6).

QOL of caregivers of patients with schizophrenia has been associated with gender (women have lower scores), caregiver state of health, positive appraisal of their role, subjective burden, and social support (1,4). It is shown that relatives' and patients' QOL are lower than QOL of the general population (7), but it is unclear whether and how characteristics of the patient relate to caregivers' QOL.

There is a difference in involvement in caring process between family members of patients with schizophrenia. In most cases it is the mother who takes the most of responsibilities in caring for the patient (8). In the study of Kurs et al. (9) there was no difference in domains of QOL between siblings of patients with schizophrenia and control subjects, but it was not clear from the study if the siblings were also the caregivers. Parents showed lower QOL comparing to other family members in the study of Awadala et al. (4), but other family members were not differentiated according to kinship status.

Gutiérrez-Maldonado et al. (10) identified kinship status as a significant predictor of relatives' subjective burden, a concept related with QOL. Nevertheless, it is not clear if and how the differences in kinship may be related to differences in their QOL.

Our aim was to assess differences in QOL between the group of patient's caregivers and control subjects and to assess if certain characteristics of the caregivers and the patients could be associated with caregivers' QOL. …

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