Effect of paliperidone palmitate treatment on disease family burden and rehabilitation effect in community schizophrenic patients / 上海预防医学

ObjectiveTo explore the effect of paliperidone palmitate treatment on schizophrenic patients in the community. Methods446 schizophrenic patients who used paliperidone palmitate injection were selected in Shanghai. Before and after the treatment， the disease family burden scale， the concise evaluation scale of drug treatment compliance， the VAS100 score of treatment satisfaction， the short form of quality of life measurement scale， and the screening scale of social function defects were used to evaluate the effects of paliperidone palmitate injection. The data were statistically analyzed using SPSS 26.0 software. ResultsAfter using paliperidone palmitate injection， the total score of family burden （13.94±12.17）， the score of daily family activities （3.26±2.74）， the score of family entertainment activities （2.21±2.30）， and the score of family relationship （2.79±2.76） were significantly higher than those before the treatment （14.98±12.64， 3.51±2.88， 2.48±2.38， 3.11±2.87， respectively， all with P<0.05）. The scores of the World Health Organization on quality of life brief scale （62.89±11.94） and the medication compliance scale （28.11±5.64） were better than those before treatment （60.67±12.62 and 27.37±6.96， all with P<0.05）. Compared with the prior treatment without paliperidone palmitate injection， the number of readmissions after treatment was significantly reduced （P<0.01）. ConclusionThe treatment of paliperidone palmitate injection has significant effect， which can effectively reduce the disease family burden of Schizophrenic patients， improve their quality of life， enhance their drug compliance， reduce the readmission rate of patients， ensure long-term treatment effect and promote disease recovery.

Reliability and validity of self-rated Family Burden Scale in families of the patients with anorexia nervosa / 上海交通大学学报（医学版）

Objective • To explore the reliability and validity of self-rated Family Burden Scale (FBS) evaluating caregiver burden in families of the patients with anorexia nervosa (AN). Methods • The study included female AN patients (n=103) treated in the Eating Disorder Center of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from Jul. 2017 to Jul. 2019 and their caregivers (parents, n=148). General demographic information of the patients and their caregivers, the course of illness and body mass index (BMI) of patients, and the time each caregiver spent in caring for the patient per day were recorded. FBS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the MOS item short form health survey (SF-36) were self-rated by the caregivers. One-third of the caregivers were selected by random number method for FBS rating by specialists. The reliability of the scale was evaluated by calculating Cronbach's α coefficient, self-rating and other-rating consistency and the consistency between husband and wife (41 couples). The validity of the scale was evaluated by calculating the correlation of FBS score with the course of disease, patients' BMI, the time spent in caring per day, scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36. Results • The Cronbach's α coefficient of FBS was 0.921, the correlation coefficient between self-rating and other-rating by specialists was 0.705 (P=0.000), and the correlation coefficient of consistency score between couples was 0.547 (P=0.000). FBS score showed no correlation with the course of disease, %BMI and the time spent in caring per day. Scores of BAI and BDI, and vitality, social function, role-emotion and mental health domain of SF-36 showed low correlation with FBS score (all P<0.05). Conclusion • Self-rated FBS shows good reliability when used in families of AN patients. The validity is not as ideal, which suggests further revision of the scale.

A cross sectional study of sociodemographic profile, disability and family burden in patients with obsessive compulsive disorder

Background: Obsessive compulsive disorder (OCD) is characterized by the presence of obsessions (intrusive and unwanted repetitive thoughts, urges, or impulses that often lead to a marked increase in anxiety or distress) and/ or compulsions (repeated behaviours or mental acts that are done in response to obsessions). OCD patients report general impairment in their functioning and family burden. They also suffer from disability in several areas of daily life.Methods: This study has a cross-sectional design, and author included total 200 consecutive selected OCD patients diagnosed according to International Classification of Disease (ICD)-10.Results: Most of respondent included in this study were married male (74%), belonged to Hindu religion and urban background (68%) with mean age of 33 year (SD=9.91), 88% subjects were found to be employed in this study, educated middle standard and above. In this study, maximum disability was noted in domains of work (mean score 1.10) and communication and understanding (mean score 0.70), the impairment in interpersonal activity was lesser (mean score 0.34). The domain in which the maximum burden was found among family members is disruption of routine/ family activities overall (52%).Conclusions: The study aimed at assessing the burden in families and disability in subjects having OCD. Subjects were of either sex having age 16 and above. All subjects were assessed using following structured clinical instruments, Yale-brown symptom check list, Yale-brown obsessive-compulsive symptom severity scale, family burden interview, and Indian disability evaluation and assessment scale.

Cuidadoras familiares de idosos dependentes: convivendo com perdas / Family caregivers of dependent elderly people: living with losses / Cuidadoras familiares de personas mayores dependientes: viviendo con pérdidas

Este artigo tem como objetivo investigar a vivência da mulher cuidadora familiar principal de idoso dependente. Foi realizada uma pesquisa qualitativa, na qual foram entrevistadas oito cuidadoras familiares principais. Do material discursivo, emergiram cinco categorias de análise. Conclui-seque a experiência de cuidar de idosos dependentes gera sobrecarga física e emocional, com prejuízos nas esferas,pessoal, familiar e social,davida da cuidadora familiar.

This article aims toinvestigatethe experience of the main female family caregiver of the elderly dependent. A qualitativestudy was carried out, in which eight main family caregivers were interviewed. From the discursive material, five categories of analysis emerged. It is concluded that the experience of caring for dependent elderly people generates physical and emotional overload,with losses in the personal, family and social spheres of the family caregiver's life.

Este artículo tiene como objetivo investigar la experiencia de la mujercuidadora principal familiar de ancianos dependientes. Se realizó una investigación cualitativa en la que se entrevistó a ocho mujeres cuidadoras familiares principales. Del material discursivo surgieron cinco categorías de análisis. Se concluye que la experiencia de cuidar a personas mayores dependientes genera sobrecarga física y emocional, con pérdidas en las esferas personales, familiares y sociales de la vida de la cuidadora familiar.

Study of disease burden of chronic hepatitis B and C patients in Shanghai based on Bronfenbrenner's ecological systems theory: a community-based survey / 中华流行病学杂志

Objective To systemically analyze family burden,quality of life of chronic hepatitis B and C patients in Shanghai and related influencing factors.Methods A representative sample of chronic hepatitis patients (n=1 478) and their family members (n=1 478) was randomly selected through a multi-stage cluster sampling from 30 communities in 10 districts of Shanghai.One patient and one family member of each family were interviewed using different questionnaires to collect related information.Based on Bronfenbrenner's ecological systems,psychological measurement,two-level random intercept model and multivariable structural equation model were applied to determine the effects and directions of the factors between life quality of chronic hepatitis patients and family burden.Results The mean score of quality of life of chronic hepatitis patients in Shanghai was 78.70 ± 13.25,the score of "specific module" was highest and the score of "social function" was lowest.Additionally,the mean score of burden reported by the family members was 12.62 ± 10.74,the score of"financial burden" was highest,and the score of"effect on family member's health" was lowest.Multivariable structural equation model indicated that eight factors were related with life quality and family burden of patients with chronic hepatitis.Among them,HCV infection,elevated serum alanine aminotransferase level,average monthly cost for patient ＞3 000 yuan (RMB) and poor health of family members were the direct risk factors for the life quality of the patients as well as family burden.The factor of drinking more than once a week influenced the patients' life quality directly and family burden indirectly.On the contrary,the factors of local household registration,hospitalization and family member's indifferent attitude to hepatitis B vaccination influenced the family burden of the chronic hepatitis patients directly and the life quality of the patients indirectly.Conclusion The findings could be used in the development of community based management and intervention of chronic hepatitis patients in Shanghai.

Correlation analysis of parental anxiety and depression and family burden of disease in children with type 1 diabetes mellitus / 中国实用护理杂志

Objective To investigate the status of family burden caused by anxiety and depression of parents and disease in children with type 1 diabetes mellitus to analyze the influence of family burden upon mental state of the parents. Methods Totally 100 parents from Shandong province whose children were diagnosed with type 1 diabetes mellitus were investigated with Self-Rating Anxiety Scale,Self-Rating Depression Sale and Family Burden Scale of Disease. Results The score of anxiety of parents was (46.22 ± 10.84) points while the score of depression was (49.20 ± 13.58) points, 98%(98/100) of the parents was influenced by family burden of disease. The higher the education level (F=4.874) and the monthly income(F=2.808),the lower the anxiety of parents,and the difference was statistically significant (P<0.05).Mothers had higher depression level than fathers(t=7.290).The higher the educational level(F=3.699), the lower the depression of parents, and the difference was statistically significant (P<0.05). Anxiety and depression of parents had positive correlation with family burden of disease(P<0.05 or 0.01). Conclusions The more serious burden of children with type 1 diabetes and their parents,the higher the level of anxiety and depression,which indicates that the nursing staff should pay special attention to the bad mood of parents with heavier burden in the process of nursing.and effective measurements should be taken to improve the unhealthy psychological state of parents. to provide a good family rehabilitation environment for children and to reduce the parents′unhealthy mood radically.

Study of disease burden of chronic hepatitis B and C patients in Shanghai based on Bronfenbrenner's ecological systems theory: a community-based survey / 中华流行病学杂志

Objective To systemically analyze family burden,quality of life of chronic hepatitis B and C patients in Shanghai and related influencing factors.Methods A representative sample of chronic hepatitis patients (n=1 478) and their family members (n=1 478) was randomly selected through a multi-stage cluster sampling from 30 communities in 10 districts of Shanghai.One patient and one family member of each family were interviewed using different questionnaires to collect related information.Based on Bronfenbrenner's ecological systems,psychological measurement,two-level random intercept model and multivariable structural equation model were applied to determine the effects and directions of the factors between life quality of chronic hepatitis patients and family burden.Results The mean score of quality of life of chronic hepatitis patients in Shanghai was 78.70 ± 13.25,the score of "specific module" was highest and the score of "social function" was lowest.Additionally,the mean score of burden reported by the family members was 12.62 ± 10.74,the score of"financial burden" was highest,and the score of"effect on family member's health" was lowest.Multivariable structural equation model indicated that eight factors were related with life quality and family burden of patients with chronic hepatitis.Among them,HCV infection,elevated serum alanine aminotransferase level,average monthly cost for patient ＞3 000 yuan (RMB) and poor health of family members were the direct risk factors for the life quality of the patients as well as family burden.The factor of drinking more than once a week influenced the patients' life quality directly and family burden indirectly.On the contrary,the factors of local household registration,hospitalization and family member's indifferent attitude to hepatitis B vaccination influenced the family burden of the chronic hepatitis patients directly and the life quality of the patients indirectly.Conclusion The findings could be used in the development of community based management and intervention of chronic hepatitis patients in Shanghai.

Factors Influencing Burden on the Primary Caregivers of Remitted Schizophrenic Outpatients / 대한정신분열병학회지

OBJECTIVES: The purpose of this study is to investigate the variables besides symptom that influence the family burden in the primary caregivers of remitted schizophrenic outpatients, and to evaluate the impact of changeable or unchangeable variables by clinical practice on the family burden. METHODS: A total 105 remitted schizophrenic outpatients and 105 their primary caregivers were participated in the psychiatric outpatient clinic of the university hospital. Socio-demographic characteristics (age, sex, education, income, marital status, religion), clinical variables (duration of illness, age of onset), patients' symptom (korean version of the positive and negative syndrome scale), patients' social function (korean version of the social functioning scale), patients' insight (self-appraisal of illness questionnaire), patients' attitude toward medication (drug attitude inventory), family perceived social support (multidimensional scale of perceived social support), family attitude toward patient (family attitude scale) were gathered from subjects. RESULTS: Total score of family burden scale (0–144) of the primary caregivers of remitted schizophrenic outpatients was 71.3 (SD 20.7) and mean score per item was 1.9. Unchangeable six variables by clinical practice (relation with patient, patients' education, age of onset, duration of illness, parent age, parent income) explain 17%, and changeable four variables (family attitude toward patient, family perceived social support, patients' social function, patients' insight) explain 72% of family burden. Four areas such as interpersonal communication, independence-performance, independence-competence, occupation/ employment explain family burden significantly in the seven areas of the social functioning scale. CONCLUSION: Primary caregivers of remitted schizophrenic outpatients feel burden considerably even though their ill relatives show few psychiatric symptoms. Changeable variables by clinical practice were more explanation than unchangeable variables on the family burden.

Factors Influencing Burden on the Primary Caregivers of Remitted Schizophrenic Outpatients / 대한정신분열병학회지

OBJECTIVES: The purpose of this study is to investigate the variables besides symptom that influence the family burden in the primary caregivers of remitted schizophrenic outpatients, and to evaluate the impact of changeable or unchangeable variables by clinical practice on the family burden. METHODS: A total 105 remitted schizophrenic outpatients and 105 their primary caregivers were participated in the psychiatric outpatient clinic of the university hospital. Socio-demographic characteristics (age, sex, education, income, marital status, religion), clinical variables (duration of illness, age of onset), patients' symptom (korean version of the positive and negative syndrome scale), patients' social function (korean version of the social functioning scale), patients' insight (self-appraisal of illness questionnaire), patients' attitude toward medication (drug attitude inventory), family perceived social support (multidimensional scale of perceived social support), family attitude toward patient (family attitude scale) were gathered from subjects. RESULTS: Total score of family burden scale (0–144) of the primary caregivers of remitted schizophrenic outpatients was 71.3 (SD 20.7) and mean score per item was 1.9. Unchangeable six variables by clinical practice (relation with patient, patients' education, age of onset, duration of illness, parent age, parent income) explain 17%, and changeable four variables (family attitude toward patient, family perceived social support, patients' social function, patients' insight) explain 72% of family burden. Four areas such as interpersonal communication, independence-performance, independence-competence, occupation/ employment explain family burden significantly in the seven areas of the social functioning scale. CONCLUSION: Primary caregivers of remitted schizophrenic outpatients feel burden considerably even though their ill relatives show few psychiatric symptoms. Changeable variables by clinical practice were more explanation than unchangeable variables on the family burden.

Influência do estresse e do sofrimento mental na sobrecarga do cuidador em saúde mental / The influence of stress and mental suffering in the burden of mental health caregiver

A demanda extra de cuidados é definida como sobrecarga e pode impactar a vida da família, considerando que a natureza crônica da doença mental submete o familiar ao efeito prolongado de eventos estressores envolvidos na experiência cotidiana de cuidar, o que pode afetar a sua própria saúde mental. Este estudo teve por objetivo avaliar a ocorrência de sobrecarga entre cuidadores de pessoas com transtorno mental em início de internação psiquiátrica e sua relação com a ocorrência de estresse e de sofrimento mental. Foi realizado um estudo epidemiológico, transversal, com duração de dois anos. Participaram do estudo 112 cuidadores, de ambos os sexos, maiores de 18 anos. Para coleta de dados foram utilizados: um questionário para coleta de dados sociodemográficos, de condições ocupacionais, de saúde e de conhecimento pelo cuidador a respeito da doença do paciente com transtorno mental; a Escala de Sobrecarga Zarit Burden Interview (ZBI); o Inventário de Sintomas de Stress para Adultos da LIPP (ISSL); e o Self-Reporting Questionnaire (SRQ 20). Utilizou-se estatísticas descritiva e analítica, com medidas de tendência central, testes Qui- Quadrado de Pearson, o Exato de Fisher e teste de Concordância Kappa, com coeficiente de correlação de Pearson e regressão logística. Foi considerado nível de significância de 0,05. Todos os aspectos éticos foram respeitados. Entre os cuidadores, houve predomínio do sexo feminino (82%), a maioria era casada ou possuía companheiro fixo (59%), e idade média de 49 anos. Os escores de sobrecarga entre os cuidadores variaram de 13 a 81 pontos, com média de 50,2. Evidenciou-se que apenas 3,6% destes cuidadores não apresentaram sobrecarga e que a maioria apresentava sobrecarga de moderada a severa; 79,5% apresentaram sintomas de estresse, sendo que a maioria estava na fase de estresse chamada de Resistência (52,7%) e com predomínio de sintomas psicológicos de estresse (66,1%); 67,9% dos cuidadores estavam em sofrimento mental. Houve associação com elevada significância estatística entre a sobrecarga destes cuidadores e a ocorrência de estresse e de sofrimento mental. Os sintomas psicológicos do estresse, como: preocupação, ansiedade e irritabilidade, foram fatores de risco para sobrecarga severa. Assim, os resultados deste estudo deflagram a alarmante situação dos cuidadores de pessoas com transtornos mentais em início de internação psiquiátrica, evidenciando sua situação de sobrecarga e vulnerabilidade ao adoecimento e ao sofrimento mental. Portanto, é evidente a necessidade de intervenções e estudos que visem ampliar e qualificar o cuidado a saúde destes familiares cuidadores

The extra demand for care is defined as burden and it can affect family life whereas mental illness chronic nature shall expose the family to the prolonged effect of stressful events involved in everyday experience of care, which can affect their own mental health. This study aimed to evaluate the burden occurrence among caregivers of patients in early psychiatric hospitalization and the relation with their stress and mental suffering. An epidemiological, cross-sectional study was conducted, lasting two years. A number of 112 family carers, older than 18 years old, participated in the study. For data collection, it was used: a questionnaire to collect sociodemographic data, occupational condition, health and knowledge by the caregiver about the mental disorder patient illness; Zarit Burden Interview (ZBI); Inventory of Stress Symptoms for Adults of Lipp (ISSL); and the Self-Reporting Questionnaire (SRQ 20). It was used descriptive and analytical statistics, performing chi-square tests of Pearson, Fisher's exact test and Kappa Agreement with Pearson's correlation coefficient and logistic regression, considering ,0.05 significance level. All ethical aspects were respected. There was a female predominance (82%), most of them were married (59%) and had an average age of 49 years old. The burden scores among carers ranged from 13 to 81 points, averaging 50.2. Only 3.6% of these caregivers did not show burden, and most of them had moderate to severe burden; 79.5% showed stress symptoms and most of them was in the phase of stress called resistance (52.7%), with a predominance of psychological symptoms of stress (66.1%); 67.9% of caregivers were in mental suffering. There was an association with high statistical significance between the burden of these caregivers and the occurrence of stress and mental suffering. Psychological symptoms of stress, such as worry, anxiety and irritability, were risk factors for severe burden. Thus, the results of this study trigger the alarming condition of the carers of people with mental disorders in early psychiatric hospitalization, indicating their vulnerability to illness and mental suffering. Therefore, it is clear the need for interventions and studies that aim to widen and improve the health care of these family caregivers

Carga familiar objetiva y subjetiva de pacientes con trastornos mentales severos a partir del family burden interview schedule

Resumen:“The Family Burden Interview Schedule – Short Form" (FBIS-SF) de Tesseler yGamache, es una entrevista que permite valorar la carga objetiva y subjetiva, querepresenta para las familias, el cuidado de pacientes con trastornos mentales severos.El Objetivo propuesto fue analizar la carga familiar objetiva y subjetiva.Material y Método: La Entrevista es de formato Modular (11 Módulos) conpuntuaciones independientes. Las áreas abordadas son carga objetiva y subjetiva enayuda familiar en actividades de la vida cotidiana, contención de comportamientosalterados, motivo de preocupación por el paciente, gastos económicos, cambios en larutina diaria del cuidador, motivos de preocupación por el paciente, ayuda quedispone el informante, repercusiones en la salud del cuidador, beneficios ygratificaciones, estigma y repercusión global del informante y del entrevistador. Cadamódulo se valora mediante respuestas. Dicotómicas y Escalas de tipo Likert,compuesto por diferentes números de ítems.La muestra poblacional fue seleccionada en 93 cuidadores mayores de 18 añosque lleven conviviendo más de 30 días con familiares donde se recopiló la informaciónde datos, tales como: edad, sexo y vinculación familiar.En la presente investigación se efectuó un análisis de la fiabilidad y deconsistencia interna, así como una adaptación semántica. Con los registros obtenidosdel instrumento se generó una base de datos a fin de estructurar organizativamentelas variables involucradas en el estudio...

Abstract:“The Family Burden Interview Schedule - Short Form” (FBIS-SF) of Tesselerand Gamache, it is a subjective interview that allows to value the objective load andthat represents for the families the care of patients with severe mental upheavals. Theobjective in this one investigation, it was to analyze the objective and subjectivefamiliar load.Matherials and methods: The interview is Modular format (11 you modulate)with independent ratings. The areas addressed are objective and subjective burden onfamily assistance in activities of daily living, containment of altered behavior, concernfor the patient, economic costs, changes in daily routine caregiver concerns by thepatient, help has the informant, impact on the caregiver's health, benefits and perks,stigma and overall impact of the informant and the interviewer. Each modulates isassessed by Dichotomous responses and Likert scales composed of differentnumbers of items. The population sample was selected in 93 caregivers aged 18 withcoexisting to over 30 days with relatives where information was collected dates, suchace age, sex and family ties. In the present investigation an internal analysis of thereliability and consistency ace well cultural ace to adaptation was made. With recordobtained from the instrument generated to variable database to organizationallystructure the involved in the study...

Study on factors associated with family burden of Alzheimer's disease / 中华流行病学杂志

Objective To understand the family burden of Alzheimer' s disease (AD) and associated factors.Methods The subjects were 168 caregivers of patients with AD selected from two class 3A hospitals and three communities in Taiyuan through cluster sampling.The data were collected by using the Caregiver Burden Inventory (CBI) and the Family Burden Scale (FBS) of diseases.Path analysis was applied to identify the factors associated with the total score of CBI.T-test and One-way analysis of variance were applied to identify the factors associated with the total score of FBS.Multiple linear regression analysis was applied to identify the factors associated with family burden of AD.Results The total score of the caregivers' burden was 52.41 ± 17.07.AD patients' cognitive function had direct (standardized β =-0.280,P＜0.001) and indirect effect on CBI;while daily performance of AD patients had indirect effect on CBI.The total score of family burden was 16.23 ± 9.00.Univariate analysis showed that the sex,age,education level,cognitive function,daily performance,mental status,depression and dementia rating of AD patients might affect the total score of FBS (P ＜ 0.05).Multivariate analysis showed that the factors which affected the total score of FBS included the sex (standardizedβ =0.280,P ＜ 0.01),cognitive function (standardizedβ =-0.158,P =0.033) and daily performance of AD patients (standardizedβ=-0.155,P=0.039).Conclusion The caregiver and family burden of AD was mainly associated with the cognitive function and daily performance of AD patients.It is necessary to take targeted measures to reduce the caregiver and family burden of AD.

Investigation and analysis of economic and family burden among patients with depression / 中国实用护理杂志

Objective To investigate and analyze the economic burden and family burden among patients with depression.Methods 180 patients who diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorders-version Ⅳ (DSM-Ⅳ) had been enrolled randomly.The self-made economic costs questionnaire and the Family Burden Scale of Diseases (FBS) were utilized for investigation.168 participants finished this study.Results The per capita total economic cost of patients was 21 650 Yuan,direct economic costs was 6 806 Yuan,indirect costs was 14 844 yuan.The total economic costs,direct economic costs and direct medical costs of hospitalized patients were significantly higher than outpatients.The total economic cost per capita,indirect economic costs,costs decreased by work delays and work ability impairment of urban patients were significantly higher than rural patients.Four factors of FBS such as subjective feeling,family life,home entertainment and mental health had higher positive answer rate,which was above 60％.The positive answer rate of family relationship and physical health was lower than 40％.Conclusions Patients with depression suffered high economic burden and family burden.

Sobrecarga do cuidado, solidariedade e estratégia de lida na experiência de familiares de Centros de Atenção Psicossocial / Family burden, support groups and coping style among family members of patients in Psychosocial Care Centers

Os familiares de usuários de serviços de saúde mental que assumem a tarefa do cuidado cotidiano são frequentemente submetidos a sobrecarga objetiva e subjetiva. Estratégias práticas de lidar com a tarefa do cuidado e ações de solidariedade entre familiares podem contribuir para a melhora da qualidade de vida de cuidadores e usuários. Este estudo descreve e analisa estratégia desenvolvida junto a serviços comunitários de saúde mental (CAPS), em colaboração com os familiares, de modo a conhecer melhor a experiência da sobrecarga e apoiar iniciativas de ajuda mútua, educação em saúde e promoção da autonomia. A coleta e análise dos dados utilizou metodologia qualitativa, como observação e grupos focais. Resultados preliminares identificam altos níveis de sobrecarga, boa resposta dos familiares à participação em grupos de ajuda mútua e atividades de educação em saúde, e a necessidade de aperfeiçoar e intensificar as ações desenvolvidas pelos CAPS para apoio e orientação dos familiares...

Family members of mental health service users who take everyday care are often subjected to objective and subjective burden. Practical strategies to deal with the task of care and solidarity actions between family members can help improve the quality of life of caregivers and users. This study describes and analyzes strategy developed with Psychosocial Care Centers (CAPS), in collaboration with the family, in order to better know the experience of overload and support self-help initiatives, health education and promotion of autonomy. The collection and analysis of data used qualitative methodology, such as observation and focus groups. Preliminary results identify high levels of overload, good response of family participation in self-help groups and health education activities, and the need to improve and intensify actions developed by CAPS for support and guidance of the family...

Stress and Family Burden in Mothers of Children with Disabilities.

The present study was designed to assess and compare parenting stress and family burden in mothers of children with disabilities and children without disability. For this purpose, a multi group design was adopted which consisted of five groups of mothers viz. mothers of children with mental disability, mothers of children with both mental and physical disability, mothers of children with physical disability, mothers of deaf and dumb children and mothers of children without disability. Parenting stress index and family burden scale were administered on 125 mothers of children with disabilities and without disability (25mothers in each group), selected from three districts of Haryana state. For statistical analysis, t- test, simple analysis of variance and Duncan‟s post hoc test were used. Results revealed that mothers of children with both mental and physical disability and mothers of children with mental disability scored significantly higher level of parenting stress and family burden compared to mothers of children with physical disability, mothers of deaf and dumb children, and mothers of children without disability.

Family Burden of Patients with Severe Mental Illness / 中国康复理论与实践

Objective To investigate the family burden of patients with severe mental illness. Methods 148 patients with schizophrenia and bipolar disorder were assessed with Family Burden Scale of disease (FBS). Results Family burden broadly exists among those patients with schizophrenia and bipolar disorder, and the burden tends to involve several dimensions, including family relations (51%), home enter-tainment (50%), daily routine (45%), economic burden (43%), mental health of family members (36%) and physical health of family mem-bers (32%). Conclusion Integrated psychological and social intervention should be made to reduce the family burden of patients with schizo-phrenia and bipolar disorder.

Family burden with substance dependence: a study from India.

Background & objectives: A substance dependent person in the family affects almost all aspects of family life. This leads to problems, difficulties or adverse events which impact the lives of family members and causes enormous burden on family caregivers. The present study aimed to assess the pattern of burden borne by the family caregivers of men with alcohol and opioid dependence. Methods: A cross-sectional study was conducted with ICD-10 diagnosed substance dependence subjects and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in north India. Family Burden Interview Schedule was used to assess the pattern of burden borne by the family caregivers of 120 men with alcohol and/or opioid dependence. Results: Compared to opioid and alcohol+opioid dependence groups, more often the alcohol dependence group was older, married, currently working, having a higher income and with the wife as a caregiver. Family burden was moderate or severe in 95-100 per cent cases in all three groups and more for ‘disruption of family routine’, ‘financial burden’, ‘disruption of family interactions’ and ‘disruption of family leisure’. Family burden was associated with low income and rural location. It was associated neither with age, education or duration of dependence of the patients, nor with family size, type of caregiver or caregiver’s education and occupation. Interpretation & conclusions: Almost all (95-100%) caregivers reported a moderate or severe burden, which indicates the gravity of the situation and the need for further work in this area.

The Reliability and Validity of the Korean Version of Burden Assessment Scale (K-BAS) / 신경정신의학

OBJECTIVES: This study was conducted for evaluation of the reliability and validity of the Korean version of the Burden Assessment Scale (K-BAS). METHODS: A sample of 256 first-order relatives of schizophrenics completed the K-BAS and the data were analyzed for internal consistency and factor structure. In addition, a subset of participants (n=112) refilled the K-BAS after two weeks for test-retest reliability. To test for validity, the Family Burden Scale (FBS), Korean version of Drug Attitude Inventory-10 (KDAI-10), and Korean version of the Scale to Assess Unawareness of Mental Disorder (SUMD-K) were administered. RESULTS: The Cronbach's alpha coefficient of the K-BAS was high (0.91), which provided evidence for good internal consistency. The test-retest reliability of K-BAS was 0.86 (correlation coefficient, p<0.001). Convergent validity was examined through correlations between the K-BAS and the FBS (r=0.80, p<0.001). Divergent validity was examined through correlations between the K-BAS and KDAI-10 (r=-0.21, p=0.001), and between the K-BAS and SUMD-K (r=-0.02, p=0.796). Results of the factor analysis revealed a three-factor solution: activity limitation, social strain, and feelings of worry and guilt. CONCLUSION: These results suggest that the K-BAS had good psychometric properties and may be a useful instrument for evaluation of burden of families with schizophrenics.

Disability in persons with Schizophrenia correlated to family burden and family distress among their caregivers.

Background: Families are the main support system or primary care givers for persons with Schizophrenia in India. Family burden and distress is a concern one should get acquainted about the disability of the client in relation to the accompanying world. Aim: To correlate the disability in persons with schizophrenia and family burden and distress among their caregivers. Objectives: (1) To assess the disability of persons with schizophrenia. (2) To assess the family burden among the caregivers of persons with schizophrenia. (3) To assess the family distress among the caregivers of persons with schizophrenia. (4) To correlate the disability of persons with schizophrenia and the family burden and family distress among their caregivers. Method: One hundred individuals diagnosed to be suffering from schizophrenia as per DSM IV or ICD – 10 criteria and hundred primary care givers were taken up for the study with their consent to participate after the intake screening. The data collected were primarily by interviewing & administering validated Indian research instruments Indian Disability Evaluation Assessment Schedule (IDEAS), Schedule for Assessment of Family Burden (SAFB), Schedule for Assessment of Family Distress (SAFD) to the client and the significant key relative or caregiver. Results: Among the participants 83% of clients found with mild to moderate disability. Majority (96%) of the key relatives had moderate to severe burden with a mean score of 1.27 + 0.863, and 46 percent had minimal distress and 50 percent had moderate to marked distress with mean score of 5.22 + 3.265. Conclusion: Level of disability does not affect the intensity or the severity of the family burden or distress experienced among their care givers. Hence psychosocial interventions are mandatory for reducing burden and distress among the primary care givers while intervening to reduce the level of the disability.

Evaluación de la sobrecarga de los cuidadores familiares de pacientes con esquizofrenia del hospital de psiquiatría "Dr. José María Alvarado" / Evaluation of the overload of family caregivers of patients with schizophrenia of the psychiatry hospital "Dr. José María Alvarado"

Objetivo. Analizar el concepto y conocer las características del cuidador informal. Material y Métodos. El presente estudio de tipo cuantitativo, descriptivo y de corte transversal, con la población que demanda asistencia sanitaria del Hospital de Psiquiatría "Dr. José María Alvarado", dependiente de la Caja Nacional de Salud, en la ciudad de La Paz, Bolivia. Se utilizó la entrevista de carga familiar objetiva y subjetiva (ECFOS). El ECFOS se ha desarrollado tomando como base "The Family Burden Interview Schedule-Short Form" (FBIS/SF). Resultados. En general podemos decir que el perfil del cuidador es el de una mujer (84,2%), de alrededor de 60 años. Normalmente madre del paciente (72,5 %), que no trabaja, pasa con el enfermo más de 4 horas al día (75%), afirma mantener una buena relación con el paciente y que no piensa que el enfermo sea una Carga Negativa ni para ella ni para su familia. Conclusiones. Se debe realizar intervenciones con los familiares de los pacientes esquizofrénicos. Se debe incorporar los programas de psicoeducación familiar debido que han demostrado su utilidad para prevenir recaídas y reducir la tensión familiar.

Objective. To analyze the concept and to know the characteristics of the informal caregiver. Material and Methods. The present study of quantitative, descriptive type and of cross section, with the population that demands medical assistance of the Hospital of Psychiatry "Dr. Jose Maria Alvarado", employee of Caja Nacional de Salud, from La Paz, Bolivia. The interview of objective and subjective familiar load was used (ECFOS). The ECFOS has been developed based on "The Family Burden Interview Schedule-Short Form" (FBIS/SF). Results. In general the profile of the caregiver is that of a woman (84.2%), of around 60 years of age. Normally mother of the patient (72.5%), who does not work, spends more than 4 hours a day with the patient (75%), claims to maintain a good relation with the patient and who does not think that the patient is a Negative load neither for her nor for her family. Conclusions. Interventions with the relatives of the schizophrenic patients should be effected. The programs of familiar psycho education should be incorporated, since they have proven efficient to prevent relapses and to reduce the familiar tensión.