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

Authors

  • 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

Keywords:

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

Abstract

              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.

References

1. World Health Organization. World health statistics 2015. Switzerland: World Health Organization; 2015.

2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, D.C: American Psychiatric Association; 2015.

3. The Department of Mental Health, Thailand, (database on the Internet); 2015 (cited Nov 2015). Available from: https://www.dmh.go.th/report/report1.asp

4. Kahn, R.S., & Sommer, I.E. The neurobiology and treatment of first-episode schizophrenia. Mol Psychiatry. 2015 20: 84–97

5. Martens, L., & Addington, J. The psychological well-being of family members of individuals with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2001 36:128-33.

6. Maj, M., Lopez-Ibor, J.J., Sartorius, N., Sato, M., & Okasha, A. Early detection and management of mental disorders. New Jersey: John Wiley & Sons; 2005.

7. Addington, J., Coldham, E.L., Jones, B., Ko, T., & Addington, D. The first episode of psychosis: the experience of relatives. Acta Psychiatr Scand. 2003 108(4):285-9.

8. McCann, T.V., Lubman, D.I., & Clark, E. First-time primary caregivers’ experience of caring for young adults with firstepisode psychosis. Schizophr Bull. 2009 37(2):381-8.

9. Meneghelli, A., Alpi, A., Pafumi, N., Patelli, G., Preti, A., & Cocchi, A. Expressed emotion in first-episode schizophrenia and in ultra high-risk patients: Results from the Programma2000 (Milan, Italy). Psychiatry Res. 2011. 189(3):331-8.

10. Tennakoon, L., Fannon, D., Doku, V., O’Ceallaigh, S., Soni William., Santamaria, M., Kuipers, E., & Sharma, T. Expeience of caregiving: relatives of people experiencing a first episode of psychosis. Brit J Psychiat. 2000 177:529-33.

11. Miller, R., & Mason, S.E. Shame and guilt in first-episode schizophrenia and schizoaffective disorders. J Contemp Psycho. 2005 35(2):211-21.


12. The Scottish schizophrenia research group. The Scottish first episode schizophrenia study IV. Psychiatric and social impact on relatives. Brit J Psychiat. 1987 150:340-412.

13. Ostman, M., & Hansson, L. Appraisal of caregiving, burden and psychological distress in relatives of psychiatric inpatients. Eur Psychiatry. 2004 19(7):402-7.

14. Mo, F., Chung, W., Wong, S., Chun, D., Wong, K., & Chan, S. Experience of caregiving in caregivers of patients with first episode psychosis. Hong Kong J Psychiatr. 2008 18:101-6.

15. Kuipers, E., Onwumere., & Bebbington, P. Cognitive model of caregiving in psychosis. Brit J Psychiat. 2010 196:259-65.

16. Franz, L., Carter, T., Leiner, A.S., Bergner, E., Thompson, N.J., Compton, M.T. Stigma and treatment delay in firstepisode psychosis: a grounded theory study. Early Interv Psychiatry. 2010 4(1):47-56.

17. Lazarus, R. S., & Folkman, S. Stress appraisal and coping. New York: Springer; 1984.

18. Czuchta, D.M.,& McCay, E. Help seeking for parents of individuals experiencing a first episode of schizophrenia. Arch Psychiatr Nurs. 2001 4 (8), 159-170.

19. Mo, F., Chung, W., Wong, S., Chun, D., Wong, K, & Chan, S. Experience of caregiving in caregivers of patients with first episode psychosis. Hong Kong J Psychiat. 2008 18:101-6.

20. Cotton, S.M., McCann, T.V., Gleeson, J.K., Crisp, K., Murphy, B.P., & Lubman, D.I. Coping strategies in carers of young people with a first episode of psychosis. Schizophr Res. 2013 146:118-24

21. Schefer, Coyne, & Lazarus. The health-related functions of social support. J Behav Med. 1981 4(4), 381-406.

22. Magliano, L., Fadden, G., Fiorillo, A., Malangone, C., Sorrentino, D., Robinson, A., Maj, M. Family burden and coping strategies in schizophrenia: are key relatives really different to other relatives?. Acta Psychiatr Scand, 1999 99 (1), 10-15.

23. Hazel, N.A., McDonell, M.G., Short, R.A., Berry, C.M., Voss, W.D., Rodgers, M.L., & Dyck, D.G. Impact of multiple-family groups for outpatients with schizophrenia on caregivers’ distress and resources. Psychiatr Serv, 2004. 55(1), 35-41.

24. Cohen, J. Statistical Power Analysis for the Behavioural Science (2nd ed.). New Jersey: Lawrence Erlbaum associates; 1988.

25. Moller-Leimkuhler, A.M. Burden of relatives and predictors of burden. Baseline results from the Munich 5 year follow up study on relatives of first hospitalized patients with schizophrenia or depression. Eur Arch Psychiatry Clin Neurosci. 2005 255:223-31.

26. Pipatananond, P, Boontong, T., Hanucharurnkul, S., Rujkorakarn, D., Vorapongsathorn T., & Sitthimongkol, Y. Caregiver burden predictive model: an empirical test among caregivers. Thai J Nurs Res. 2002 6(2):24-40.

27. Szmukler, G.I., Burgess, P., Herrman, H., & Benson, A. Caring for relatives with serious mental illness: the development of the experience of caregiving inventory. Soc Psychiatry Psychiatr Epidemiol. 1996 31:137-48.

28. Lazarus RS, Folkman S. Ways of coping (database on the Internet); 1985 (cited 15 Oct 2013). Available from: https:// caps.ucsf.edu/uploads/tools/surveys/pdf/Way%20 of%20coping.pdf

29. Lambert, V.A., et al. Cross-cultural comparison of workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses in Japan, Thailand, South Korea and the USA (Hawaii). Int J Nurs Stud. 2004 41(6):671-84.

30. Nilchaikovit, T., Sukying, C., & Silpakit, C. Reliability and validity of the Thai version of General Health Questionnaire. J Psychiatr Assoc Thailand. 1996 41(1): 2-17.

31. Munro, B. H., et al. Statistical methods for health care research (5th ed.). New York.JB. Lippincott; 2005.

32. Sandra, E.W., & Judith, C. D. Love, Loss, and Learning: The Experiences of Fathers Who Have Children Diagnosed With Schizophrenia. J Couns Dev. 2009 87:339-48.

33. Tanskanen S, Morant, N., Hinton, M., Lloyd-Evans, B., Crosby, M., Killaspy, H., Raine, R., Pilling, S., & Johnson, Sonia. Service user and carer experiences of seeking help for a first episode of psychosis: a UK qualitative study. BMC Psychiatry. 2011 11:157-68.

34. Gerson, R., Wong, C., Davidson, L., Malaspina, D., McGlashan, T., Corcoran, C. Self-reported coping strategies in families of patients in early stages of Psychotic disorder: an exploratory study. Early Interv Psychiatry. 2011 5(1): 76-80.

35. Ferriter M, & Huband, N. Experiences of parents with a son or daughter suffering from schizophrenia J Psychiatr Mental Health Nurs. 2003 10:552-60.

36. Sin, J, Moone, N., & Harris, P. Siblings of individuals with first-episode psychosis: understanding their experiences and needs. J Psychosoc Nurs Ment Health Serv. 2008 46(6):33-40.

37. Corcoran C, Gerson, R., Sills-Shahar, R., Nickou, C., McGlashan, T., Malaspina, D.,& Davidson, L. Trajectory to a first episode of psychosis: a qualitative Research study with families. Early Interv Psychiatry. 2007 1 308-15.

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Published

2016-07-11

How to Cite

1.
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 Nov. 5];20(3):183-95. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/42718

Issue

Vol. 20 No. 3 (2016): July-September 2016

Section

Original paper

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Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.