Predictors of burden and infectious illness in schizophrenia caregivers.

The Washington Institute for Mental Illness, Research and Training, Washington State University and Eastern State Hospital, Spokane 99201-3899, USA.
Psychosomatic Medicine (Impact Factor: 4.09). 01/1999; 61(4):411-9. DOI: 10.1097/00006842-199907000-00001
Source: PubMed

ABSTRACT The objective of the study was to test predictive models of schizophrenia caregiver burden and infectious illness episodes for caregivers who had regular contact with their mentally ill family members.
A nurse interviewer, blind to the patient's symptoms, caregiver burden, and psychosocial status, administered the Health Review to 70 caregivers. A second family interviewer, blind to caregiver health status and patient symptoms, assessed caregiver resources (eg, active coping and social support), vulnerabilities (eg, anger expression and passive coping) and burden. Concurrently, independent patient raters, blind to caregiver health and psychosocial status, assessed caregiver stressors. The Brief Psychiatric Rating Scale and the Modified Scale for the Assessment of Negative Symptoms were used to assess the severity of positive (eg, hallucinations and delusions) and negative (eg, anhedonia and asociality) symptoms, respectively.
Predictive models, including measures of stressors, resources, and vulnerability factors for caregiver burden and for presence of infectious illness, were each highly significant, accounting for 40% and 29% of the variance, respectively. However, the specific measures that predicted burden and infectious illness differed. Greater burden was predicted by more severe patient negative symptoms (stressor), greater anger control and blame self-coping (vulnerability), and decreased tangible social support (resource). Presence of infectious illness episodes was predicted by more severe patient positive symptoms (stressor) and less satisfaction with social support while controlling for the frequency of reporting on the Health Review. When scores from the Brief Psychiatric Rating Scale (stressors) were categorized into quartiles, it was found that the frequency of infectious illness in the highest quartile was four times that in the lowest quartile. Other results indicated that even though burden was not associated with infectious illness, it was associated with "continuing health problems," perceived stress, and depression.
These data indicate that although schizophrenia caregiver burden and infectious illness are predicted by measures of patient stressors, vulnerabilities, and resources, the specific measures predicting these outcomes differ. The results also call attention to the powerful influence of patient symptoms as a predictor of burden and the presence of infectious illness among caregivers.

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    ABSTRACT: Background The care giving experience has an impact on every facet of a caregiver’s life, from physical to psychological and emotional health (Dyck, Short, & Vitalino, 1999). Caregivers of children with chronic diseases face circumstances that challenge their adaptation to the disease and influence their well-being. The aim of this research was to study the role emotional burden plays in predicting the quality of life of informal caregivers of children infected with HIV. Materials and Methods The sample comprised 20 Portuguese informal caregivers (17 women; M=42.7 years old, DP=10.2) of 20 children and adolescents with HIV (6 to 17 years old). Subjects answered to the Portuguese version of The Revised Burden Measure (RBM; Montgomery et al., 2006) composed by four dimensions – Burden of the relationship (Cronbach’s α=.86; M=10.1;SD=7.2), Objective burden (α=.89; M=16.2; SD=7.2), Subjective burden (α=.93; M=14.8; SD=6.8) and Personal growth (α =.77; M=22.0; SD=5.3) – and to the World Health Organization Quality of Life Questionnaire (WHOQOL-Bref; Fleck et al., 2000) that measures four quality of life domains – Physical health (α=.89; M=65.2; SD=23.3), Psychological health (α=.91; M=67.5; SD=22.2), Social relationships (α=.87; M=64.6; SD=24.2) and Environment (α=.87; M=60.2; SD=19.9). Results The four dimensions of emotional burden explain 53.4% of the caregiver’s quality of life, Rmultiple= .73, F(4,15)=4.3, p<.05, with the Psychological health domain being the most affected (R2=.51), followed by Environment (R2=.36), Physical health (R2=.34), and Social relationships (R2=.33). The three types of emotional burden predict negatively on the four domains of quality of life, whereas Personal growth predicts positively on Psychological health, though with low magnitude (see Figure 1). The Subjective burden is the strongest predictive dimension of the four quality of life domains. Conclusions Since Subjective burden seems to be the main negative predictor of caregivers’ physical and psychological quality of life, it might be important that social and health services develop adequate responses in considering caregivers’ welfare when the well-being of children and adolescents with HIV is at stake. Key-words: Emotional burden; Quality of life; Caregivers; Children; HIV.
    Journal of the International AIDS Society 01/2014; 17(1):22-23. DOI:10.7448/IAS.17.2.19131 · 4.21 Impact Factor
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    Indian journal of social psychiatry 01/2006; 21((1-2):35.
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    ABSTRACT: Background: The evaluation of health-related quality of life in children with chronic diseases has gained increasing interest as they face a host of psychological and social problems that need to be considered along with their physical treatments (Malee et al., 2011; Wang et al., 2012). The aim of this research is to analyze the influence of physical well-being, family, and social support of children and adolescents with HIV on their self-perception, psychological well-being and emotions. Materials and Methods: The sample comprises children and adolescents with HIV recruited from the Consultation of Infectious Diseases of a Portuguese Pediatric Hospital, 11 boys aged between 8 and 17 years-old (M=11.73; SD=3.43) and 4 girls aged between 9 and 13 years-old /M=10.50; SD=1.92). They responded to six dimensions of the Portuguese version of the KIDSCREEN-52 (The Kidscreen Group Europe, 2006; consistency coefficient of .821). Results: The mean scores (from 0 to 100%) showed higher values for Social support and peers (M=90.8; SD=15.3), followed by Moods and Emotions (M=84.7; SD=16.7), Psychological Well-Being (M=84.6; SD=15.4), Relations with parents and home life (M=82.9; SD=14.5), Physical well-being (M=70.1; SD=33.3), and Self-perception (M=57.5; SD=13.7). Altogether, Relations with parents and home life, Physical well-being, and Social support and peers explained 40% of the children and adolescents’ Psychological well-being, 46% of their Moods and emotions, but only 5% of their Self-perception (see results of Multivariate Multiple Regression in Figure 1). The Relations with parents and home life didn’t show any significant influence. Inversely, the Physical well-being had a strong influence on Moods and emotions (β=.59) and Psychological well-being (β=.46), but less in Self-perception (β=.22). Social support and peers showed a positive albeit moderate influence in Psychological well-being (β=.25) and Moods and emotions (β=.28), but not in Self-perception. Conclusions: When considering the emotional and psychological health of young people with HIV, accounting for their physical well-being and supporting their socio-developmental tasks can serve as important protective factors, enhancing their quality of life and promoting more adaptive developmental pathways. Key-words: Children and adolescent; HIV; Psychological well-being; Physical Well-Being; Self-perception; Emotions; Social support.
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