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Background: Caring for people with mental illness requires a significant investment of personal physical, mental, social, and financial resources, which greatly impact the daily lives of caregivers. The process of providing care is multifaceted and intricate, involving both positive and negative emotional responses. Burden of care is a term used to describe the negative effects of caregivers' burden on their physical, psychological, social, and economic well-being. Therefore, the aim of this systematic review and meta-analysis is to provide an overview of the most recent information available regarding the pooled prevalence of burden of care among people with mental illness in Africa. Methods: In this study, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), which is a suitable guideline for reports of systematic reviews and meta-analyses. The PROSPERO protocol number for this review is CRD42024499138. To find publications for the systematic review and meta-analysis, we used PubMed, MEDLINE, EMBASE, Cochrane Library, and Scopus databases. The Joanna Briggs Institute (JBI) for cross-sectional study quality assessment was employed to evaluate the methodological quality of the studies included in this review. The data was extracted in Microsoft Excel, and then it was exported into STATA 11.0 for analysis. A funnel plot and an objective examination of Egger's regression test were used to check for publication bias. Results: We have included 12 studies conducted in African countries with 2156 study participants, of whom 1176 (54.55%) were female individuals. In this meta-analysis, the pooled prevalence of burden of care among caregivers of people with mental illness in Africa was 61.73 (95% CI: 51.25–72.21%). Further, in subgroup analysis regarding the study country, the pooled prevalence of carer burden among caregivers of people with mental illness in Egypt and Nigeria was 79.19% and 55.22%, respectively. Conclusion: This review found a high pooled prevalence of caregiver burden related to mental illness in Africa. To minimize the challenges faced by individuals with mental illnesses, as well as the burden on their caregivers, stakeholders may find these findings useful for addressing prevention, early screening, and management. [ABSTRACT FROM AUTHOR]

Abstract Background Caring for people with mental illness requires a significant investment of personal physical, mental, social, and financial resources, which greatly impact the daily lives of caregivers. The process of providing care is multifaceted and intricate, involving both positive and negative emotional responses. Burden of care is a term used to describe the negative effects of caregivers’ burden on their physical, psychological, social, and economic well-being. Therefore, the aim of this systematic review and meta-analysis is to provide an overview of the most recent information available regarding the pooled prevalence of burden of care among people with mental illness in Africa. Methods In this study, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), which is a suitable guideline for reports of systematic reviews and meta-analyses. The PROSPERO protocol number for this review is CRD42024499138. To find publications for the systematic review and meta-analysis, we used PubMed, MEDLINE, EMBASE, Cochrane Library, and Scopus databases. The Joanna Briggs Institute (JBI) for cross-sectional study quality assessment was employed to evaluate the methodological quality of the studies included in this review. The data was extracted in Microsoft Excel, and then it was exported into STATA 11.0 for analysis. A funnel plot and an objective examination of Egger's regression test were used to check for publication bias. Results We have included 12 studies conducted in African countries with 2156 study participants, of whom 1176 (54.55%) were female individuals. In this meta-analysis, the pooled prevalence of burden of care among caregivers of people with mental illness in Africa was 61.73 (95% CI: 51.25–72.21%). Further, in subgroup analysis regarding the study country, the pooled prevalence of carer burden among caregivers of people with mental illness in Egypt and Nigeria was 79.19% and 55.22%, respectively. Conclusion This review found a high pooled prevalence of caregiver burden related to mental illness in Africa. To minimize the challenges faced by individuals with mental illnesses, as well as the burden on their caregivers, stakeholders may find these findings useful for addressing prevention, early screening, and management.

Accessible Summary What is known about the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aim Method Results Discussion Implications for Practice Caring for a family member with a mental illness induces a burden on the caregiver, an impact on their quality of life and premature ageing of more than ten years. We conducted systematised and individualised nursing interviews with family members, on the first days of a relative’s hospitalisation, during hospitalisation and three months after discharge. We observed persistent depressive symptoms during and after hospitalisation. Burden and depression were higher, and quality of life was lower, for women caregivers and when the caregivers admitted the patients involuntarily in the hospital ward. When the caregivers were experiencing a patient’s first hospitalisation, we also found higher depressive symptoms and lower quality of life. This study emphasises the need for new interventions such as psychoeducation to alleviate the suffering of families. Considering the burden of families could become a prevention objective from the patient’s first hospitalisation and prevent them from mental or physical health problems. The burden consequent to providing care to patients with psychiatric chronic conditions is often overlooked by health professionals.We assessed the impact of patients' psychiatric hospitalisation on their caregivers, through evaluating their suffering, burden and quality of life, in three stages: upon the patients' admission, their discharge and 3 months after their discharge.In total, 127 caregivers of adult patients whose first hospitalisation was less than 5 years ago were assessed using the 36‐item Short‐Form Health Survey, the Zarit Burden Interview and the Center for Epidemiologic Studies Depression scale.Females and caregivers who admitted patients against their will experienced higher burden and depression and lower mental quality of life. We also found higher depressive symptoms and lower quality of life among caregivers during a patient's first hospitalisation. The caregiver's familial relationship to the patient was not associated with these outcomes. Finally, burden decreased and quality of life increased over time.Results suggest that several variables associated with patient hospitalisations were correlated with burden, depression or quality of life.Burden could be targeted with interventions such as group psychoeducation for caregivers during or after the patient's hospitalisation, in order to reduce their distress and improve their quality of life. Psychiatric and mental health nurses can provide support to caregivers with systematic assessments of their burden and quality of life, so as to better meet their needs and promote their ability to cope with mental illness. [ABSTRACT FROM AUTHOR]

Aim: The study aims to determine the level of family burden and psychological symptoms in mothers who have children with Cerebral Palsy (CP) in Turkey. Methods: The descriptive study was completed with 200 mothers of children with CP. Results: Depression was found in mothers (1.11 ± 0.79) and the Family Burden Assessment Scale (FBAS) mean score was also high (143.71 ± 22.68). A statistically significant difference was found between mothers who received support to care for their children and their level of depression (p = 0.003). A positive and significant relationship was also found between emotional burden and psychiatric symptoms, such as anxiety, depression, negative self-perception, somatization, and hostility (r = 0.458, p = 0.001; r = 0.552, p = 0.001; r = 0.494, p = 0.001; r = 0.376, p = 0.001; r = 0.404, p = 0.001), respectively. A weak and positive relationship was determined between time requirement and psychiatric symptoms, such as anxiety, depression, and negative self-perception (r = 0.166, p = 0.019; r = 0.259, p = 0.001; r = 0.223, p = 0.001, respectively). Conclusion: The main factor affecting depression in caregivers was lack of support. As the mothers' emotional burden increases, their psychiatric symptom scores also increase. In our study, mothers' anxiety, depression, and negative self-perception scores increase as their time requirements increase. Mothers should be supported with certain interventions, such as education and instruction, to meet the necessities while caring for their children. Policymakers should support mothers with low-income levels to ensure that the required services reach their recipients. Psychological support and counseling services can be provided to the children and mothers following the diagnosis of CP. [ABSTRACT FROM AUTHOR]

Aim: The number of older adults with chronic diseases is growing. When caring for and accompanying their family members, the quality of life (QoL) of elderly family caregivers is highly affected. The aim is to find the relationship between family burden, family environment, and QoL among caregivers of older adults with chronic diseases. Methods: The study involved 409 caregivers in Samarinda (East Kalimantan), Makassar, and Gowa (South Sulawesi), Indonesia. It analyzed family burden, family environment, and QoL using descriptive, Spearman, Kruskal--Wallis, Mann--Whitney, and hierarchy regression analysis using SPSS version 21. Results: Family burden was negatively associated with QoL physical domain (r = -0.05, p = 0.26), psychological domain (r = 0.05, p = 0.31), and social domain (r = -0.02, p = 0.55), Family burden was positively associated with QoL environmental domain (r = -0.09, p = 0.05). Family environment was positively associated with QoL physical domain (r = -0.24, p = 0.00), psychological domain (r = 0.39, p = 0.00), social domain (r = 0.30, p = 0.00), and environmental domain (r = 0.41, p = 0.00). Hierarchy regression analysis shows that family environment has a tremendous positive correlation on QoL physical domain (β = 0.21, p = 0.00), psychological domain (β = 0.31, p = 0.00), social domain (β = 0.23, p = 0.00), and environmental domain (β = 0.33, p = 0.00). Conclusion: Family burden and family environment are crucial factors in the QoL of caregivers of older adults with chronic diseases. Family and public health nurses should develop interventions to relieve the burden and enhance family environments, ultimately improving caregiver's QoL. [ABSTRACT FROM AUTHOR]

Background: Palliative care and the integration of health and social care have gradually become the key direction of development to address the aging of the population and the growing burden of multimorbidity at the end of life in the elderly. Aims: To explore the benefits/effectiveness of the availability and stability of palliative care for family members of terminally ill patients in an integrated institution for health and social care. Methods: This prospective observational study was conducted at an integrated institution for health and social care. 230 patients with terminal illness who received palliative care and their family members were included. Questionnaires and scales were administered to the family members of patients during the palliative care process, including quality-of-life (SF-8), family burden (FBSD, CBI), anxiety (HAMA), and distress (DT). We used paired t-tests and correlation analyses to analyze the data pertaining to our research questions. Results: In the integrated institution for health and social care, palliative care can effectively improve quality of life, reduce the family's burden and relieve psychological impact for family members of terminally ill patients. Palliative care was an independent influencing factor on the quality of life, family burden, and psychosocial status. Independently of patient-related and family-related factors, the results are stable and widely applicable. Conclusion: The findings underline the availability and stability of palliative care and the popularization of an integrated service model of health and social care for elder adults. [ABSTRACT FROM AUTHOR]

Background: Mental illness is a leading cause of global burden of disease among both general and deaf persons. Family burden is viewed as the non-mediated effect on families living with and caring for a relative affected by mental illness. Family burden positively affected caregivers financial, physical, mental, and social well-being. To alleviate impact of burden proper coping skills to be implemented by caregivers. Aim: To assess caregivers' burden and to correlate with coping skills among caregivers. Materials & Methodology: A cross sectional study carried out at SCB medical college, a tertiary care hospital of Odisha with 120 voluntary participants. This study was conducted by collecting data from caregivers by applying Family burden interview schedule and brief COPE inventory questionnaires. Statistical analysis was done on categorical variables, and they were expressed as frequencies and percentages. Continuous variables were measured using mean and standard deviation. The correlation between caregiver burden and the various coping skills was done by using Pearson's correlation test. Results: Severe burden accounted for 60% and moderate for 40%. The highest amount of burden was seen in the areas of physical, financial, mental health, and in areas of external support. The brief COPE showed that the most often used coping styles were practicing religion, problem solving, active coping, and planning. Conclusion: We concluded that caregivers for people with mental illnesses is extremely burdensome. Female caregivers having more burden than male caregivers. Therefore, it's important to come up with helpful strategies, like giving them access to counselling services and a support system. Patients with mental illnesses may also have less relapse prevention as a result. [ABSTRACT FROM AUTHOR]

Background: Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide. With survivors often exhibiting degrees of function loss, a significant burden is exerted on their caregivers. The purpose of this study was to explore the predictive factors of caregiver burden among caregivers of patients with TBI. Methods: Sixty-eight family members of individuals with a TBI who had been admitted to three hospitals were assessed in terms of caregiver burden using the Zarit Burden Interview. The association of caregiver burden with patients' baseline cognitive function according to the Montreal Cognitive Assessment (MoCA) test, as well as caregivers' sociodemographic characteristics, were evaluated using multiple regression analysis. Results: Based on the multiple regression model, the MoCA score of the patients (std β=-0.442, p < 0.001), duration of caregiving (std β = 0.228, p = 0.044), and higher education of the caregivers (std β = 0.229, p = 0.038) were significant predictors of caregiver burden. Conclusion: Overall, our findings highlight the importance of taking caregivers' psychosocial needs into account. Long-term caregivers of TBI patients with cognitive impairment should be viewed as vulnerable individuals who could benefit from psychosocial intervention programs, to improve their well-being and enabling them to enrich their care of the TBI patient. [ABSTRACT FROM AUTHOR]

Background and Aims: There is limited research on the impact of COVID-19 pandemic on caregivers of patients with severe mental illness (SMI) during its late phase when sufficient and widespread knowledge about management and preventive aspects existed. We aimed to assess the impact of COVID-19 pandemic on caregivers of patients with SMI during Omicron wave. Methodology: We assessed 100 caregivers of patients with preexisting SMI diagnosed on the Diagnostic and Statistical Manual of Mental Disorders-5, 50 each of schizophrenia and related psychotic disorders (SCZ) and bipolar disorder (BD) from December 14, 2021, to February 9, 2022. We assessed symptoms of depression, anxiety, stress, and family burden in caregivers and their coping strategies by the Depression, Anxiety, and Stress Scale-21 Hindi version, Family Burden Interview Schedule (FBIS), and Brief-Coping Orientation to Problem Experienced, respectively. Results: Caregivers of SMI experienced symptoms of depression (51%), anxiety (72%), and stress (13%), with significantly more symptoms of depression (P = 0.002) and anxiety (P = 0.025) in caregivers of SCZ. High caregiver burden (score: 25.76, > half of the total score on FBIS) was found with no significant difference in the two groups. Caregivers of SCZ used a greater number of emotion-focused coping strategies, whereas those with BD used more problem-focused coping, but the difference was not significant. A significant association was seen between coping strategies of substance use and depressed symptoms (P = 0.003), substance use and anxiety symptoms (P = 0.007); anxiety symptoms with denial (P = 0.001) anxiety symptoms and venting (P = 0.008) in caregivers of BD. Conclusion: Caregivers of patients with preexisting SMI experienced depression, anxiety, and high family burden during Omicron wave. They used both emotion- and problem-focused coping strategies. [ABSTRACT FROM AUTHOR]

Chronic diseases, such as childhood diabetes mellitus (DM), are a complex and continuous struggle as well as a great challenge both for the children who face the disease and for their parents. DM is characterized by the complex management of therapeutic treatments, thus causing physical and psychological complications infamily members. There are many families who, upon hearing the diagnosis of their child with DM, stand still in front of these new facts as their lives change. All these unprecedented conditions cause parents intense stress and discomfort, leading them to a mental burden, as the only thing that concerns them upon diagnosis is how the family will survive in the face of the current conditions they are experiencing as well as the future of the sick child. The purpose of this brief literature review is to present the research findings related to the psychological burden of families withchildren with DM, focusing on the quality of life and stress. [ABSTRACT FROM AUTHOR]

This research was conducted to determine the family burden and quality of life of parents with children with disabilities. This descriptive study was carried out within special education and rehabilitation centers between the dates of October, 2017 and July, 2018. The sample of the study consisted of 518 parents. Data regarding the study were collected using the "Family Burden Assessment Scale" and "WHOQOL-BREF-TR Scale". A negative moderate and significant relationship has been detected between the physical domain and FBAS scores of the parents subjected while a negative strong and significant relationship was detected in the spiritual, social and environmental domains. It has been concluded that the quality of life has decreased as the family burden of the parents increased. In addition, family burden of parents had a negative effect on their quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Caring for the disabled elderly puts heavy burdens on their families. This study aimed to explore family function (FF) as a mediator in the relationship between disability severity (DS) and family burden (FB) of the Uygur and Kazakh home-dwelling disabled elderly cared for by informal caregivers in China. Method: A cross-sectional design with multistage sampling was used to recruit 431 families with Uygur and Kazakh disabled elderly in Bortala, Xinjiang, China. Data were collected using the Activities of Daily Living Scale, Family Burden Interview Schedule, and Family Adaptation, Partnership, Growth, Affection, and Resolve Index Scale and then analyzed using hierarchical regression. Results: FF had a partial mediating effect on the relationship between DS and FB (β = 0.131; 95% confidence interval [CI] = [0.074, 0.197]; p <.01); the effective rate was 41.46%. Discussion: Multidisciplinary care teams should implement targeted interventions to improve FF of the disabled elderly to alleviate FB. [ABSTRACT FROM AUTHOR]

(1) Background: Phenotypic diversity and long-term health outcomes of individuals with urea cycle disorders (UCDs) have been described in detail. However, there is limited information on the burden on affected families. (2) Methods: To evaluate the family burden in parents with children suffering from UCDs, we used validated questionnaires. Socio-demographic characteristics were evaluated, and an adapted version of the Parental Need Scale for Rare Diseases questionnaire was used. The survey was conducted in families of UCD patients cared for at the University Children's Hospital Heidelberg. (3) Results: From April to November 2021, 59 participants were interviewed (mothers n = 34, fathers n = 25). The affected patients most frequently suffered from ornithine transcarbamylase deficiency (OTC-D) (female n = 12, male n = 12), followed by argininosuccinate synthetase deficiency (ASS-D, n = 13) and argininosuccinate lyase deficiency (ASL-D, n = 8). About one-third of the participants were "dissatisfied" or "extremely dissatisfied" with health professionals' disease knowledge. In addition, 30% of the participants reported a medium or high need for "additional information on the development of their children", and 44% reported a medium or high need "for information on available services". A majority of 68% reported a need for additional support regarding services such as support groups (42%) or psychological counseling (29%). (4) Conclusions: Our study indicates that there is an unmet need for sufficient information about the development of children with UCDs, as well as for information about available support services for families with UCD patients. Furthermore, the results highlight the importance of establishing or improving family-centered care approaches. This pilot study may serve as a template for the assessment of the family burden associated with other inherited metabolic diseases. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the family burden of relatives of patients diagnosed with schizophrenia, bipolar disorder, and substance use disorder. In this study, 50 patients diagnosed with substance use disorder, 50 patients diagnosed with schizophrenia, and 50 patients diagnosed with bipolar disorder according to DSM-5 diagnostic criteria were included. A total of 150 caregivers were included, 50 for each group. Caregivers had been providing continuous care to patients for at least 1 year. Along with a semistructured sociodemographic data form, the Addiction Profile Index for patients diagnosed with substance use disorder, Positive and Negative Syndrome Scale for patients with schizophrenia, Hamilton Depression Rating Scale, and Young Mania Rating Scale for patients with bipolar disorder were administered. Zarit Caregiver Burden Scale and Family Assessment Device were administered to patient caregivers. The mean Zarit Caregiver Burden Scale score of the group with substance use disorder was found to be significantly higher than the bipolar disorder and schizophrenia groups (p = .001). There was no significant difference between the bipolar disorder and schizophrenia groups in terms of the Zarit Caregiver Burden Scale (p > .05). Substance use disorder can cause more family burden than other chronic disorders such as schizophrenia and bipolar disorder. [ABSTRACT FROM AUTHOR]

Coping with a child's psychiatric disorder involves various challenges for parents that can result in family burden. One factor related to family burden, which has been examined in previous studies, involves the interaction of the parent with the child diagnosed with the disorder. The current study, expanding on this notion, examined the interactions between parents and two of their children, one with a disorder and one without, by assessing parental expressed emotion (EE). The study also assessed the relations between the interactions with each child, examining whether these two interactions were positively or negatively-related: the "spillover hypothesis" and the "compensation hypothesis," respectively. In addition, the current study examined a mediation model whereby parental competence would mediate the association between parental EE towards each child and perceived family burden. 41 parents, whose children were treated at a mental health center, participated in the study. The Five Minute Speech Sample was administered to the parents to assess parental EE, as well as scales of parental competence and family burden. Results showed positive correlations between parental EE towards the two children (in the relationship and warmth subscales). The mediation model was confirmed only with regard to parental EE (relationship subscale) towards the child with the disorder. These findings support the spillover hypothesis, according to which feelings and cognitions are transferred from one family subsystem to another. Findings also highlight the importance of sense of competence in parenting a child with a psychiatric disorder, as it reduces family burden. Highlights: Parental expressed emotion (EE) towards child with a disorder and healthy child were positively-related. The finding supports the "spillover hypothesis"—transferring emotions from one child to the other. More warmth and less emotional over-involvement towards the healthy child were observed. We found negative association between parents competence and family burden. Parental competence is a key factor in reducing family burden for a child with a disorder. [ABSTRACT FROM AUTHOR]

Parents of children with psychiatric disorders who are hospitalized in a psychiatric unit often experience family burden. Family burden has been found to be affected by many variables related to parents' personal traits and ways of reacting to the disorder. The current study examined the association between information coping styles (monitoring and blunting) and family burden, among parents of children who were hospitalized in a day care unit. The possible role of self‐stigma as a mediator between coping style and family burden and the role of self‐concealment as a moderator between coping style and self‐stigma were examined. A total of 41 parents completed questionnaires assessing their levels of self‐stigma, information coping style, self‐concealment, and family burden. Self‐stigma was found to mediate the positive association between the monitoring coping style and family burden. Moreover, a moderation effect of self‐concealment was found, indicating that monitoring parents suffered from higher levels of self‐stigma particularly if they had a high tendency toward self‐concealment. Taking into account parents' information, coping style, self‐stigma, and self‐concealment can help professionals tailor family interventions according to parents' diverse needs. A monitoring coping style may not be beneficial especially when combined with concealment, suggesting the need to promote other coping styles. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study is to analyse how the quality of life of children diagnosed with attention‐deficit/hyperactivity disorder (ADHD) impacts the relationship between disease severity and family burden. Method: The data collected by a longitudinal, observational study involving 1478 children with ADHD residing in 10 European countries (aged 6 to 18 years) were analysed to evaluate the relationships between ADHD severity, the children's quality of life and family burden. Results: The disorder's severity directly and indirectly affected the children's health‐related quality of life (HRQoL) and family burden. The degree of family burden was modulated by the children's HRQoL. Conclusions: One of the primary causes of the stress experienced by parents of children with ADHD is their perception of the child's reduced HRQoL and not the symptom severity itself. Efforts to minimize symptom severity cannot alone reduce family burden. [ABSTRACT FROM AUTHOR]

The present study aims to explore the economic distress and pertinent coping strategies in families with a member suffering from a severe mental illness. Furthermore it endeavors to gauge the impact of illness burden and that of the Greek recession on economic distress, while disentangling their contribution. In total, 190 key relatives of people with severe mental illness were recruited from community mental health services in the region of Attica. Relatives completed a self-reported questionnaire consisting of the Index of Personal Economic Distress, the Family Burden scale and the Family Rituals scale. Information on financial strategies for tackling recession and income loss due to the recession was also gleaned. Regarding economic distress, only 15% had frequent difficulty meeting routine financial demands in their household. The preponderant strategy was spending savings (56.8%). Income category and spending less on basic needs were the main predictors of economic distress. Objective poverty indices rather than burden predicted economic distress to a greater extent. [ABSTRACT FROM AUTHOR]

Background: Close relatives of people with severe mental illness (SMI) experience problems known as family burdens. In addition, they may have their own needs for support, something often overlooked by the healthcare system. Meta-syntheses in this area may help explore the meaning of the experience of living with someone who has a SMI. Aim: Our aim was to describe the burdens experienced and needs perceived on a daily basis by relatives to someone who has a SMI. Methods: The databases PubMed, CINAHL, and PsychInfo were searched using a systematic search strategy. Studies were screened for relevance and quality was appraised. A meta-synthesis of nine qualitative studies was then conducted. Results: The nine studies discerned the following themes. Burden themes; Forced to carry a sometimes unbearable burden; Burdened by own ill-health and disrupted relationships; Distressed and stigmatized by society. Needs themes; strengthening protective factors; Skills and practical support greatly appreciated. Conclusions: The burdens and needs of relatives of persons with SMI strongly influence their lives. They require relief from both practical and emotional burdens. Family interventions and other programs to support relatives should be encouraged with this knowledge in mind. [ABSTRACT FROM AUTHOR]

Empathy is considered a positive aspect of caregiving, although in certain circumstances, being empathic might increase the burden of caregivers. The current study assessed the associations between empathy, parental efficacy, and family burden among parents of children who were hospitalized in a psychiatric unit. Specifically, we examined whether the association between empathy and family burden was moderated by the parents' sense of self‐efficacy. Seventy parents of children with psychiatric disorders, hospitalized in an inpatient psychiatric unit, filled out questionnaires of empathy, parental efficacy, and family burden. Results supported a moderating role of parental efficacy between empathy and family burden (interaction effect: β = −1.72, p =.0406). Specifically, empathy was positively related to family burden among parents with low self‐efficacy (conditional effect = 0.70, p =.032) and negatively related to family burden among parents with high self‐efficacy (conditional effect = −0.39, p = N.S). Implications for practice include the importance of self‐efficacy and address the possible negative implications of empathy among parents of children treated in a psychiatric hospital. [ABSTRACT FROM AUTHOR]

Objective: Obsessive-compulsive disorder (OCD) is one of the leading causes of disability and poor quality of life, with impairment in many areas. It can also adversely affect family members and friends that the person lives with, and this results in a burden. We aimed to evaluate the disease burden in caregivers of patients with OCD and the factors that negatively affect caregiver burden. Method: The study population consisted of 94 patients with OCD and their caregivers. The Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Hamilton Depression Rating Scale, and the World Health Organization Quality of Life Questionnaire Brief Form were filled out by the patients, and the Burden Assessment Scale (BAS) by the caregivers. Results: Longer duration of treatment, higher YBOCS obsession and compulsion scores of the patients, and lower environmental quality of life dimension scores of the patients were found to increase the BAS scores of the caregivers. Additionally, these variables were found to be significant predictors for disease burden (BAS score) (p<0.05). Conclusion: Our study revealed that many variables affect burden, even in caregivers who have no extra burden (who has no disease to cause a burden). Caregivers of patients with OCD should be included in the behavioral and pharmacologic treatment process for the benefit of both the OCD treatment management and the protection of family health. [ABSTRACT FROM AUTHOR]

Aim: Admission to Intensive Care Unit (ICU) is a stressful event and unforeseen crisis for the caregivers. Burden and psychosocial distress among caregivers in the ICU were unexplored. Therefore, the current study was aimed to assess the caregivers' burden and psychological distress among caregivers of traumatic brain injury (TBI) patients at emergency ICU during hospitalization. Materials and Methods: A total of 60 caregivers recruited by using purposive sampling method with descriptive research design. Consent was obtained. Interview schedule of family for depression, anxiety, stress scale (DAS-21) were administered. The data were analyzed by using SPSS. Descriptive statistics and independent burden t-test were used. Results: Results revealed that male caregivers (75%) and female caregivers (25%) took part in the study. Caregivers' mean age was found to be 35.22±11.29 years. Most of the TBI survivors admitted in ICU had severe injury (8.30±3.63). Mean scores showed that caregivers had experienced financial burden (6.28±2.36), severe depression (12.15±4.84), and a moderate level of anxiety (12.85±5.20). Independent t-test showed significant difference in caregiving burden between male and female caregivers at ICU (Male = 18.43±4.83; Female = 14.29±4.83; t = 2.16; p <0.035). Overall, caregivers experienced higher family burden and severe psychological distress at ICU. Conclusion: There is an immediate need to assess psychological distress and family burden of caregivers at ICU and provide timely psychosocial intervention. [ABSTRACT FROM AUTHOR]

Background: A substance-dependent person affects almost all aspects of family life, for example, interpersonal and social relationships, leisure time activities, and finances. Substance dependence invariably increases conflicts, negatively affects family members, and burdens the families. Aims and Objectives: To assess family burden perceived by primary caretakers (PCTs) of individuals with substance dependence and relevant clinico socio demographic profile of individuals as well as PCTs. Materials and Methods: Individuals and primary caretakers (n = 150) attending psychiatry OPD and emergency were included in the study. Individuals were selected by convenient sampling. The individuals and PCTs were administered psychiatric thesis/interview pro forma and drug abuse schedule. PCTs were administered "family burden interview schedule." Results: Majority of caretakers had moderate objective burden (65.3%) and severe subjective burden (74%). Objective burden was more in areas of "financial burden" and "disruption of routine activities." Objective burden had correlation (P < 0.05) with monthly family income, monthly expenses on substance, number and type of substances, treatment history, sex and type of caretaker. Subjective burden was dependent on sex and type of caretaker and treatment history of the patient. Conclusion: Our study concluded that substance dependence is associated with substantial burden for family members, more for subjective and objective burden in families with low income and with patients who are dependent on more number of substances and had taken treatment in the past. Higher proportion of severe burden was reported by female caretakers. These findings suggest directions for future research in this area. [ABSTRACT FROM AUTHOR]

Study Objectives: The objective was to assess cognitive impairment (CI) in adults older than 59 years, residing in rural and tribal population and to assess family burden of those who had significant CI. Materials and Methods: This cross-sectional study was conducted among adults residing in the rural population of a block in a district located in Western India in 2015. A total of 240 households from 12 villages of the block were selected by multistage and random sampling method. Mini-mental state examination and Zarit Burden Interview tools were used to assess CI and burden. Data were entered in MS Excel 2007 and analyzed with descriptive statistics and Chi-squared test. Results: A total of 212 adults aged over 59 years were studied. The overall prevalence of CI was 42.92%. There was a statistically significant difference seen in CI among females as compared to males. Interview of primary care taker showed that 32 (35.16%) caregivers had little or no burden, 53 (58.24%) had mild-to-moderate burden, and 6 (6.59%) had moderate-to-severe burden, while none had a severe burden. Conclusions: Enabling caregivers to provide at home care for longer periods before hospitalization would decrease the burden of CI. [ABSTRACT FROM AUTHOR]

Background: Caring for a family member diagnosed with mental illness requires a holistic support system. However, some families experience the feeling of burden, loss, and stigma affecting the entire family structure. Therefore, exploring the studies on the family experiences of mental illness is crucial. Purpose: This meta-synthesis explored the available literature on the family experiences of mental illness. Methods: An initial comprehensive search was conducted in the following databases such as Web of Science, Scopus, PsycINFO, CINAHL and Ovid-based MEDLINE using the keywords like mental illness, mental disorder, family, family member, qualitative studies and phenomenology. A total of five qualitative studies and one thesis dissertation published between 2001-2016 that elicited views of family members on their experience of mental illness were reviewed. A thematic analysis was used to identify, analyze, and report patterns among the data, allowing for specific organization and description and interpretations. Results: Family empowerment emerged as the grand theme from the perceived effects of mental illness on the family, the process of coping and their perspectives on family empowerment grounded on family experiences. Conclusion: Despite caring for a family member diagnosed with mental illness imposes threats, it further offers openness, readiness, and acceptance that empower each family to appreciate, acknowledge, and affirm the wholeness of a family member with mental illness. [ABSTRACT FROM AUTHOR]

This study examines illness-specific family burden as a mediator of the association between late effects of childhood cancer and survivors' emotional and behavioral outcomes. Childhood cancer survivors ( n = 65; ages 10-17) two or more years off-treatment completed measures assessing internalizing and PTSD symptoms. Parents reported on illness-specific family burden, late effects severity, and survivor internalizing/externalizing problems. Providers documented the number of late effects. Illness-specific family burden was correlated with provider-reported late effects ( r = .29, p < .05) and parent report of severe late effects ( r = .56, p < .01). Results supported an indirect effect of illness-specific family burden on number of late effects and parent-reported survivor internalizing problems, p < .05. Indirect effects were not found in models predicting PTSD and externalizing problems. Illness-specific family burden is an important intervention target for reducing internalizing problems in childhood cancer survivors with late effects. [ABSTRACT FROM AUTHOR]

The current cross-sectional study investigated and compared the associations between insight, self-stigma, and family burden among Jewish and Arab mothers of an adult son or daughter with serious mental illness (SMI) in Israel. A total of 162 Israeli mothers of a person with SMI participated in the study; 95 were Jewish (58.6%), and 67 were Arab (41.4%). Insight, self-stigma, and family burden scales were administered. Jewish mothers reported higher levels of insight into their son’s or daughter’s illness and reported greater family burden compared to Arab mothers. No significant differences in self-stigma scores were found between Jewish and Arab mothers. The pattern of associations between insight, self-stigma, and burden differed between Jewish and Arab mothers. Self-stigma was found to mediate the relationship between insight and burden among Jewish mothers but not among Arab mothers. Ethno-national affiliation should be taken into consideration regarding how family members conceptualize and experience mental illness, as this might affect care. [ABSTRACT FROM AUTHOR]

Background: Caregiving in schizophrenia is a demanding and exhausting activity that challenges the physical and emotional resources of family caregivers. In traditional societies such as India, this is further compounded by illiteracy, ignorance and religious and cultural explanations attributed to mental illness. Aims: This study aimed to assess primary caregivers of persons with schizophrenia in terms of their perceived burden, manifestation of psychological distress and quality of life (QOL). Methods: The study used a quantitative cross-sectional design and survey methodology to collect data from caregivers in a hospital setting in Thanjavur, India. Standardized instruments were used to collect data from patients and their caregivers. Results: High perceived burden and lower QOL were seen in the majority of caregivers. They also manifested high levels of anxiety and depression. Patient characteristics such as age, gender, symptoms and duration of illness did not influence the perceived burden of caregivers, while positive and negative symptoms and the duration of illness were correlated with their QOL. Conclusions: Findings indicate the need for intervention for family caregivers to enable them cope more effectively with the demands of caregiving. Psychoeducation and participation in peer support groups are advocated as low resource and effective outcome strategies for caregivers in India. [ABSTRACT FROM AUTHOR]

Background: The difference of burden between caregivers of acute patients with schizophrenia and bipolar disorder has not been well studied in China, a culture where family responsibility has a very high value. Our aim is to compare family burden in these two categories diagnosis and to identify predictors of family burden in a large psychiatric hospital in China. Methods: Two hundred forty-three schizophrenic patients and 200 bipolar patients were enrolled in a cross-sectional study. Patients were independently evaluated on symptoms, insight, attitudes toward medication, quality of life during the first week of their admissions. The prime caregiver for each patient was also evaluated with a standard measure of family burden within 1 week of patients' admission. Results: Caregiver perceptions of violent behavior and suicidal risk among patients with bipolar disorder were significantly greater than among families of those with schizophrenia. Hierarchical regression analyses demonstrated differential correlates of burden for all predictive factors with R² values ranging from 0.14 to 0.27 in the five burden factors in schizophrenia families; and from 0.12 to 0.24 in bipolar disorder families. Symptoms severity explained the greatest proportion of variance, whereas patient and caregiver demographic variables explained much less variance. Conclusion: Family burden, especially the caregiver perceptions of violent and suicidal behaviors were greater in care givers of acute bipolar disorder patients than among caregivers of schizophrenia patients in the present sample. However, in families of patients with both disorders clinical features were the strongest predictor of caregiver burden. [ABSTRACT FROM AUTHOR]

Aims The objective of this study was to compare the family burden and environment of patients with panic disorder ( PD) with those of a control group composed of relatives of patients with clinical diseases. Methods A cross-sectional study was performed with 67 relatives of patients with PD, and 66 family members of patients with clinical diseases. All patients were administered a set of instruments to assess family burden and environment. Results Multivariate analyses revealed significant between-group differences on measurements of objective and subjective burden, both of which can be influenced by kinship, since higher levels of family burden tend to be reported by the children of the affected individual. Levels of family burden also tend to be associated with the severity of PD symptoms. Conclusions The assessment of family burden may be useful in developing family-focused therapeutic strategies and may contribute to the improvement of patient outcomes. [ABSTRACT FROM AUTHOR]

Families of children with Duchenne muscular dystrophy (DMD) go through significant challenges in dealing with the condition. Few studies have looked into the situation, especially in the sociocultural scenario that is unique to India. The authors' aim was to identify the psychosocial challenges for caregivers of children with DMD. A cross-sectional descriptive study was performed among the caregivers of 60 children with DMD who were attending the neuromuscular disorders clinic ofa national tertiary referral center for neurological disorders. The knowledge and attitude, psychosocial needs, burden, and coping patterns were assessed in an interview. The findings showed that parents of children with DMD tended to have inadequate understanding of the disease but had a positive attitude, had a moderate family burden, and tended to rely more on religion, focus on and venting of emotions, and instrumental and emotional social support for coping. Caregivers of children with DMD would benefit from psychosocial intervention to address their understanding of and attitude toward the disease, as well as burden of dealing with it, and to help them develop their coping skills and meet their children's and their own needs. [ABSTRACT FROM AUTHOR]

Accessible summary This randomized-controlled trial investigated the effect of group psychoeducation therapy on family burden in caregivers of Iranian patients with schizophrenia., Results of this study on 71 caregivers of patients with schizophrenia showed that a 4-week group psychoeducational programme was significantly effective in reducing family burden by more than one third., Findings showed that group psychoeducational programme for caregiver and family of patients with schizophrenia is beneficial for reducing family burden., Abstract This study was aimed at assessing the impact of group psychoeducation therapy on family burden in caregivers of Iranian patients with schizophrenia during the acute phase of the disease. Using a randomized-controlled trial design, 71 caregivers of patients with schizophrenia were randomly assigned to either a 4-week group psychoeducational programme ( n = 36) or the control group ( n = 35). Family burden was assessed by Family Burden Index Schedule ( FBIS) at the beginning, and after a month of psychoeducation therapy as a follow-up. FBIS assesses family burden in six different dimensions with score ranging from 0 to 48, higher scores indicating higher burdens. At baseline mean, FBIS score was not significantly different between the cases and the controls. After the intervention, the mean total FBIS score was significantly lower in the case group compared with the control group ( P < 0.001). In the intervention group, FBIS score change was significant through the study in all dimensions as well as the total score ( P < 0.001). A significant reduction in family burden has been achieved by implementing group psychoeducational programmes for inpatients with acute phase schizophrenia in Iranian population. [ABSTRACT FROM AUTHOR]

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This study examined hope and family burden among Latino families of individuals with schizophrenia. The sample consisted of 54 family members, one family member per outpatient adult recruited from public mental health programs in a diverse urban community. Hierarchical linear regression analyses were used to test the hypothesis that the family member's increased hope for the patient's future would be associated with decreased family burden beyond effects explained by the patient's length of illness and severity of symptoms. Results supported the study hypothesis. Family hope for the patient's future was associated with four of five types of family burden. Findings point to the prominent role of hope as a source of resilience for Latino families dealing with severe mental illness of a loved one. [ABSTRACT FROM AUTHOR]

Background. Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method. Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. Results. Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4 % money, while 24.4-30.6 % felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle- income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. Conclusions. Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries. [ABSTRACT FROM AUTHOR]

Few studies have been found that to assess the factors that explain higher levels of family burden in adults with intellectual disability (ID) and intellectual disability and mental disorders (ID–MD). The aims of this study were to assess family burden in people with ID and ID–MD and to determine which sociodemographic, clinical and functional disability variables account for family burden. The sample is composed of pairs of 203 participants with disability and their caregivers, of which 33.5% are caregivers of people with ID and 66.5% of ID–MD. Assessments were performed using scales of clinical and functional disability as the following instruments: Weschler Adult Intelligence Scale-III (WAIS-III), Inventory for Client and Agency Planning (ICAP), Psychiatric Assessment Schedule for Adults with Development Disability (PAS-ADD checklist), Disability Assessment Schedule of the World Health Organization (WHO-DAS-II) and family burden (Subjective and Objective Family Burden Inventory – SOFBI/ECFOS-II). People with ID–MD presented higher levels of functional disability than those with ID only. Higher levels of family burden were related to higher functional disability in all the areas (p <0.006–0.001), lower intelligence quotient (p <0.001), diagnosis of ID–MD (p <0.001) and presence of organic, affective, psychotic and behavioral disorders (p <0.001). Stepwise multiple regression showed that behavioral problems, affective and psychotic disorder, disability in participation in society, disability in personal care and presence of ID–MD explained more than 61% of the variance in family burden. An integrated approach using effective multidimensional interventions is essential for both people with ID and ID–MD and their caregivers in order to reduce family burden. [Copyright &y& Elsevier]

Purpose: In this study, the individuals with psychotic disorders' daily life function was investigated on six dimensions considering their relations to family burden. Functional ratings carried out by relatives and staff were also compared. Methods: Totally 88 relatives, to as many individuals diagnosed with a psychotic disorder, participated in this study. Relatives were to rate their own perceived burden and their ill relatives' physical functioning, personal care skills, interpersonal relationships, social acceptability, activities, and work skills. The outpatient staff, in all 24 case managers also rated the patients' functional level on the same assessment tool as did the relatives. Results: Most dimensions of patients' everyday functioning were highly correlated to relatives' burden. The two functional dimensions 'interpersonal relationships' and 'activities' were best at classifying burden when rated by relatives. Also, comparing independent functional ratings by relatives and staff showed that despite great agreements on most dimensions, they differed significantly on 'social acceptability' where relatives rated the function to be poorer and 'activities' where relatives rated the function to be better. Conclusions: Relatives, who perceive individuals with a psychotic disorder to be limited in their ability to interpersonal relationships and limited in their ability to activate in everyday life, are more likely to perceive a higher burden. Even though staff and relatives mainly agree on the patients' functional ability, they often differ in ratings regarding patients' social acceptability and ability to activate in everyday life. This should be worth considering in clinical practice as well as in future research. [ABSTRACT FROM AUTHOR]

Introduction: Research in the last two decades has documented a high level of burden in caregivers of bipolar disorder. The present study is aimed at studying family burden among relatives of patients with bipolar affective disorder.Methods: Thirty four consecutive hospitalized patients with bipolar affective disorder currently in mania and their relatives were assessed twice: at the time of admission and during follow-up four weeks after discharge. A semi-structured performa designed for the study was completed. Patients were assessed on Young’s Mania Rating Scale and relatives were assessed on Family Burden Assessment Scale.Results: More than 90% of family members reported severe subjective (rated by relative) and objective burden (rated by interviewer) at admission; none of them was free of burden. At the time of follow-up, about one quarter (23.5%) and two thirds (64.7%) of family members did not experience any objective and subjective burden respectively; subjective and objective family burden was moderate in about one third (35.3%) and a half (52.9%), respectively. None of the family members reported severe burden subjectively, while the objective burden was rated to be severe in a quarter (23.5%) of family members.Limitations: The study was limited by the lack of a control group from an outpatient setting as hospitalization increases family burden. Also, the rater at the second assessment was not blind to ratings at the first assessment.Conclusions: Almost all the family members experienced severe burden initially. Even when symptoms subsided, family members continued to experience burden specifically related to finances. Objective burden was significantly higher than subjective burden. [ABSTRACT FROM PUBLISHER]

Abstract: Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household’s absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005–06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child’s care and whether the parent stopped working due to the child’s health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child’s health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child’s impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden. [Copyright &y& Elsevier]

Approximately 20% of children in the United States have mental health problems. The factors associated with childhood mental health problems and the associated burdens on families are not well understood. Therefore, our goals were to profile mental health problems in children to identify disparities, and to quantify and identify correlates of family burden. We used the National Survey of Children's Health, 2003 (n = 85,116 children aged 3–17 years) for this analysis. The prevalence, unadjusted and adjusted odds ratios (AOR) of mental health problems and family burden were calculated for children by child-, family- and health systems-level characteristics. The prevalence of mental health problems among children aged 3–17 years was 18%. The odds of mental health problems were higher for boys, older children, children living in or near relative poverty, those covered by public insurance, children of mothers with fair or poor mental health, children living in homes without two parents, children without a personal doctor or nurse and children with unmet health care needs. Among families with children with mental health problems, 28% reported family burden. Correlates of family burden included white race, severity, older age, higher income, non-two-parent family structure and having a mother with mental health problems. In conclusion, childhood mental health problems are common, and disproportionally affect children with fewer family and health care resources. Families frequently report burden, especially if the mental health problem is moderate to severe, but the correlates of family burden are not the same correlates associated with mental health problems. Understanding those highest at risk for mental health problems and family burden will help assist clinicians and policy makers to ensure appropriate support systems for children and families. [ABSTRACT FROM AUTHOR]

Haugstvedt A, Wentzel-Larsen T, Rokne B, Graue M. Perceived family burden and emotional distress: similarities and differences between mothers and fathers of children with type 1 diabetes in a population-based study. Background: Parenting children with diabetes entail an extra burden for the families. More information is needed about associations between perceived family burden and emotional distress in both mothers and fathers. Objective: To analyze (i) perceived burden and emotional distress in mothers and fathers of children with type 1 diabetes and (ii) associations between parental burden and distress and factors related to the child. Methods: Mothers (n = 103) and fathers (n = 97) of 115 children (1-15 yr) with type 1 diabetes participated in this population-based survey. The parents completed the Hopkins Symptom Checklist-25 items (HSCL-25), measuring emotional distress, and the Family Burden Scale, which includes five questions measuring perceived family burden related to the child's diabetes. Results: Both mothers and fathers reported that the greatest burden was related to long-term health concerns. The mothers reported a significantly greater burden related to medical treatment and significantly more emotional distress than the fathers. The mothers' perceived burden was significantly correlated with emotional distress. Nighttime blood glucose measurements were significantly associated with perceived parental burden, and experienced nocturnal hypoglycemia was significantly associated with parental emotional distress. Conclusions: The higher perceived burden related to medical treatment, the more emotional distress, and the correlations between burdens and emotional distress in mothers vs. fathers emphasize the importance of discussing both parents' roles and responsibilities in relation to the child's diabetes in follow-up. In the consultations, emphasizing nighttime caregiving and nocturnal hypoglycemia might also be important to prevent emotional distress. [ABSTRACT FROM AUTHOR]

Previous research has shown that symptom severity often implies an increased family burden. Few other illness-related variables have, however, been investigated in this context. This study investigates how family burden is affected by symptom, function, and cognition, as well as how the patient perceives his/her illness and quality of life. A total of 99 relatives, to as many patients diagnosed with psychosis and with their illness at a stable level, participated in this study. The relatives estimated their perceived burden, the patients rated the distress caused by their illness as well as the quality of their lives, and the care staff rated the patients’ symptom and function as well as tested their cognitive abilities. Increased family burden can be tied to the patients’ increased symptom severity, to their impaired functioning as well as to the patients’ higher self ratings regarding distress. The family burden is also connected to the patient’s reduced working memory and reduced executive functioning, but this connection is not totally clear and should be further investigated. Of the variables that the patients were rated on, it was the overall functional ability measured with GAF that had the single most impact on perceived family burden. Controlling of illness-related variables, such as symptoms, impaired functioning, impaired working memory and executive functioning, as well as the patients’ own experiences of distress, is important in order to lessen the burden for the relatives. All aspects of family burden are, however, not explained by these factors, which is why further research within this realm is required. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study evaluated the effectiveness of first- and second-generation antipsychotics in reducing family burden associated with schizophrenia. Methods: The family caregivers of 623 SCID-diagnosed patients enrolled in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) randomly assigned to a first-generation antipsychotic (perphenazine) or one of four second-generation drugs (olanzapine, quetiapine, risperidone or ziprasidone) were interviewed about resources provided and stresses experienced at baseline and followed for 18months. Patient symptoms, side effects and service use were assessed as well. Hierarchical regression analyses evaluated the effect of treatment assignment on four burden factors: problem behavior, resource demands and disruption, impairment in activities of daily living and patient helpfulness. Intention-to-treat analyses with all available observations classified based on initial treatment assignment, including observations after medications changed were followed by secondary analyses excluding observations after the first medication change, i.e. only considering initial medication. Results: Despite significant reductions on the problem behavior and resource demands/disruption factors, there were no significant differences between perphenazine and any of the second-generation medications. When only initial treatment period observations were included, patients were perceived as more helpful when medicated with perphenazine as compared to risperidone. In comparisons between second-generation drugs, patients on quetiapine were perceived as more helpful than those on risperidone (p =0.004). Conclusion: In this 18-month randomized trial, there was no evidence of superiority of second-generation antipsychotics in relieving family burden. [Copyright &y& Elsevier]

Objective: To examine anxiety, depression, family burden and quality of life in Primary caregivers of patients with mental illness. Design: Cross Sectional Study Place & Duration of study: The study was carried out in Mayo Hospital Lahore from January to June 2009. Subjects & Methods: One hundred Primary Caregivers of Psychiatric patients were interviewed and administered Hospital Anxiety & Depression Scale (HADS), Family Burden Interview Schedule and WHO- QOL Bref. Results: Majority of Primary caregivers of Psychiatric patients were females (74%) and spending more than 32 hours/week with the patient (56%). High proportion of caregivers scored above the cutoff of HADS for Anxiety & Depression respectively (86% and 85% respectively). We did not found any significant association between anxiety and depression with various patient and caregiver related factors in our sample. Financial constraints and effect on family routine were found to be significant sources of family burden. Caregivers of patients with Mental Illness had impaired Quality of life(QOL). Conclusion: Primary Caregivers of Patients with Mental Illness have high rates of Mental Health Difficulties, family Burden and impaired Quality of Life. Healthcare Personnel in contact with Caregivers should consider screening them for psychiatric symptoms and QOL and if necessary, recommend evaluation by their doctors. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to measure changes over 3-years in caregiving burden and emotional distress in relatives of people with schizophrenia and to identify factors predicting the levels of caregiving burden. Method: A cohort of 51 caregivers of patients with schizophrenia attending the South-Verona Community Mental Health Service was assessed over 3-years with the Involvement Evaluation Questionnaire, European Version. Predictors of caregiving burden included both caregivers' and patients' characteristics and patterns of carer-patient interaction. Results: Baseline levels of family burden were high in worrying and urging domains. Fifty-one per cent of caregivers experienced significant emotional distress. Both overall burden and emotional distress improved. Higher patients' psychopathology, higher numbers of patient-rated needs, patients' lower global functioning and patients' poorer quality of life were found to be related to the severity of family burden. The only significant predictor of caregivers' burden at follow-up was the baseline level of caregivers' burden itself. Conclusion: A policy addressing the caring burden of informal caregivers beyond patients' symptoms reduction should be considered. [ABSTRACT FROM AUTHOR]

Background: The lack of formal instruments to measure Burden in primary caregivers of Children in a hospital context is limited because mostly of published instruments are related to cancer survivors, ambulatory environment or general context for children with chronic conditions, but none of them adapted property to prolonged hospitalization context. This leaves the rising population of hospitalized chronic children's caregivers without a proper assessment. The aim of this study was to develop a version of the Revised Impact on Family Scale adapted to primary caregivers of chronic hospitalized children. A cross-sectional study with two main stages was conducted. The first one describes the linguistic and contextual adaptation process of the instrument, and the second refers to the psychometric testing and analysis.. Results: Less than 15% of the participants expressed problems with some adapted items in the scale. Eighty-six caregivers were evaluated at Josefina Martinez Hospital, mostly female (34.2 ± 11.6 years old). Majority of participants were graduated from high school, salaried employee and mothers of the chronic child. The scale exhibits a high level of internal consistency (Cronbach's alpha 0.73), excellent intra-observer reliability (Intraclass Correlation Coefficient 0.9), acceptable empirical evaluation of content validity and low and negative construct validity (Pearson's correlation coefficient − 0.23). Conclusions: This adapted version of the Revised Impact on Family Scale to the hospital context is a reliable, valid, self-administered and simple instrument to implement in order to assess the burden of primary caregivers with chronic hospitalized children. [ABSTRACT FROM AUTHOR]