Effects of a psychoeducational intervention program on the attitudes and health perceptions of relatives of patients with schizophrenia

  • José Gutiérrez-Maldonado
  • Alejandra Caqueo-Urízar
  • Marta Ferrer-García
ORIGINAL PAPER

Abstract

Background

In recent years there has been increased interest in the role played by families in the treatment of patients with schizophrenia. Some family interventions may significantly reduce clinical difficulties and may have a positive impact, both emotionally and economically. The aim of this study is to assess the efficacy of a family psychoeducational program in changing attitude and health perceptions in relatives of patients with schizophrenia.

Methods

Sample: 45 relatives, key caregivers of patients with schizophrenia seen at a public mental health outpatient centre in Arica (Chile).

Instruments

Attitudes of Relatives toward Schizophrenia Questionnaire and General Health Questionnaire SF-36.

Procedure

The sample was randomly divided into a control group, in which caregivers received the usual treatment (a monthly interview with a psychiatric nurse), and an experimental group, which participated in a family psychoeducational intervention program in addition to the usual treatment. Medication of patients remained unchanged in both groups.

Results

The psychoeducational program was effective in modifying caregivers’ attitudes. However, it had no effect on their health perceptions.

Conclusions

This family psychoeducational treatment program modifies the negative attitudes of relatives towards schizophrenia. However, programs of this kind may not improve health problems; alternatively, their effects may only be seen in the long term.

Keywords

mental health  continuity of care  community medicine psychoeducation 

Notes

Acknowledgments

This work was supported by Ministerio de Educación y Ciencia, Spain. Grants: SEJ2006-14301. Consolider Project “Nuevas tecnologías de la información y la comunicación: integración y consolidación de su uso en ciencias sociales para mejorar la salud, la calidad de vida y el bienestar”, and the research project SEJ2005-09170-C04-01.

References

  1. 1.
    Alonso J, Prieto L, Antó J (1995) La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de los resultados clínicos. Med Clin (Barc) 10:771–776Google Scholar
  2. 2.
    Anderson C, Reiss D, Hogarty G (1986) Taller de supervivencia. In: Anderson C, Reiss D, Hogarty G (eds) Esquizofrenia y familia. Guía práctica de psicoeducación. Amorrortu, New York, pp 110–190Google Scholar
  3. 3.
    Barrowclough C, Terrier N (1995) Intervención con las familias. In: Barrowclough C, Tarrier N (eds) El tratamiento psicológico de la Esquizofrenia. Editorial Ariel, Barcelona, pp 69–99Google Scholar
  4. 4.
    Belloso J, García B, de Prado E (2000) Intervención psicoeducativa en un centro de rehabilitación psicosocial. Rev Asoc Esp Neuropsiquiatr XX(73):23–40Google Scholar
  5. 5.
    Berenstein I (1987) Familia y Enfermedad mental. Editorial Paidós, Buenos AiresGoogle Scholar
  6. 6.
    Berglund N, Olof J, Edman A (2003) Family intervention in schizophrenia. Impact on family burden and attitude. Soc Psychiatry Psychiatr Epidemiol 38:116–121PubMedCrossRefGoogle Scholar
  7. 7.
    Butzlaff R, Hooley J (1998) Expressed emotion and psychiatric relapse. Arch Gen Psychiatry 55(6):547–551PubMedCrossRefGoogle Scholar
  8. 8.
    Caqueo-Urízar A, Gutiérrez-Maldonado J (2006) Burden of care in families of patients with schizophrenia. Qual Life Res 15(4):719–724PubMedCrossRefGoogle Scholar
  9. 9.
    Girón M, Gómez M (2004) Relationship between family attitude and social functioning in schizophrenia. J Nerv Ment Dis 192(6):414–420PubMedCrossRefGoogle Scholar
  10. 10.
    Gutiérrez-Maldonado J, Caqueo-Urízar A (2003) Cuestionario de Actitudes hacia la Esquizofrenia para Familiares (unpublished manuscript)Google Scholar
  11. 11.
    Gutiérrez-Maldonado J, Caqueo-Urízar A (2007) Effectiveness of a psycho-educational intervention for reducing burden in latin american families of patients with schizophrenia. Qual Life Res 16(5):739–747PubMedCrossRefGoogle Scholar
  12. 12.
    Gutiérrez-Maldonado J, Caqueo-Urízar A, Ferrer-García M (2006) Esquizotipia en familiares de pacientes con esquizofrenia en una muestra latinoamericana. Psicothema 18(3): 433–438PubMedGoogle Scholar
  13. 13.
    Gutiérrez-Maldonado J, Caqueo-Urízar A, Kavanagh DJ (2005) Burden of care and general health in families of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 40: 899–904PubMedCrossRefGoogle Scholar
  14. 14.
    Hare R, Rogers H, Lester H, McManus R, Mant J (2006) What do stroke patients and their carers want from community services? Fam Pract 23(1):131–136PubMedCrossRefGoogle Scholar
  15. 15.
    Kavanagh D, O’Halloran P, Manicavasagar V, Clark D, Piatkowska O, Tennant C, Rosen A (1997) The family attitude scale: reliabity and validity of a new scale for measuring the emotional climate of families. Psychiatry Res 70:185–195PubMedCrossRefGoogle Scholar
  16. 16.
    Kazarian SS, Vanderheyden DA (1992) Family education of relatives of people with psychiatric disability: a review. Psychosoc Rehabil J 15:67–84Google Scholar
  17. 17.
    King S (2000) Is expressed emotion cause or effect in the mothers of schizophrenic young adults? Schizophr Res 45:65–78PubMedCrossRefGoogle Scholar
  18. 18.
    Leff J, Berkowitz R, Shavit N, Strachan A, Glass I, Vaughn C (1990) A trial of family therapy versus a relatives group for schizophrenia. Two-year follow-up. Br J Psychiatry 157:571–577PubMedCrossRefGoogle Scholar
  19. 19.
    Losada A, Izal M, Montorio I, Márquez M, Pérez G (2004) Eficacia de dos intervenciones psicoeducativas para cuidadores de familiares con demencia. Rev Neurol 38(8):701–708Google Scholar
  20. 20.
    Magliano L, Fadden G, Economou M, Held T, Xavier M, Guarneri M, Malangone C, Marasco C, Mm Maj (2000) Family burden and coping strategies in schizophrenia: 1-year follow-up data from the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 35:109–115PubMedCrossRefGoogle Scholar
  21. 21.
    Magliano L, Marasco C, Guarneri M, Malangone C, Lacrimi G, Zanus P, Maj M (1999) A new questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and social consequences of the disorder: reliability and validity. Eur Psychiatry 14:71–75PubMedCrossRefGoogle Scholar
  22. 22.
    Magliano L, Veltro F, Guarneri M, Marasco C (1995) Clinical and social-demographic correlatos of coping strategies in relatives of schizophrenic patients. Eur Psychiatry 10:155–158CrossRefGoogle Scholar
  23. 23.
    Martínez J, Nadal S, Beperet M, Mendióroz P, Psicot Group (2000) Sobrecarga de los cuidadores familiares de pacientes con esquizofrenia: factores determinantes. An Sist Sanit Navar 23(1):101–110Google Scholar
  24. 24.
    Montero I (1995) Tratamientos familiares y programas psicoeducativos en la esquizofrenia. In: Gutiérrez M, Escurre J, Pichot P (eds) Esquizofrenia entre la sociogénesis y el condicionamiento biológico (II). Ediciones en neurociencias, Barcelona, pp 219–227Google Scholar
  25. 25.
    Muela J, Godoy J (1998) Programa de Intervención Familiar en Esquizofrenia. Tesis Doctoral no publicada. Universidad de Granada, GranadaGoogle Scholar
  26. 26.
    Mueser K, Sengupta A, Schooler N, Bellack A, Xie H, Glick I et al (2001) Family treatment and medication dosage reduction in schizophrenia: effects on patient social functioning, family attitude, and burden. J Consult Clin Psychol 69(1):3–12PubMedCrossRefGoogle Scholar
  27. 27.
    Rakesh K, Singh T, Ganguly K (2007) Caregiver burden and coping. Soc Psychiatry Psychiatr Epidemiol 42:923–930CrossRefGoogle Scholar
  28. 28.
    Ran M, Xiang M, Wan Chan C, Leff J, Simpson P, Huang M et al (2003) Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia. A randomised controlled trial. Soc Psychiatry Psychiatr Epidemio 38:69–75CrossRefGoogle Scholar
  29. 29.
    Samele C, Manning N (2000) Level of caregiver burden among relatives of the mentally ill in South Verona. Eur Psychiatry 15(3):196–204PubMedCrossRefGoogle Scholar
  30. 30.
    Sayers S, White T, Zubritsky C, Oslin D (2006) Family involvement in the care of healthy medical outpatients. Fam Pract 23(3):317–324PubMedCrossRefGoogle Scholar
  31. 31.
    Sefasi A, Crumlish N, Samalani P, Kinsella A, O’Callagahn E, Chilale H (2008) A little knowledge: caregiver burden in schizophrenia in Malawi. Soc Psychiatry Psychiatr Epidemiol 43:160–164PubMedCrossRefGoogle Scholar
  32. 32.
    Solomon P (1996) Moving from psychoeducation to family education for families of adults with serious mental illness. Psychiatr Serv 47(12):1364–1370PubMedGoogle Scholar
  33. 33.
    Solomon P, Draine J, Mannion E (1996) The impact of individualized consultation and group work shop family education interventions in ill relative’s outcomes. J Nerv Ment Dis 184(4):252–255PubMedCrossRefGoogle Scholar
  34. 34.
    Solomon P, Draine J, Mannion E, Meisel M (1997) Effectiveness of two models of brief family education: retention of gains by family members of adults with serious mental illness. Am J Orthopsychiatry 67(2):177–186PubMedCrossRefGoogle Scholar
  35. 35.
    The Scottish Schizophrenia Research Group (1987) The Scottish First Episode Schizophrenia Study IV. Psychiatric and social impact on relatives. Br J Psychiatry 150:340–344CrossRefGoogle Scholar
  36. 36.
    The Scottish Schizophrenia Research Group (1992) The Scottish First Episode Schizophrenia Study VIII. Five-years follow-up: clinical and psychosocial finding. Br J Psychiatry 161:496–500CrossRefGoogle Scholar
  37. 37.
    Thompson M, Goldstein M, Lebel M, Mintz L, Marder S, Mintz J (1995) Schizophrenic patients’ perceptions of their relatives’ attitudes. Psychiatry Res 57:155–167CrossRefGoogle Scholar
  38. 38.
    Tomaras V, Mavreas V, Economou M, Ionnovich E, Karydi V, Stefanis C (2000) The effect of family intervention on chronic schizophrenic under individual psychosocial treatment: a 3-year study. Soc Psychiatry Psychiatr Epidemiol 35:487–493PubMedCrossRefGoogle Scholar
  39. 39.
    Vallina O, Lemos S (2001) Tratamientos psicológicos eficaces para la esquizofrenia. Psicothema 13(3):345–364Google Scholar
  40. 40.
    Ware J, Snow K, Kosinski M, Gandek B (1993) SF-36 Health Survey. Manual and Interpretation Guide. The Health Institute, New England Medical Center, BostonGoogle Scholar

Copyright information

© Steinkopff Verlag Darmstadt 2008

Authors and Affiliations

  • José Gutiérrez-Maldonado
    • 1
  • Alejandra Caqueo-Urízar
    • 2
  • Marta Ferrer-García
    • 1
  1. 1.Dept. of Personality, Assessment and Psychological TreatmentsUniversity of BarcelonaBarcelonaSpain
  2. 2.Dept. of PsychologyUniversity of TarapacáAricaChile

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