Psychological Distress of Family Members Caring for a Relative with First Episode Schizophrenia


  • Suchanya Lohacheewa RN, PhD Candidate, Faculty of Nursing, Mahidol University, Thailand
  • Yajai Sitthimongkol RN, PhD, Associate Professor, Faculty of Nursing, Mahidol University, Thailand
  • Yupapin Sirapo-ngam RN, DSN, Associate Professor, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
  • Chukiat Viwatwongkasem PhD, Associate Professor, Department of Biostatistics, Faculty of Public Health, Mahidol University, Thailand


Appraisal, Coping; Family, First episode schizophrenia, Path analysis, Perceived social support, Psychological distress, Serious illness, Stress, Thailand


              The purpose of this study was to examine the pattern of relationships among factors related to psychological distress of family members caring for a relative with first episode schizophrenia. The conceptual model was built on Lazarus and Folkman’s theory of stress and coping. A total of 210 family members providing care for a relative with first episode schizophrenia were recruited from outpatient departments of three different psychiatric hospitals located in Bangkok and the surrounding vicinity. The Behaviors and Symptom Perception Scale, Social Support Questionnaire, Experience of Caring Inventory, Revised Way of Coping Questionnaire, General Health Questionnaire, and a demographics questionnaire were used to collect the data. Data was analyzed by descriptive statistics and path analysis.
                The results revealed that the modified model fitted the empirical data and explained 33% of the variance in the psychological distress. Appraisal of the stressful situation, and coping were associated with psychological distress of family members. Appraisal, both positive and negative perspectives, appeared to mediate the effects of the seriousness of illness and perceived social support on psychological distress. Coping was found to mediate the relationship between perceived social support and psychological distress. The results suggested that appraisal of the stressful situation and coping should be considered major influential factors when developing nursing interventions to attenuate psychological distress of family members caring for a relative with first episode schizophrenia. Psychiatric nurses should offer family members an opportunity to exchange information and share experiences with other family members so as to enable them to develop a positive appraisal, and strengthen the appropriate coping strategies to reduce their psychological distress.


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How to Cite

Lohacheewa S, Sitthimongkol Y, Sirapo-ngam Y, Viwatwongkasem C. Psychological Distress of Family Members Caring for a Relative with First Episode Schizophrenia. PRIJNR [Internet]. 2016 Jul. 11 [cited 2024 May 25];20(3):183-95. Available from:



Original paper