Effectiveness of the enhanced psychological well-being intervention on the psychological well-being and the burden of care for family caregivers of the persons with schizophrenia 10.55131/jphd/2022/200312
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Abstract
Most of the family-based interventions focus on assisting patients more than the family caregivers. Family caregivers of persons with schizophrenia require intervention that focuses more on their strengths than on solving problems for persons with schizophrenia. Of 127 family caregivers of persons with schizophrenia, 63 were in the intervention group and 64 were in the control group. The 4 sessions of intervention were held every other week. All participants were assessed for psychological well-being and burden of care at pre-intervention, post-intervention, and at 3 months follow up. After receiving the intervention, the intervention group had a significant increase in psychological well-being but did not have a significant decrease in the burden of care. Further research is needed to develop specific interventions to better alleviate the burden of care for family caregivers, which might include skill-building and psychoeducation to care for persons with schizophrenia.
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References
World Health Organization. Schizophrenia [Internet]. 2018. Available from: https://www.who.int/ en/news-room/fact-sheets/detail/ schizophrenia.
Kwansanit P, Srisurapanont M. The parameters for calculating the burden of schizophrenia in Thailand. J Ment Health Thai [Internet]. 2018 [cited 2022 May 20]; 26(1): 50-62. Available from: https://he01.tci-thaijo.org/index.php/ jmht/ article/view/142991
Tamizi Z, Fallahi-Khoshknab M, Dalvandi A, Mohammadi-Shahboulaghi F, Mohammadi E, Bakhshi E. Caregiving burden in family caregivers of patients with schizophrenia: A qualitative study. J Educ Health Promot [Internet]. 2020 [cited 2022 May 15]; 9:12. doi: 10.4103/jehp.jehp_356_19.
Kttiratanapiboon P, Rojanalapa S, editor. mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health setting. Version 2.0. Bangkok: WHO; 2016.
Chang CC, Yen CF, Jang FL, Su JA, Lin CY. Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan. J Nerv Ment Dis [Internet]. 2017 [cited 2022 May 20];205(7):542-9. doi:10.1097/NMD.0000000000000 671.
Chang CC, Su JA, Chang KC, Lin CY, Koschorke M, Rüsch N, et al. Development of the Family Stigma Stress Scale (FSSS) for Detecting Stigma Stress in Caregivers of People With Mental Illness. Evaluation & the Health Professions [Internet]. 2019 [cited 2022 May 20]; 42(2):148-68. doi:10.1177/0163278717745658
Hegde A, Chakrabarti S, Grover S. Caregiver distress in schizophrenia and mood disorders: the role of illness-related stressors and caregiver-related factors. Nord J Psychiatry [Internet]. 2019 [cited 2022 May 15];73(1):64-72. doi: 10.1080/08039488.2018.1561945.
Sharma R, Sharma SC, Pradhan SN. Assessing Caregiver Burden in Caregivers of Patients with Schizophrenia and Bipolar Affective Disorder in Kathmandu Medical College. J Nepal Health Res Counc [Internet]. 2018 [cited 2022 May 15];15(3): 258-263. doi: 10.3126/jnhrc. v15i3.18851.
Zhou Y, Ning Y, Rosenheck R, Sun B, Zhang J, Ou Y, et al. Effect of living with patients on caregiver burden of individual with schizophrenia in China. Psychiatry Res [Internet]. 2016 [cited 2020 Apr 2];245:230-237. doi 10.1016/j.psychres.2016.08.046
Perceived burden and family functioning among informal caregivers of individuals living with schizophrenia in Tanzania: a cross-sectional study. BMC Psychiatry [Internet]. 2022 [cited 2022 May 15]; 22(1):1-12. doi: 10.1186/s12888-021-03560-0
Gupta A, Solanki RK, Koolwal GD, Gehlot S. Psychological well-being and burden in caregivers of patients with schizophrenia. IJMSPH [Internet]. 2015 [cited 2020 Apr 2];4(1):70-76. doi 10.5455/ijmsph.2015.0817201416
Okpokoro U, Adams CE, Sampson S. Family intervention for schizophrenia. Cochrane Database Syst Rev [Internet]. 2014 [cited 2020 Apr 2]; (3). Available from: https://www.cochranelibrary. com/cdsr/doi/10.1002/14651858.CD009802.pub2/full
Pharoah F, Mari J, Rathbone J, Wong W. Family intervention for schizophrenia. Cochrane Database Syst Rev [Internet]. 2010 [cited 2020 Apr 2]; (12). Available from: https://www. cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000088.pub3/full
Durmaz H, Okanli A. Effects of Interpersonal Psychotherapy (IPT) Techniques and Psychoeducation on Self-Efficacy and Care Burden in Families of Patients with Schizophrenia. Am. J. Fam. Ther [Internet]. 2021 [cited 2022 May 18]; 49(4): 373-391. doi: 10.1080/ 01926187.2020.1820401
Ashcroft K, Kim E, Elefant E, Benson C, Carter J A. Meta-Analysis of Caregiver-Directed Psychosocial Interventions for Schizophrenia. Community Mental Health Journal [Internet]. [cited 2022 May 18] 2018;54:983–91. doi: 10.1007/s10597-018-0289-x
Zhang X, Zhao M, Li J, Shi L, Xu X, Dai Q, et al. Associations between family cohesion, adaptability, and functioning of patients with bipolar disorder with clinical syndromes in Hebei, China. Int. J. Med. Res [Internet]. 2019 [cited 2022 May 20]; 47(12):6004-15. doi:10.1177/ 0300060519877030
Verma PK, Walia TS, Chaudhury S, Srivastava S. Family psychoeducation with caregivers of schizophrenia patients: Impact on perceived quality of life. Ind Psychiatry J [Internet]. 2019[cited 2022 May 18] 2019; 28(1): 19-23. doi: 10.4103/ipj.ipj_2_19
Gutierrez-Maldonado J, Caqueo-Urizar A. Effectiveness of a psycho-educational intervention for reducing burden in latin american families of patients with schizophrenia. Qual Life Res [Internet]. 2007[cited 2020 Apr 2];16(5):739-47. doi: 10.1007/s11136-007-9173-9
Chien W-T, norman I, Thompson DR. A randomized controlled trial of a mutual support group for family caregivers of patients with schizophrenia. Int J Nurs Stud [Internet]. 2004 [cited 2020 Apr 2];41(6):637-49. doi: 10.1016/ j.ijnurstu.2004.01.010
Martín-Carrasco M, Fernández-Catalina P, Domínguez-Panchón AI, Gonçalves-Pereira M, González-Fraile E, Muñoz-Hermoso P, et al. A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia. Eur Psychiatry [Internet]. 2016 [cited 2020 Apr 2];33:9-17. doi: 10.1016/ j.eurpsy.2016.01.003
Bernard, R. Foundamentals of Biostatistics. 7 ed. 2011. Canada: BROOKS/ COLE, CENGAGE Learning.
Purposive sampling. US: Lund Research [Internet]. 2012 [cited 2020 Aug 1]. Available from: http:// dissertation.laerd.com/purposive-sampling.php
Given LM. The Sage Encyclopedia of Qualitative Research Methods Volume 2. LA: Sage; 2008.
Purposive sampling. US: Business Research Methodology [Internet]. 2017 [cite 2020 Aug 1]. Available from: https://research-methodology.net/ sampling-in-primary-data-collection/purposive-sampling/
Thyer BA. Quasi-Experimental Research Designs. New York: Oxford University Press; 2012.
Ryff CD. Psychological Well-Being Revisited: Advances in the Science and Practice of Eudaimonia. Psychother and Psychosom. 2013;83(1):10-28. doi: 10.1159/000353263
Ryff CD, Lachman ME, Mailick Marsha, and Radler Barry. Midlife in the United States (MIDUS 3): Retention Early Warning Project, 2018-2019. Inter-university Consortium for Political and Social Research. US: NACDA [Internet]. 2021 [cited 2021 Nov 29]. Available from: https:// doi.org/10.3886/ICPSR38291.v1
Ryff CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Pers Soc Psychol [Internet]. 1989;57(6):1069-81. Available from: https://doi.org/ 10.1037/0022-3514.57.6.1069
26.Ryff CD. 14-items handout of Psychological Well-Being Scale [unpublished work]. US: University of Wisconsin, Institute on Aging; 2012.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. J Adv Nurs. 2001; 25(24):3186-91. doi: 10.1097/00007632-200012150-00014
Sawasdipanich N, Tiansawad S. Instrument Translation for Cross-Cultural Research: Technique and Issues to be considered. TJNC [internet]. 2011 [cited 2020 Apr 2];26(1):19-28. Available from: https://he02.tci-thaijo.org/index.php/ TJONC/article/view/2652
Cha Eun-Seok, Kim KH, Erlen JA. Translation of scales in cross-cultural research: issues and techniques. J Adv Nurs. 2007 [cited 2020 Apr 2];58(4):386-95. doi: 10.1111/j.1365-2648.2007.04242.x
Chan TSF, Lam LCW, Chiu HFK. Validation of the Chinese version of the Zarit Burden Interview. Hong Kong Journal of Psychiatry [Internet]. 2005 [cited 2020 Apr 2];15(1):9-13. Available from: https://psycnet.apa. org/record/2005-14575-003
Zarit SH. Zarit Burden Interview (ZBI). US :Mapi Research Trust [Internet]. 2016 [cited 2019 Jan 15]. Available from: https://eprovide.mapi-trust.org/ instruments/zarit-burden-interview
Lin CY, Ku LE, Pakpour AH. Measurement invariance across educational levels and gender in 12-item Zarit Burden Interview (ZBI) on caregivers of people with dementia. Int. Psychogeriatr. 2017;29(11):1841–8. doi: 10.1017/S1041610217001417.
Lin CY, Wang JD, Pai MC, Ku LJE. Measuring burden in dementia caregivers: Confirmatory factor analysis for short forms of the Zarit Burden Interview. Arch Gerontol Geriatr. 2017;69:8-13. doi: 10.1016/ j.archger.2016.08.005
Validity and Reliability of the Zarit Burden Interview in Assessing Caregiving Burden. Ann Acad Med Singap [Internet]. 2010 [cited 2019 Jan 15]; 39(10):758-63. Available from: https://tsaofoundation.org/doc/Zarit_Validation_Sin.pdf
Silpakit O, Silpakit C, Chomchuen R. Psychometric study of the Thai version of Zarit Burden Interview in psychiatric caregivers. J Ment Health Thai [Internet]. 2015 [cited 2020 Apr 2]; 23(1):12-23. Available from: https:// pubmed.ncbi.nlm.nih.gov/32122404/
36.Rothwell J. ANCOVA (Analysis of Covariance) [Internet]. UK: University of Sheffield [Internet]. 2020 [cited 2020 Jan 15]. Available from: https://www. sheffield.ac.uk/polopoly_fs/1.531229!/file/MASH_ANCOVA_SPSS.pdf.
Andrew UoS. ANOVA & ANCOVA. UK: University of Saint Andrew [Internet]. 2020 [cited 2020 Jan 15]. Available from: https://www.st-andrews.ac.uk/media/capod/students/mathssupport/ANOVA.pdf.
Lund A, Lund M. one-way ANCOVA in SPSS statistics. UK: Laerd Statistics [Internet]. 2018 [cited 2020 Jan 15]. Available from: https://statistics.laerd. com/spss-tutorials/ancova-using-spss-statistics.php
Lyubomirsky S, Sheldon KM, Schkade D. Pursuing happiness: The architecture of sustainable change. Rev Gen Psychol. 2005;9(2):111-31. doi.org/ 10.1037/1089-2680.9.2.111
Ryff CD. Psychological Well-Being in Adult Life. Curr Dir Psychol Sci [Internet]. 1995 [cited 2020 Apr 2]; 4(4):99-104. Available from: https:// www.jstor.org/stable/20182342
Dweck Carol S. Mindset: The New Psychology of Success. US: Ballentine Books; 2006.
Hefferon K, Boniwell I. Positive Psychology Intervention in Positive Psychology. UK: Open University Press; 2011. p.150-174.
Ruini C, Fava GA. Role of Well-Being Therapy in Achieving a Balanced and Individualized Path to Optimal Functioning. Clin Psychol Psychother 2012;19(4):291-304. doi: 10.1002/ cpp.1796
Fava GA. Well-Being Therapy: Current Indications and Emerging Perspectives. Psychothe Psychosom 2016;85(3):136-45. doi: 10.1159/000444114
Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. J Psychosom Res 2004;57(1): 35-43. doi: 10.1016/S0022-3999(03) 00573-7
Bohlmeijer E, Prenger R, Taal E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: A meta-analysis. J Psychosom Res 2010;68(6):539-44. doi: 10.1016/j.jpsychores.2009.10.005
Young LA, Baime MJ. Mindfulness-based stress reduction: Effect on emotional distress in older adults. J Evid Based Complementary Altern Med 2010;15(2):59-64. doi: 10.1177/ 1533210110387687
Gallegos AM, Hoerger M, Talbot NL, Krasner MS, Knight JM, Moynihan JA, et al. Toward Identifying the Effects of the Specific Components of Mindfulness-Based Stress Reduction on Biologic and Emotional Outcomes Among Older Adults. J Altern Complement Med 2013;19(10):787-792. doi:10.1089/acm.2012.0028
Robert-McComb JJ, Cisneros A, Tacón A, Panike R, Norman R, Qian X-P, et al. The Effects of Mindfulness-Based Movement on Parameters of Stress. Int J Yoga Therap 2015;25(1):79-88. doi: 10.17761/1531-2054-25.1.79
Chesak SS, Khalsa TK, Bhagra A, Jenkins SM, Bauer BA, Sood A. Stress Management and Resiliency Training for public school teachers and staff: A novel intervention to enhance resilience and positively impact student interactions. Complement Ther Clin 2019;37:32-38. doi: 10.1016/j.ctcp. 2019.08.001
Nyklíček I, Kuijpers KF. Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism? Ann Behav Med 2008;35:331-340. doi: 10.1007/s12160-008-9030-2
Weston SJ, Lewis NA, Hill PL. Building sense of purpose in older adulthood: Examining the role of supportive relationships. J Posit Psychol 2020;16(3):398-406. doi: 10.1080/17439760.2020.1725607
Heekerens JB, Eid M. Inducing positive affect and positive future expectations using the best-possible-self intervention: A systematic review and meta-analysis. J Posit Psychol 2020; 16(3):322-347. doi: 10.1080/17439760. 2020.1716052
Altintas E, Karaca Y, Moustafa A, El Haj M. Effect of Best Possible Self Intervention on Situational Motivation and Commitment in Academic Context. Learn Motiv 2020;69(2):101599. doi: 10.1016/j.lmot.2019.101599
Enrique Roig Á, Bretón-López J, Molinari G, Baños R, Botella C. Efficacy of an adaptation of the Best Possible Self intervention implemented through positive technology: a randomized control trial. Appl Res Qual Life 2017;13(3):671–689. doi: 10.1007/ s11482-017-9552-5
Bean MR. Best possible future self writing : effects on well-being, self-regulation, and related processes. [dissertation]. Sheffield: Sheffield Hallam University; 2019. Available from: http://shura.shu.ac.uk/24808/
King LA. The health benefits of writing about life goals. Pers Soc Psychol Bull. 2001;27(7):798-807. doi: 10.1177/ 0146167201277003
Harrist S, Carlozzi BL, McGovern AR, Harrist AW. Benefits of expressive writing and expressive talking about life goals. J Res Pers. 2007;40:923-930. doi: 10.1016/j.jrp.2006.09.002
Sabo Mordechay D, Nir B, Eviatar Z. Expressive writing - Who is it good for? Individual differences in the improvement of mental health resulting from expressive writing. Complement Ther Clin Pract. 2019;37:115-121. doi: 10.1016/j.ctcp.2019.101064
Sweeney LG, L'Abate L. Research on Writing Approaches in Mental Health. USA: Emerald Group Publishing Limited; 2011.
Jungbauer J, Wittmund B, Dietrich S, Angermeyer MC. Subjective burden over 12 months in parents of patients with Schizophrenia. Arch Psychiatr Nurs [Internet]. 2003;17(3):126-134. doi: 10.1016/s0883-9417(03)00056-6
Chareanchum A. Psychological experiences of family caregivers in caring for Schizophrenic patients. Master [Dessertation]. Bangkok: Chulalongkorn University; 2008.
Perlick DA, Rosenheck RA, Kaczynski R, Swartz MS, Canive JM, Lieberman JA. Impact of antipsychotic medication on family burden in schizophrenia: Longitudinal results of CATIE trial. Schizophr Res 2010;116(2–3):118-125. doi: 10.1016/j.schres.2009.09.026
Rhee TG, Rosenheck RA. Does improvement in symptoms and quality of life in chronic schizophrenia reduce family caregiver Burden? Psychiatry Res 2019 ;271:402-404. doi: 10.1016/j.psychres.2018.12.005
Koç M, Tel H, Karakülah K. Determining care burden and psychiatric symptom level in caregiver of schizophrenia patient. Perspect Psychiatr Care 2021; 57(2): 642-7. doi: 10.1111/ppc.12588
Hsiao, C.-Y., Lu, H.-L., Hsieh, M.-H., & Tsai, Y.-F. Effectiveness of a brief family strengths-oriented therapeutic conversation intervention for patients with schizophrenia and their caregivers. J Nurs Scholarsh 2022; 54(2): 213– 25. doi: 10.1111/jnu.12741 Verma, Pankaj
Alexandra P, Konstantinos K, Clive R, Economou M P. Effects of Group Psychoeducational Intervention for Family Members of People with Schizophrenia Spectrum Disorders: Results on Family Cohesion, Caregiver Burden, and Caregiver Depressive Symptoms. Int J Ment Health 201; 44(4): 277-289. doi : 10.1080/ 00207411.2015.1076291
Kretchy IA, Osafo J, Agyemang SA, Appiah B, Nonvignon J. Psychological burden and caregiver-reported non-adherence to psychotropic medications among patients with schizophrenia. Psychiatry Res 2018;259:289-294. doi: 10.1016/j.psychres.2017.10.034
Webb C, Pfeiffer M, Mueser KT, Gladis M, Mensch E, DeGirolamo J, et al. Burden and well-being of caregivers for the severely mentally ill: the role of coping style and social support. Schizophrenia Res 1998;34(3):169-80. doi: 10.1016/s0920-9964(98)00089-9