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Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia

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Abstract

Purpose

Deinstitutionalization of persons living with mental illness has led to many patients residing in communities with family members and shifting the burden of care and caregiving from hospitals to homes. The aim of the study was to determine the burden on caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital (EFSTH).

Methods

This was a descriptive cross-sectional study design with a sample consisting of 161 randomly selected caregivers of patients with schizophrenia. The GHQ-12 questionnaire was used to determine the general health status of the caregivers. The caregivers’ burden was assessed using the Zarit Burden Scale. The data were collected using the researcher-administered method. The collected data were analyzed with IBM SPSS Version 20 using descriptive statistics, mean differences, and the general linear model (GLM).

Results

The main findings of this study were that caregivers experienced a significantly high level of burden. Most of them experienced high levels of physical (70%), psychological (93.2%), social (78.3%) and financial (55.3%) burdens. Employment status, specifically unemployment status and belonging to the Wolof ethnic group, was a significant predictor of the level of financial burden on the caregivers. Similarly, the total score for social burden was also significantly greater among unemployed caregivers. Educational level was a significant predictor of the total score on the psychological and physical burden scale.

Conclusion

The caregivers of patients with schizophrenia at EFSTH are experiencing a high level of burden as a result of their caregiving role, which affects their health, and this calls for urgent intervention.

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References

  1. Firoz AH, Karim ME, Alam MF, Rahman AH, Zaman MN, Chandra V. Community Based Multicentric Service Oriented Research on Mental Illness with focus on Prevalence. Medical Care, Awareness and Attitude towards Mental Illness in Bangladesh. Bangladesh Journal of Psychiatry. 2006;20:9–32. Accessed at https://www.researchgate.net/publication/274066561_Prevalence_medical_care_awareness_and_attitude_towards_mental_illness_in_Bangladesh. Accessed date: October 2022.

  2. Šimunović Filipčić I, Filipčić I. Schizophrenia and physical comorbidity. Psychiatria Danubina. 2018 Jul 22;30(suppl. 4):152–7. Accessed at: https://pubmed.ncbi.nlm.nih.gov/29864751/. Accessed date: October 2022.

  3. Owen MJ Sawa A Mortensen PB Schizophrenia. Lancet. 2016; 388: 86-97. https://doi.org/10.1016/S0140-6736(15)01121-6.

  4. Mahariba K, Vijayalakshmi K, Anuradha C, Venkatesan L. Predictors of family burden among patients with schizophrenia. TNNMC J Mental Health Nurs. 2019;7(1):11–6. Accessed at: https://www.indianjournals.com/ijor.aspx?target=ijor:tnnmcjmhn&volume=7&issue=1&article=002. Accessed date: October 2022.

  5. World Health Organization (WHO). (2018). Mental disorders fact sheet. 2016. View at: Publisher Site.

  6. World Health Organization. Mental Health Action Plan 2013–2020. 2013 Geneva World Health Organization https://www.who.int/publications/i/item/9789241506021

  7. Kotwal SB, Shitole SY. Schizophrenia: Its Complications and Treatments. 2019. Accessed at: https://ijisrt.com/assets/upload/files/IJISRT19DEC561.pdf. Accessed date: July, 2022

  8. Lasebikan VO, Ayinde OO (2013) Family burden in caregivers of schizophrenia patients: Prevalence and sociodemographic correlates. Indian J Psychol Med 35(1):60–66. https://doi.org/10.4103/0253-7176.112205

    Article  PubMed  PubMed Central  Google Scholar 

  9. Suro G, Weisman de Mamani AG. Burden, interdependence, ethnicity, and mental health in caregivers of patients with schizophrenia. Family Process. 2013 52(2):299–311. Fam Proc 52:299–311, 2013

  10. Gutiérrez-Maldonado J, Caqueo-Urízar A, Kavanagh DJ (2005) The burden of care and general health in families of patients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 40:899–904. https://doi.org/10.1007/s00127-005-0963-5

    Article  PubMed  Google Scholar 

  11. Jagannathan A, Thirthalli J, Hamza A, Hariprasad VR, Nagendra HR, Gangadhar BN (2011) A qualitative study on the needs of caregivers of inpatients with schizophrenia in India. Int J Soc Psychiatry 57(2):180–194. https://doi.org/10.1177/0020764009347334

    Article  CAS  PubMed  Google Scholar 

  12. Chakrabarti S, Kulhara P. Family burden of caring for people with mental illness. The British Journal of Psychiatry. 1999 174(5):463- https://doi.org/10.1192/S0007125000262430

  13. Von Kardorff E, Soltaninejad A, Kamali M, Eslami SM (2016) Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia–a qualitative exploratory study. Nord J Psychiatry 70(4):248–254. https://doi.org/10.3109/08039488.2015.1084372

    Article  Google Scholar 

  14. Kretzschmar I, Nyan O, Mendy AM, Janneh B (2012) Mental health in the Republic of The Gambia. Intern Psychiatry 9(2):38–40. https://doi.org/10.1192/S1749367600003076

    Article  Google Scholar 

  15. World Health Organization. Mental Health Atlas 2017 member state profile. World Health Organization, Geneva. 2017. Accessed at: https://www.who.int/publications/i/item/9789241514019. Accessed date: October, 2022

  16. Cochran WG. Sampling techniques. John Wiley & Sons; 1977. Accessed at https://www.academia.edu/29684662/Cochran_1977_Sampling_Techniques_Third_Edition. Accessed date: October, 2022

  17. Zarit SH, Reever KE, Bach-Peterson J (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20(6):649–655. https://doi.org/10.1093/geront/20.6.649

    Article  CAS  PubMed  Google Scholar 

  18. Zarit S, Orr NK, Zarit JM. The hidden victims of Alzheimer's disease: Families under stress. NYU Press; 1985.

  19. Yap P. Validity and reliability of the Zarit Burden Interview in assessing caregiving burden. Ann Acad Med Singapore. 2010;39:758–63. Accessed at: https://tsaofoundation.org/doc/Zarit_Validation_Sin.pdf. Accessed date: July, 2022

  20. Dada MU, Okewole NO, Ogun OC, Bello-Mojeed MA (2011) Factors associated with caregiver burden in a child and adolescent psychiatric facility in Lagos, Nigeria: a descriptive cross-sectional study. BMC Pediatr 11(1):1–6. https://doi.org/10.1186/1471-2431-11-110

    Article  Google Scholar 

  21. Goldberg DP (1972). The Detection of Psychiatric Illness by Questionnaire: A Technique for the Identification and Assessment of Non-Psychotic Psychiatric Illness (Maudsley Monograph, 21). Oxford University Press. Accessed at https://www.scirp.org/reference/referencespapers?referenceid=1984248. Accessed date: October, 2022

  22. Lee B, Kim Y. Factor structure of the 12-item General Health Questionnaire (GHQ-12) among Korean university students. Psychiatry Clin. Psychopharmacol. 2020 30(1). https://doi.org/10.5455/PCP.20200518112914

  23. Liang Y, Wang L, Yin X (2016) The factor structure of the 12-item general health questionnaire (GHQ-12) in young Chinese civil servants. Health Qual Life Outcomes 14(1):1–9. https://doi.org/10.1186/s12955-016-0539-y

    Article  CAS  Google Scholar 

  24. Anjara SG, Bonetto C, Van Bortel T, Brayne C (2020) Using the GHQ-12 to screen for mental health problems among primary care patients: psychometrics and practical considerations. Int J Ment Heal Syst 14:1–3. https://doi.org/10.1186/s13033-020-00397-0

    Article  Google Scholar 

  25. Hamed Taherdoost. Validity and Reliability of the Research Instrument; How to Test the Validation of a Questionnaire/Survey in a Research. Intern J Acade Res Manage, 2016, 5 (3), 28–36, ISSN: 2296–1747. Accessed at: https://hal.science/hal-02546799/document. Accessed date: September, 2022

  26. Nunnally JC. An overview of psychological measurement. Clinical diagnosis of mental disorders: A handbook. 1978:97–146. https://doi.org/10.1007/978-1-4684-2490-4_4

  27. Shamsaei F, Cheraghi F, Bashirian S. Burden on family caregivers caring for patients with schizophrenia. Iran J Psychiatry. 2015 10(4):239. Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4801494/. Accessed date: October, 2022

  28. Stanley S, Balakrishnan S, Ilangovan S. Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. J Mental Health. 2017 26(2):134–41 Accessed at: https://research.edgehill.ac.uk/ws/portalfiles/portal/21274725/Psychological_distress_perceived_burden_and_quality_of_life_in_caregivers_of_persons_with_schizophrenia.pdf. Accessed date: October, 2022

  29. Inogbo CF, Olotu SO, James BO, Nna EO (2017) Psychiatric disorders amongst caregivers who are first-degree relatives of patients with schizophrenia. J Psychiatry Human Behav Sci 1(1):1. https://doi.org/10.11604/pamj.2017.28.284.11574

    Article  Google Scholar 

  30. Cw Lam P, Ng P, Tori C (2013) Burdens and psychological health of family caregivers of people with schizophrenia in two Chinese metropolitan cities: Hong Kong and Guangzhou. Community Ment Health J 49:841–846. https://doi.org/10.1007/s10597-013-9622-6

    Article  PubMed  Google Scholar 

  31. Yu Y, Liu ZW, Li TX, Li YL, Xiao SY, Tebes JK (2020) Test of the stress process model of family caregivers of people living with schizophrenia in China. Soc Sci Med 1(259):113113. https://doi.org/10.1016/j.socscimed.2020.113113

    Article  Google Scholar 

  32. Bastawrous M (2013) Caregiver burden—A critical discussion. Int J Nurs Stud 50(3):431–441. https://doi.org/10.1016/j.ijnurstu.2012.10.005

    Article  PubMed  Google Scholar 

  33. Kulhara P, Kate N, Grover S, Nehra R (2012) Positive aspects of caregiving in schizophrenia: A review. World J Ppsychiatry 2(3):43. https://doi.org/10.5498/wjp.v2.i3.43

    Article  Google Scholar 

  34. Awad AG, Voruganti LN (2008) The burden of schizophrenia on caregivers: a review. Pharmacoeconomics 26:149–162. https://doi.org/10.2165/00019053-200826020-00005

    Article  PubMed  Google Scholar 

  35. McEvoy JP. The costs of schizophrenia. J Clin Psychiatry. 2007 68:4. Accessed at: https://pubmed.ncbi.nlm.nih.gov/18284271/. Accessed date: October, 2022

  36. Mitchell D. Stress, coping, and appraisal in an HIV-Seropositive rural sample: a test of the goodness-of-fit hypothesis (Doctoral dissertation, Ohio University). Accessed at: https://www.teachertoolkit.co.uk/wp-content/uploads/2016/10/ohiou1103225821.pdf. Accessed date: October, 2022

  37. Carretero S, Garcés J, Ródenas F, Sanjosé V. The informal caregiver's burden of dependent people: theory and empirical review. Arch Gerontol Geriatrics. 2009 49(1):74–9. Accessed at: https://core.ac.uk/download/pdf/71039891.pdf. Accessed date: May, 2022

  38. Chang HY, Chiou CJ, Chen NS. Impact of mental health and caregiver burden on family caregivers’ physical health. Arch Gerontol Geriatrics. 2010 1;50(3):267–71. Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7114152/

  39. Tennakoon L, Fannon D, Doku V, O'Ceallaigh S, Soni W, Santamaria M, Kuipers E, Sharma T. Experience of caregiving: relatives of people experiencing a first episode of psychosis. British J Psychiatry. 2000;177(6):529–33. Accessed at: https://pubmed.ncbi.nlm.nih.gov/11102328/. Accessed date: May, 2022

  40. Fekih-Romdhane F, Mhedhbi N, Ben Ali S, Cheour M (2020) Sleep quality in caregivers of older patients with schizophrenia spectrum and bipolar disorders: A case-control study. Clin Gerontol 43(5):533–544. https://doi.org/10.1080/07317115.2019.1680588

    Article  PubMed  Google Scholar 

  41. Papastavrou E, Kalokerinou A, Papacostas SS, Tsangari H, Sourtzi P (2007) Caring for a relative with dementia: family caregiver burden. J Adv Nurs 58(5):446–457. https://doi.org/10.1111/j.1365-2648.2007.04250.x

    Article  PubMed  Google Scholar 

  42. Jenkins JH, Schumacher JG (1999) The family burden of schizophrenia and depressive illness: specifying the effects of ethnicity, gender, and social ecology. Br J Psychiatry 174(1):31–38. https://doi.org/10.1192/bjp.174.1.31

    Article  CAS  PubMed  Google Scholar 

  43. Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family-caregivers of people with mental illnesses. World J Psychiatry. 2016 6(1):7. Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804270/ Accessed date: October, 2022.

  44. Li J, Lambert CE, Lambert VA (2007) Predictors of family caregivers’ burden and quality of life when providing care for a family member with schizophrenia in the People’s Republic of China. Nurs Health Sci 9(3):192–198. https://doi.org/10.1111/j.1442-2018.2007.00327.x

    Article  PubMed  Google Scholar 

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Acknowledgements

We express our sincere appreciation for the support and contributions of the management and staff of Edward Francis Small Teaching Hospital.

Author information

Authors and Affiliations

Authors

Contributions

MJM conceived the research idea, designed and collected the data. MJM and HTB analyzed the data. HTB reviewed the data. MJM conducted the literature search. MJM wrote the first draft of the manuscript. All authors reviewed, revised, and approved the final manuscript.

Corresponding author

Correspondence to Haddy Tunkara Bah.

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Funding

The authors declare that there was no source of funding.

Availability of data and materials

The data used to support the findings of this study are available from the corresponding author upon request.

Conflict of interest

The authors declare that they have no competing interests. All the authors declare that the submitted work has not been published before (neither in English nor in any other language) and that the work is not under consideration for publication elsewhere.

Ethical approval and consent to participate

The research was approved by the Gambia Government/MRC Joint Ethics Committee. All the study participants signed consent forms and were therefore included in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.

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Marega, J., Bah, H.T. Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02634-0

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