[Burden and perceived stress among informal caregivers of people suffering from mental disorders]. / Fardeau et stress perçu chez les proches aidants de personnes souffrant de troubles psychiques.

Informal caregivers of people with severe mental illness are particularly at risk of experiencing high levels of burden and perceived stress, which can worsen their global health. In addition, the semi-confinement in 2020 represented a period of additional difficulties for informal caregivers in French-speaking of Switzerland. The burden represents all the negative consequences linked to the informal caregiver role. Perceived stress is the way in which the informal caregiver will perceive a potentially threatening situation, according to their coping strategies and personal resources. Burden and perceived stress can be rapidly assessed in primary care, to suggest useful and effective support interventions to the informal caregivers.

Les proches aidants de personnes atteintes d'un trouble psychique sont particulièrement à risque de vivre des niveaux élevés de fardeau et de stress perçu, ce qui peut détériorer leur état de santé globale. En outre, le semi-confinement de 2020 a représenté une période de difficultés supplémentaires pour les proches en Suisse romande. Le fardeau représente l'ensemble des conséquences défavorables relatives au rôle d'aidant. Le stress perçu est la façon dont le proche aidant va percevoir une situation potentiellement menaçante, selon ses stratégies de coping et ses ressources personnelles. Fardeau et stress perçu peuvent être évalués de façon rapide déjà en soins de première ligne afin de proposer aux proches aidants une orientation vers des interventions de soutien utiles et efficaces.

A randomized controlled trial of a targeted support program for informal caregivers in adult psychiatry.

Background: The importance of informal caregivers for persons with severe mental illness has been demonstrated. However, this role may cause a high care burden that considerably affects caregiver health. The Ensemble program is a five-session brief individual intervention designed to support informal caregivers. This trial aimed to assess the efficacy of the program versus SAU (support as usual) for participants with a high care burden. Methods: A single-center randomized controlled trial including 149 participants was conducted. Caregivers in the intervention arm participated in the Ensemble program. The effects of the intervention were assessed using mixed models for repeated measures analysis of variance on improvements in informal caregivers' psychological health status, optimism levels, burden scores, and quality of life at three time points (T0 = pretest; T1 = posttest at 2 months, and T2 = follow-up at 4 months). Results: Analysis of the Global Psychological Index showed no significant effect at the two endpoints in favor of the Ensemble group. However, the Brief Symptom Inventory-Positive Symptom Distress Index was significantly lower at the two-month follow-up. A significant reduction in burden on the Zarit Burden Interview was observed post-intervention, along with an increase in optimism levels on the Life Orientation Test-Revised at follow-up in the Ensemble group. No significant differences were observed in quality of life. Clinical improvements in both psychological health status and burden levels were also identified. Conclusion: The Ensemble program offers an inclusive approach based on a recovery perspective that significantly reduces symptom distress and burden and increases optimism among informal caregivers.Clinical trial registration: https://clinicaltrials.gov/, NCT04020497.

[The Ensemble Program: Making sense of your actions through ACT]. / Programme Ensemble : redonner du sens à ses actions grâce à l'ACT.

The Ensemble program supports informal caregivers of people with mental health problems. Tailor-made support is offered in order to target the tools that will be most useful to them in their personal situation. Acceptance and commitment therapy can be used to help them give meaning to their actions.

Ability to Care for an Ill Loved One During the First COVID-19 Lockdown: Mediators of Informal Caregivers' Stress in Europe.

Informal caregivers are overlooked, healthcare actors. They are at particular risk of distress and suffer from poor mental health. This study aimed to investigate the perceived stress and modulating factors during the first COVID-19 lockdown in Europe, regardless of the illness that care recipients suffer from. Sociodemographic data, coping resources, and perceived stress level using the Perceived Stress Scale (PSS-10) questionnaire were assessed using a web-based survey in Switzerland, France, and Belgium with 232 informal caregivers. Mediation analyses were used to identify the factors that modulate stress. Higher perceived stress among informal caregivers was associated with a younger age for the care recipient, family relationship with the care recipient, cohabitation, and female sex of the informal caregiver. These associations were partially mediated by the fear of getting ill (age, cohabitation), the conviction that lockdowns had a negative impact on health (age, kinship), and the perceived deterioration of the care recipient's health (gender). The fear of losing the ability to cope with caregiving tasks due to an illness (COVID-19 and/or other) and the negative impact of the lockdown on care recipients' health, particularly on the mental health of young care recipients, increased the stress of informal caregivers. Our results emphasize the importance of informal caregiving support to prevent heightened stress in lockdown conditions, regardless of care recipient illness or kinship.

Ensemble programme for early intervention in informal caregivers of psychiatric adult patients: a protocol for a randomised controlled trial.

INTRODUCTION: Informal caregivers play a major role in the support and maintenance of community patients with severe psychiatric disorders. A pilot study showed that an individualised brief intervention such as the Ensemble programme leads to significant improvements in psychological health state and optimism. METHODS AND ANALYSIS: This randomised controlled trial aims to compare the efficacy of using Ensemble in improving informal caregivers' psychological health states and the ability to play an active role in their situations with that of support as usual. Improvements on the psychological health global index will be measured three times (T0-pre, T1-post and T3 2 months follow) with standardised questionnaires (the Global Severity Index of Brief Inventory Symptoms, the Life Orientation Test-Revised, the 36-item Medical Outcome Study Short-Form Health Survey and the French Zarit Burden Interview). Differences between groups in post-test and pretest values will be examined using an analysis of covariance for each outcome variable. The severity of illness measured by the Social and Occupational Functioning Assessment Scale will also be collected at T0 and T2 to compare eventual patient improvements. At the end of the programme, the experiences of the 20 patients participating in the Ensemble programme will be evaluated qualitatively. ETHICS AND DISSEMINATION: The research protocol received full authorisation from the Human Research Ethics Committee of the Vaud state, Switzerland. The principal paper will concern the results of the experimental design used to test the Ensemble programme. The research team will prioritise open access publications. TRIAL REGISTRATION NUMBER: NCT04020497.