Abstract
Family members charged with the care of those suffering from schizophrenia experience considerable stress due to their multiple responsibilities. Research regarding the burdens of caregiving is scant in Hong Kong and China. The present study quantified the association of the duties of caregivers with mental health symptoms in two Asian cities having distinct health care systems (i.e., Hong Kong and Guangzhou, China). Thirty nine caregivers in Hong Kong and 70 caregivers in Guangzhou were recruited from nongovernmental mental health organizations. They were assessed using the Chinese version of the Involvement Evaluation Questionnaire and the General Health Questionnaire. While the Guangzhou family caregivers had a significantly higher burden than the Hong Kong sample, there was no significant difference in the psychological health status of family caregivers in the two cities. Result of correlational analyses, however, revealed high associations between burden of care variables and the psychological health of the caregivers. Findings for the present study have implications regarding the physical and mental health needs of those caring for seriously disturbed relatives.
References
Awad, A.G., & Wallace, M. (1999). Patient and carer perspectives in schizophrenia: a workshop. Paper presented at the The First Worldwide Pfizer Neuroscience Consultants Forum.
Birchwood, M., & Jackson, C. (2001). Schizophrenia. East Sussex, England: Psychology Press.
Bleuler, M. (1978). The schizophrenic disorders, long term patient and family studies. [Die schizophrenia Geistess torvingen im lichte langjalriger Kranker-under familienge schichgen]. (S. M. Clements, Trans.). New Haven, CT: Yale University Press. (Original work published 1972).
Boey, K. W., & Chiu, H. F. K. (1998). Assessing psychological well-being of the old–old: A comparative study of GDS-15 and GHQ-12. Clinical Gerontologist, 19, 65–75.
Chan, D. W., & Chan, T. S. (1983). Reliability, validity and the structure of the General Health Questionnaire in a Chinese context. Psychological Medicine, 13, 363–371.
Chao, K. (2000). Caregiver burden: A concept analysis. Journal of Paediatric Nursing, 15, 398–406.
Chou, K., LaMontagne, L., & Hepworth, J. (1999). Burden experienced by caregivers or relative with dementia in Taiwan. Nursing Research, 48, 206–214.
Daradkeh, T. K., Ghubash, R., & El-Rufaie, O. E. F. (2001). Reliability, validity, and factor structure of the Arabic version of the 12-item General Health Questionnaire. Psychological Report, 89, 85–94.
Foldemo, A., Gullberg, M., Ek, A., & Bogren, L. (2005). Quality of life and burden in parents for outpatients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 40, 133–138. doi:10.1007/s00127-005-0853-x.
Goldberg, D., & Williams, P. (1988). A user guide to the General Health Questionnaire. Slough: NFER-Nelson Publishing Company.
Guangzhou Municipal Statistical Bureau. (2007). Guangzhou statistical yearbook. China Beijing: Statistical Press.
Gutierrez-Maldonado, J., Caqueo-Urizar, A., & Kavanagh, D. (2005). Burden of care and general health in families of patients with schizophrenia. Social Psychaitry and Psychiatric Epidemiology, 40, 899–904. doi:10.1007/s00127-005-0963-5.
Harvey, K., Burns, T., Fahy, T., Manley, C., & Tattan, T. (2001). Relatives of patients with severe psychotic illness: Factors that influence appraisal of caregiving and psychological distress. Social Psychiatry and Psychiatric Epidemiology, 36, 456–461.
Huang, X. Y., Hung, B. J., Sun, F. K., Lin, J. D., & Chen, C. C. (2009). The experiences of carers in Taiwanese culture who have long-term schizophrenia in their families: A phenomenological study. Journal of Psychiatric Mental Health Nursing, 16, 874–883. doi:10.1111/j.1365-2850.2009.01468.x.
Jungbaur, J., Wittmund, B., & Dietrich, S. (2003). Subjective burden over 12 months in parents of patients with schizophrenia. Archive of Psychiatric Nursing, 17, 126–134.
Knapp, M., Mangalore, R., & Simon, J. (2004). The global costs of schizophrenia. Schizophrenia Bulletin, 30, 279–293.
Lau, D. Y. K., & Pang, A. H. T. (2007). Caregiving experience for Chinese caregivers of persons suffering from severe mental disorders. Hong Kong Journal of Psychiatry, 17, 75–80.
Lee, P. W., Lieh-Mak, F., Wong, M. C., Fung, A. S., Mak, K. Y., & Lam, J. (1998). The 15-year outcome of Chinese patients with schizophrenia in Hong Kong. Canadian Journal of Psychiatry, 43, 706–713.
Liu, M., Lambert, C., & Lambert, V. (2007). Caregiver burden and coping patterns of Chinese parents of a child with a mental illness. International Journal of Mental Health Nursing, 16, 86–95. doi:10.1111/j.1447-0349.2007.00451.x.
Loomis, L. S., & Booth, A. (1995). Multigenerational caregiving and well-being. The myth of the beleaguered sandwich generation. Journal of Family Issues, 16, 131–148.
Madianos, M., Economou, M., & Dafni, O. (2004). Family disruption, economic hardship and psychological distress in schizophrenia: Can they be measured? European Psychiatry, 19, 408–414. doi:10.1016/j.eurpsy.2004.06.028.
Magana, S. M., Ramirez Garcia, J. I., Hernandez, M. G., & Cortez, R. (2007). Psychological distress among latino family caregivers of adults with schizophrenia: The roles of burden and stigma. Psychiatric Services, 58, 378–384. doi:10.1176/appi.ps.58.3.378.
Mo, F. Y. M., Chung, W. S., Wong, S. W., Chun, D. Y. Y., Wong, K. S., & Chan, S. S. M. (2008). Experience of caregiving in caregivers of patients with first-episode psychosis. Hong Kong Journal of Psychiatry, 18, 101–106.
Monahan, D. J., Geene, V. L., & Coleman, P. D. (1992). Caregiver support groups: Factors affecting use of services. Social Work, 37, 254–260.
Pearson, V., & Ning, S. P. (1997). Family care in schizophrenia: An undervalued resource. In W. L. W. Chan & N. Rhind (Eds.), Social work intervention in health care (pp. 317–336). Hong Kong: Hong Kong University Press.
Phillips, M. R., Pearson, V., Li, F., Xu, M., & Yang, L. (2002). Stigma and expressed emotion: A study of people with schizophrenia and their family members in China. British Journal of Psychiatry, 181, 488–493.
Provencher, H. L. (1997). Schizophrenia: Revisited. Journal of Psychiatric and Mental Health Nursing, 4, 275–285.
Sartorius, N., Jablensky, A., Korten, A., Ernbert, G., Anker, M., Cooper, J. E., et al. (1986). Early manifestation and first contact incidence of schizophrenia in different cultures: A preliminary report on the initial evaluation phase of the WHO collaborative study on determinants of outcome of severe mental disorders. Psychological Medicine, 16, 909–928.
Schene, A. H., & van Wijngaarden, B. (1992). The involvement evaluation questionnaire. Amsterdam: Department of Psychiatry. University of Amsterdam.
Sisk, R. J. (2000). Caregiver burden and health promotions. International Journal of Nursing Studies, 37, 37–43.
Tang, V. W., Leung, S. K., & Lam, L. C. (2008). Clinical correlates of the caregiving experience for Chinese caregivers of patients with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 43, 720–726. doi:10.1007/s00127-008-0357-6.
Tsang, H. W. H., Tam, P. K. C., Chan, F., & Chang, W. M. (2003). Sources of burden on families of individuals with mental illness. International Journal of Rehabilitation Research, 26, 123–130. doi:10.1097/01.mrr.0000070761.13531.a1.
Tsuang, M. T., Faraone, S. V., & Green, A. I. (1999). Schizophrenia and other psychotic disorders. In A. M. Nicholi (Ed.), The harvard guide to psychitry (3rd ed., pp. 240–280). London: Mass: Belknap Press of Harvard University Press.
van Wijngaarden, B., & Schene, A. H. (1997). The Involvement Evaluation Questionnaire (European Version). Amsterdam: Department of Psychiatry. University of Amsterdam.
van Wijngaarden, B., Schene, A. H., & Koeter, M. W. J. (2002). Caregiver consequences in the Netherlands and other European countries: The development and use of the Involvement Evaluation Questionnaire (IEQ). In H. P. Lefley & D. L. Johnson (Eds.), Family Interventions in mental illness: International perspectives (pp. 145–169). Westport, CT: Praeger Publisher.
Wijngaarden, B., Schene, A., Koeter, M., Becker, T., Knapp, M., Knudsen, H. C., et al. (2003). People with schizophrenia in five countries: Conceptual similarities and intercultural differences in family caregiving. Schizophrenia Bulletin, 29, 573–586.
Wu, E. Q., Birnbaum, H. G., Shi, L., Ball, D. E., Kessler, R. C., Moulis, M., et al. (2005). The economic burden of schizophrenia in the United States in 2002. Journal of Clinical Psychiatry, 66, 1122–1129.
Xiang, Y. T., Ma, X., Cai, Z. J., Li, S. R., Xiang, Y. Q., Guo, H. L., et al. (2008). Prevalence and socio-demographic correlates of schizophrenia in Beijing, China. Schizophrenia Research, 102, 270–277. doi:10.1016/j.schres.2008.04.009.
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CW Lam, P., Ng, P. & Tori, C. 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 (2013). https://doi.org/10.1007/s10597-013-9622-6
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DOI: https://doi.org/10.1007/s10597-013-9622-6