Academic journal article Iranian Journal of Psychiatry

Burden on Family Caregivers Caring for Patients with Schizophrenia

Academic journal article Iranian Journal of Psychiatry

Burden on Family Caregivers Caring for Patients with Schizophrenia

Article excerpt

Schizophrenia is a chronic psychosis in which the patient losses contact with reality. It is a devastating illness, often resulting in a loss of social functioning in affected individuals. The family remains the major source of care for the patient with schizophrenia and has a profound effect on their illness. Having a patient with schizophrenia in a family also affects the roles and interactions within the family. They face lots of burden including care burden, fear and embarrassment about illness signs and symptoms, uncertainty about the course of the disease, lack of social support, and stigma. Burden refers to the negative impact of the individual's mental illness on the entire family (1, 2).

Living with a schizophrenic relative is stressful. Studies have demonstrated that family caregivers of persons with severe mental illness experience significant stresses and have a high level of burden (3, 4). The perceived burdens among family caregivers of patients with schizophrenia had been studied in various Regions and cultures. In Europe, a Spanish study described several major effects of caring, which included poor health of family members, disruptions to social and leisure activities and domestic routines, and reduction in household income (5).

In Italy, Magliano et al. (1999) investigated the burden and coping strategies of key relatives of patients with schizophrenia and found that the levels of burden on key relatives did not differ significantly from those on other relatives (6). A study in Switzerland identified that the most important predictor of burden was the relationship between the caregiver and the patients with exacerbating schizophrenia. There were significant changes in the relationship during the acute phase of the illness. Other determinants of burden included threats, nuisances, time, and restricted social and leisure activities (7). In a Swedish study, family burden and participation in care of relatives to both voluntarily and compulsorily admitted patients were investigated. It was found that interventions for establishing a well-functioning network in families where relatives experienced mental health problems are useful (8).

In Thailand, families preferred to take care of their mentally ill relatives at home. Nevertheless, a qualitative study found that families perceived caring as suffering; "suffering" referred to the negative experiences in caregiving, which included physical burdens, emotional distress, economic problems, stigma about mental illness, and knowledge deficit about mental illness and its symptoms (9). Another qualitative study in Iran revealed that six major themes included fears and anxiety for the future, psychosomatic impact, feeling isolated and loneliness, financial impact, change in lifestyle and family functioning, and lack of support and knowledge in experiences of family member caregivers of bipolar disorder patients (10).

The problem of family burden when caring for schizophrenic patients is a common challenge in both developed and developing countries. Different health care and social systems in different countries may influence family's commitment to care. Family care burdens are echoed and encountered in many parts of the world (4). Iranian families are characterized through their intimate interpersonal relationships and many interactions among family members. Therefore, illnesses of one family member cause a substantial burden for the whole family. In addition, Iranian families report a low level of formal support services compared with the Western countries (11). However, little research has been devoted to the identification and understanding of this phenomenon among Iranians. The aim of this study was to determine the prevalence of the burden reported by family caregivers of schizophrenic patients.

Materials and Method

Study Design and Participants

This cross- sectional descriptive study was conducted from July to September 2012. …

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