Living with a Schizophrenic Patient: A Comparative Study of Burden as It Affects Parents and Spouses
Based on the analysis of 42 in-depth interviews, this article highlights different aspects of the subjective burden experienced by parents and spouses of patients suffering from schizophrenia. The onset of a schizophrenic disorder and acute episodes during the later course of the disease lead to considerable emotional distress for the patients' caregivers. In everyday life with the patient, parents and spouses experience a comparatively less dramatic chronic burden, which nevertheless can severely affect their living situation and well-being. Caregivers often feel disappointed and dissatisfied with the information and cooperation offered by psychiatric institutions. Parents and spouses perceive the caregiver burden differently, although there are some apparent similarities. The study reveals that the symptoms of a schizophrenic disorder as well as different family roles contribute to the subjective burden of parents and spouses. Supportive assistance for schizophrenic patients' caregivers should address their particular needs more adequately.
Available from: Alejandra Caqueo-Urizar
- "Finally, most of the studies show that the mother is the one who takes main care of the patient and has worse QOL than other type of informal caregivers caused likely by her caring chores [5,15,19,22,30,35,38]. "
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ABSTRACT: A couple of decades ago, hospitals or psychiatric institutions were in charge of caring for patients with schizophrenia; however, nowadays this role is performed by one or more patient's relatives. Evidence shows that informal caregivers experience negative changes in their quality of life (QOL). The aim of this study is to review the main factors associated with the QOL of caregivers of people with schizophrenia.
A search through databases from journals published last decade between 1998 and 2008 was performed. In accordance with the inclusion criteria, titles and abstracts of citations obtained from the search were examined independently by two authors and irrelevant articles discarded. The full text of those studies considered relevant by either reviewer were obtained and assessed independently. Where differences of opinion rose they were resolved by discussion. Out of the 258 references, 37 were included in the review. Studies which assessed factors associated with caregivers of people with schizophrenia's quality of life were included and the information summarized.
Evidence suggest that physical, emotional and economic distress affect negatively caregiver's QOL as a result of a number of unfulfilled needs such as, restoration of patient functioning in family and social roles, economic burden, lack of spare time, among other factors.
Decreased QOL may be associated with caregivers' burden, lack of social support, course of the disease and family relationships problems. In addition, in developing countries, QOL is affected by caregivers' economic burden. High quality research is needed in order to identify factors associated with QOL over time and testing the efficacy of interventions aiming to improve QOL in caregivers of patients with schizophrenia.
Available from: Marzieh Nojomi
- "Due to shortage of facilities, paying attention to patients and their families and providing a charge-free care was considered a great virtual support, which reduced their isolation and families' burden. There is a positive relationship between isolation and burden of caring for chronic mentally ill patients (Wolthause et al. 2002; Tsang et al. 2002; Jungbauer and Angermeyer 2002; Mueser et al. 1997; Schene et al. 1998; Raj et al. 1991; Oldridge and Hughes. 1992; North et al. 1998). "
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ABSTRACT: The objective of this study was to evaluate the effectiveness of case-management services and the feasibility of considering the Consumers' Family Members (CFM) as service providers in Iran as a developing country. Three trained case-managers were allocated into each group (Mental Health Worker-MHW and CFM), providing 12 months of home-visit services for 129 individuals with schizophrenia. Burden, knowledge, quality of life and the general health condition of the caregivers, as well as positive/negative symptoms and social skills of the consumers were evaluated. Most clinical variables were improved without significant differences between groups. The hospitalization rate was reduced by 67%.
Available from: Johannes Jungbauer
- "From our point of view, it is very significant that parents experience their relationships with their adult children as indissoluble, lifelong bonds. This is an important difference compared to spouses of mentally ill people, whose solidarity can terminate in situations of extreme burden (Mannion et al. 1994, Johnson 2000, Jungbauer & Angermeyer 2002). Furthermore, our results support the thesis derived from Carter and McGoldrick's (1989) family lifecycle model that schizophrenia causes considerable developmental problems for both patients and their parents. "
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ABSTRACT: In the past, family relationships of people with schizophrenia have mainly been investigated from a clinical viewpoint. The perspective of family development has generally been overlooked in this area of research.
This paper reports a study exploring problems of development and detachment in families with an adult child with schizophrenia.
Using in-depth interviews, 51 parents of people with schizophrenia were questioned about their living situations and relationships with patients.
Spatial separation from the family home was often complicated or even prevented entirely, with patients permanently living in their parents' household or in the same neighbourhood. Many patients remained dependent on their parents' emotional, practical and financial support. Typically, the parent-child relationship was re-intensified, often with a concurrent loss of social contacts outside the family. From a biographical point of view, schizophrenia often caused problems for families by making parenthood permanent and lifelong parental support necessary. Many parents had to revise their expectations of both their ill child's development and their own personal plans.
From the viewpoint of family psychology, schizophrenia is a serious obstacle to development that affects both patients and their parents. Family-related support should increasingly take into account the issue of the difficult detachment of patients from their parents.
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