Search

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]

Understanding affiliate stigma and its impact on family of people living with schizophrenia (PLS) in China is important for culturally informed intervention. This study aims to describe the pattern of affiliate stigma of family members of PLS in China and investigated the association between affiliate stigma and family burden. PLS and their family members dwelling in community were randomly recruited from four cities across China and completed measures of affiliate stigma and family burden. Linear regression analyses were used to determine the association between affiliate stigma and family burden. A total of 493 dyads of family member and PLS were include in this study. The mean affiliate stigma in family members was 2.21 (SD = 0.61). The vast majority of family members reported the feeling of inferiority, helpless and sad because of their family members' schizophrenia, but few family members refusing to communicate or contact with the PLS. The mean score of overall family burden was 22.25 (SD = 14.90), with 98 % of participants reported moderate or severe burden. A higher level of affiliate stigma was associated with more family burden (b = 7.837, 95CI: 5.240 to 8.747). Affiliate stigma was significantly associated with family daily activities, entertainment activities, family relationship, physical health and mental health of family members, but not family economic burden. A higher level of affiliate stigma was associated with more family burden among family with PLS. Anti-stigma intervention of mental illness should be consider not only PLS but also their family members. [ABSTRACT FROM AUTHOR]

Background: Developmental coordination disorder (DCD) is a neurodevelopmental disorder impacting 5% – 6% of children and continues into adulthood for 50% – 70% of cases. Despite the multidomain and lifelong influence of this disorder, little consideration has been given to the experiences of the family. Post-diagnostic support has been recommended however, the specific areas requiring support remain vague. Objectives: This study described the familial experiences of living with a member diagnosed with DCD. Method: A qualitative descriptive study using a phenomenological approach allowed insight into the lived experiences of families journeying with DCD. Forty-four participants representing 8 countries participated in an online questionnaire with 12 participating in an online semi-structured interview. Results: Themes generated reveal that obtaining a diagnosis and navigating the healthcare and education systems can be troublesome. Upon diagnosis, families tend to experience positive emotions such as relief. However, the daily challenges soon result in dominant negative emotional responses. DCD places significant financial burdens on families and impacts marital, parental and sibling relationships. Families often feel isolated from their communities as DCD is poorly understood. Conclusion: DCD places families at risk as daily struggles require support which targets identified motor, cognitive, academic and emotional challenges. Creating awareness in society, education and healthcare would alleviate continual frustrations. Contribution: This study provides insight into the wide-ranging impact that DCD has on families so that individualised support can be tailored, and general awareness raised. [ABSTRACT FROM AUTHOR]

Having a child with special needs has a significant impact on family life. While adapting to this new situation, parents often face difficulties related to the care of their children, family relations, and financial situation. The present study examined differences between family burden and spousal support perceived by mothers and fathers of children with special needs and investigated predictors of perceived family burden and spousal support. A total of 394 parents of children with disabilities (197 couples) from a large urban city in Northern Turkey participated in this survey study. Results showed the perceived family burden and spousal support differed significantly between couples. Mothers of children with special needs had significantly higher perceived family burden and significantly lower perceived spousal support in comparison to fathers. Moreover, perceived spousal support significantly predicted family burden perceived by mothers and fathers. Implications in relation to services offered to families of children with disabilities along with the recommendations for future research in this area are discussed. [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]

Objective: The current study sought to assess what adverse life events were experienced by people living in Algeria during the coronavirus pandemic and the impact of these experiences on families. The country went into a first lockdown in March 2020 with a further significant increase in cases of coronavirus in November 2020. Method: N=123 were randomly recruited via the internet in November 2020 and completed two outcome measures assessing negative life events and family burden. Results: Among the most common events reported Participants reported a high frequency of adverse life events during the pandemic. Participants also perceived the impact of events as being like a ‘moderate crisis’ concerning the perceived burden placed on their families. also a relationship between the termination of the relationship with the partner and the loss of a close family member to his job and the 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]

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]

The aim of study was to assessment of the family burden in schizophrenia. The present study was conducted on 25 schizophrenic patients and his / her family members in the out-patient department of Gwalior Mansik Arogyashala, Gwalior, in the age group of 21-45 years of either sex, diagnosed by ICD-10 criteria for patients and minimum 21 years age of either sex for informants and who has been with continuously for the last two years and spending a lot of time and emotional support providing to the patients. Result indicate that family members experience less burden after they were assessed after six months of follow-up. [ABSTRACT FROM AUTHOR]

Aim: Chronic diseases increase family burden and affect family functioning. The aim of this study was to investigate the relationship between family burden and socio-demographic characteristics, clinical findings, family functioning and coping attitudes in schizophrenia patients and caregivers. Material and Method: The study include, DSM-IV TR diagnosed 100 schizophrenic patients and 100 of their caregivers who admitted with sequential order to Recep Tayyip Erdoğan University Psychiatric outpatient clinic. The subjects were assessed by using a sociodemographic data form, Positive and Negative Syndrome Scale (PANSS), and Social Functioning Scale (SFS). Their primary caregivers were assessed using the Coping Attitudes Scale (COPE), the Perceived Family Burden Scale (PFBS) and the Family Assessment Scale (FAD). Results: According to our findings, patients were 57% of women (n = 57), 43% of male (n = 43) and the mean age was 37.4 ± 10. Mean illness duration was 14.9 ± 8. The majority of caregivers (63%) were women. The mean age was 47.5 ± 11 years. The mean age of caregiving was 11.4 ± 7 years and the mean time was 12.8 ± 8 hours. Symptoms of the patients, duration of disease, degree of impairment in the functionality of the patients and impaired family functions were found to be related to family burden (p<0.05). Conclusion: In this study, as the severity of positive and negative symptoms of patients with schizophrenia increases, subjective family burden, objective family burden and total burden increase; family burden increases with decreasing social functioning level, positive reinterpretation and development, active coping and plan coping methods they use. In order to reduce family burden in caregivers who are diagnosed with schizophrenia, control of symptoms, improved social functioning of patients, education of caregivers about disease and family functions, positive coping attitudes that caregivers apply to stressful situations, determining treatment target and monitoring the effectiveness of treatment will help. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a mental disorder that is still being a stigma and causes a conflict in the family due to maladaptive behavior. Coping strategies are needed by the family members to dealing burden, so that they can care patients well. Purpose: This study aimed to determine the relationship between family burden and coping with the family ability of caring for patients with schizophrenia. Method: This study used a cross sectional approach. The population was a family of patients with schizophrenic in the Wijaya Kusuma room at Menur mental hospital. The number of samples was 21 respondents. The independent variable was family burden and coping. The dependent variable was the family ability of caring. Data were collected by questionnaires of demographic, family ability, family burden, and family coping. Data analysis used Spearman Rho correlation test with a significance level of α = 0.05. Results: The statistical results showed that family burden has a correlation with family ability (r = 0.656), while family coping has a very strong correlation with family ability (r = 0.868) with family integrity better than psychological status and communication. Conclusion: Family with a low burden did not necessarily have a good ability in caring for patient, but family with good coping will be able to provide good care for patient. Therefore, nurses are expected to develop methods to improve family coping in family caregivers of patient with schizophrenia. [ABSTRACT FROM AUTHOR]

• Covariation in change over time occurs between family burden and patient quality of life. • Family burden, quality of life, and positive symptoms improved over time. • Baseline level of patient quality of life and positive symptoms were not associated with change in family burden. • Baseline level of family burden was not associated with changes in patient quality of life or positive symptoms. The present study examined longitudinal associations between family member perceived burden and clinical correlates to understand potential covariation in change over time in the context of first-episode schizophrenia in the RAISE-ETP study (N = 282). Across 24 months, family burden, patient quality of life, and positive symptoms improved. Findings from the present study suggest covariation in change over time in quality of life and family burden. As patient quality of life improved, family burden decreased. However, initial levels of quality of life were not significantly associated with changes in family burden and vice versa. Initial levels of positive symptoms were significantly associated with initial levels of family burden. These findings have treatment implications by suggesting the potential for interventions aimed at improving quality of life to have a spillover effect on family burden, or alternatively, that reducing perceived family burden may improve patient quality of life. [ABSTRACT FROM AUTHOR]

Objectives: This descriptive research was conducted with the aim of determining the difficulties families with intellectually disabled children face and their family burdens. Methods: The research population consisted of the mothers of 220 children who are aged 0-18 and monitored at a Special Guidance and Research Center due to their intellectual disabilities. The sample group was composed of 160 mothers who consented to participate in the research. Results: Of the children, 36.9% had mild, 43.1% had moderate, and 20% had severe mental retardation. Of the mothers, 48.8% reported they had no one with whom to share the care of the child. Mothers also reported that they felt disappointment (38.8%), bewilderment (48.1%), shock (31.3%), desperation (52.5%), anger (16.9%), guilt (14.4%). Of the mothers, 13.1% blamed others, 61.9% accepted the situation as an act of God, 12.5% had thoughts of committing suicide, and 28.1% suffered from depression. On the "Family Burden Assessment Scale (FBAS)," 7.5% of the mothers got low scores, and 92.5% got high scores. Conclusion: This research found that most of the families felt anxious about the future, felt like their burden was too much to bear, and expected information and support from healthcare professionals. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Background Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. Design A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. Methods The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. Results This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Conclusions Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. Relevance to clinical practice The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress management and make meaningful contribution to the relief of family relocation stress, promote patient recovery and enhance the well-being of patients and family caregivers. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate possible differences in family environment among patients experiencing their First Episode of Psychosis (FEP), chronic patients and controls. Family cohesion and flexibility (FACES-IV) and psychological distress (GHQ-28) were evaluated in families of 50 FEP and 50 chronic patients, as well as 50 controls, whereas expressed emotion (FQ) and family burden (FBS) were assessed in families of FEP and chronic patients. Multivariable linear regression analysis, adjusted for confounders, indicated impaired cohesion and flexibility for families of FEP patients compared to controls, and lower scores for families of chronic patients compared to those of FEP patients. Caregivers of chronic patients scored significantly higher in criticism, and reported higher burden and psychological distress than those of FEP patients. Our findings suggest that unbalanced levels of cohesion and flexibility, high criticism and burden appeared to be the outcome of psychosis and not risk factors triggering the onset of the illness. Furthermore, emotional over-involvement both in terms of positive (i.e. concern) and negative behaviors (i.e. overprotection) is prevalent in Greek families. Psychoeducational interventions from the early stages of the illness should be considered to promote caregivers' awareness regarding the patients' illness, which in turn, may ameliorate dysfunctional family interactions. [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]

Objective: This study was conducted to determine the effects of family-to-family support programs provided for the families of schizophrenic patients on the need for information about the illness, family burden and self-efficacy Method: The study was carried out with 34 relatives who have key roles in the lives of 34 outpatients who were diagnosed with schizophrenia under DSM-IV-TR. A volunteering family member was given training about the purpose, contents and planning of the program. The family member who had been trained then extended this training to other family members with the assistance of the psychiatric nurse. The training was done once a week, for a total of 12 sessions. The data were collected using a Disease Information Form (DIF), the Perceived Family Burden Scale (PFBS) and the Self-Efficacy Scale (SES). Results: There was a significant decrease in the PFBS objective scores (from 11.76±3.89 to 9.82±4.03, p=0.000), subjective scores (from 37.85±14.57 to 32.74±4.39, p=0.030) and total scores (from 49.62±18.25 to 42.56±7.56, p=0.005) and a significant increase in the SESS scores (from 82.65±12.01 to 97.79±7.17, p=0.000). Before training, 58.8% of family members correctly answered that schizophrenia is a brain disease, while 94.1% correctly stated that, it must be treated with medication; however, 55.9% of caregivers incorrectly believed in magical attributions relating to the disease. After training, all caregivers were able to answer correctly. Conclusion: A family-to-family support program was found to be effective in reducing caregivers' need for information, reducing their burden, and increasing their self-efficacy in our country. [ABSTRACT FROM AUTHOR]

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Background & objectives: A substance dependent person in the family affects almost all aspects of family life. This leads to problems, difficulties or adverse events which impact the lives of family members and causes enormous burden on family caregivers. The present study aimed to assess the pattern of burden borne by the family caregivers of men with alcohol and opioid dependence. Methods: A cross-sectional study was conducted with ICD-10 diagnosed substance dependence subjects and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in north India. Family Burden Interview Schedule was used to assess the pattern of burden borne by the family caregivers of 120 men with alcohol and/or opioid dependence. Results: Compared to opioid and alcohol+opioid dependence groups, more often the alcohol dependence group was older, married, currently working, having a higher income and with the wife as a caregiver. Family burden was moderate or severe in 95-100 per cent cases in all three groups and more for 'disruption of family routine', 'financial burden', 'disruption of family interactions' and 'disruption of family leisure'. Family burden was associated with low income and rural location. It was associated neither with age, education or duration of dependence of the patients, nor with family size, type of caregiver or caregiver's education and occupation. Interpretation & conclusions: Almost all (95-100%) caregivers reported a moderate or severe burden, which indicates the gravity of the situation and the need for further work in this area. [ABSTRACT FROM AUTHOR]

Abstract: Family impact (or family burden) is a concept born in the field of mental health that has successfully been exported to the ambit of intellectual disability (ID). However, differences in family impact associated with severe mental health disorders (schizophrenia), to ID or to mental health problems in ID should be expected. Seventy-two adults with intellectual disability clients of the Carmen Pardo-Valcarce Foundation''s sheltered workshops and vocational employment programmes in Madrid (Spain), 203 adults diagnosed with schizophrenia from four Spanish Community Mental Health Services (Barcelona, Madrid, Granada and Navarra) and 90 adults with mental health problems in ID (MH-ID) from the Parc Sanitari Sant Joan de Déu Health Care Site in Sant Boi de Llobregat, Barcelona (Spain) were asked to participate in the present study along with their main caregivers. Family impact experienced by caregivers was assessed with the ECFOS-II/SOFBI-II scale (Entrevista de Carga Familiar Objetiva y Subjetiva/Objective and Subjective Family Burden Interview). In global terms, results showed that the higher family impact was found between caregivers to people with MH-ID. The interaction of both conditions (ID and mental health problems) results in a higher degree of burden on families than when both conditions are presented separately. There was also an impact in caregivers to people with schizophrenia, this impact being higher than the one detected in caregivers to people with intellectual disability. Needs of caregivers to people with disability should be addressed specifically in order to effectively support families. [Copyright &y& Elsevier]

The Italian psychiatric reform of 1978 was one of the most radical attempts in history to abolish the practise of custodial psychiatry using legislation. The work of the charismatic reformer Franco Basaglia had four main objectives, which have taken more than 30 years to achieve. Although the creation of outpatient mental health centres and a reduction in involuntary commitments occurred rapidly, the expensive development of small acute psychiatric departments in general hospitals as an alternative to psychiatric hospitals was implemented very slowly. According to a national survey by the Italian Ministry of Health, in 2001, there were a total of 9,300 acute beds for all of Italy, of which as many as 4,000 were in private facilities. With 1.72 acute beds per 10,000 inhabitants, Italy has one of the lowest figures in Europe of psychiatric beds. However, Italy's apparent and often praised low bed requirement places a large burden on families. The implementation of the reform process was most delayed and occurred at its worst in South Tyrol, in North Italy. In an effort to achieve a modern and progressive community-based psychiatric service, in particular one with more specialised services, mental health providers in this region have examined German, Austrian and Swiss models of psychiatric practice. [ABSTRACT FROM AUTHOR]

The present study examined associations between negative family exchanges (patient perceptions of family overprotection and negative expressiveness, and patient feelings of being a burden), and two indicators of adaptation to illness (mental health and negative affect) in patients with end-stage renal disease (ESRD). Data were collected using the perceptions of illness-related family exchanges questionnaire, the SF36 and the PANAS in a structured interview with 127 patients with ESRD in Greece. Findings indicate that patient perceptions of negative family exchanges are related to outcomes, even after controlling for demographic and clinical factors. It is important to consider caregivers in intervention programmes of ESRD patients. [ABSTRACT FROM PUBLISHER]

Objective: Psychiatric deinstitutionalization resulted in greater involvement of families in daily care of patients. Family caregivers burden has been described by international researches. In Brazil very few studies investigated family burden with validated scales, perhaps due to the restrict availability of scales to measure this construct. The present study examined the reliability of the Brazilian version of the Family Burden Interview Schedule. Method: Scale reliability was assessed through its internal consistency and temporal stability. A sample of 243 family caregivers of psychiatric patients attending public outpatient services were interviewed with the scale. Socio-demographic data were collected with a standardized form. A sub-sample of 42 relatives participated in a retest, after 3 weeks, for assessment of the scale temporal stability. Results: Cronbach alpha coefficients ranged from 0.58 to 0.90 for global and domains scores. Pearson correlation coefficients and intra-class correlation coefficients for test and retest ranged from 0.54 to 0.90. Discussion: Results for internal consistency were similar to the original scale. Four subscales presented alpha coefficients superior to the original ones. The temporal stability cannot be compared because this analysis was not performed for the original scale. Conclusion: The Brazilian version of the scale had good psychometric properties of temporal stability and internal consistency. [ABSTRACT FROM AUTHOR]

Objectives: To describe the economic impact on families of caring for children with special health care needs (CSHCN), and to determine the relative contributions of socioeconomic and health-related factors to these impacts on families in the State of New Hampshire. Methods: Seven hundred and fifty families with CSHCN in New Hampshire were interviewed in the National Survey of Children with Special Health Needs. Among respondents with CSHCN, univariate and bivariate analyses were conducted to examine economic impact and independent factors (income, insurance type, and impact of condition). Multiple logistic and linear regression models were used to examine relationships between impact and independent factors, controlling for race/ethnicity. Results: Compared to typical children, CSHCN were more likely to have public insurance (12% and 21%, respectively) and less likely to live in higher income families (56% and 48%, respectively). Among CSHCN, nearly one-quarter were greatly affected by their condition, 31% had inadequate insurance, families of 21% had financial problems, parents of 27% had to cut work hours, and almost 15% needed professional care coordination. Adjusting for other factors in regression models, the impact of the condition was associated with all measures of impact, insurance type was associated with out-of-pocket costs, and income was associated with the total number of impacts. Parents of children who are usually or always affected by their conditions were 14 times more likely than those who are never affected to need care coordination. Conclusion: A family’s need for support services, and particularly for care coordination, may depend less on the family’s means than on the impact of their child’s condition. [ABSTRACT FROM AUTHOR]

Background:. Schizophrenia as a chronic mental disorder not only has far-reaching consequences for patients, but also for their family members or other informal caregivers. In this study, we investigated whether needs for care of patients with schizophrenia are related to (negative) consequences for their informal caregivers. Method:. A total of 287 patients with schizophrenia and their informal caregivers participated in the EPSILON study of schizophrenia in five European countries. Caregiver consequences were measured by the Involvement Evaluation Questionnaire (IEQ) and needs for care by the Camberwell Assessment of Need (CAN). Results:. Total number of needs for care as well as specific areas of needs for care of patients appeared to be only weak predictors of caregiver consequences in terms of explained variance. Conclusion:. Subjective needs for care as measured by the CAN are not a good indicator for consequences experienced by the informal care system of patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Abstract Background During the last decade, there has been a growing interest in outpatient support services for persons with intellectual disability (ID) and psychiatric and/or behavioural problems and their families. In this study, we explore the family burden that is associated with children or adults with ID and behavioural or psychiatric problems living at home. Method The research group consisted of 66 clients of In Casa, a project of outpatient treatment. Their average age is 18.97 years and their average IQ 55.37. The Reiss Screen for Maladaptive Behaviour (adults) or Reiss Scales for Children's Dual Diagnosis (children) and the Nijmegen Family Situation Questionnaire have been administered. Results About 62% of the children and 86% of the adults living at home and referred to In Casa have severe psychiatric or behavioural problems as measured by the Reiss scales. The dual diagnosis has a more negative impact on the family situation than the condition of ID only. Conclusion Parents consider the psychiatric or behavioural problems of their child to be an extra burden and feel it more difficult to raise and manage such a child. This impels them to change the situation and to call on the help of external services. Some methodological questions and the implications of the findings in terms of support needs are discussed. [ABSTRACT FROM AUTHOR]

The investigators of this project examined the relationships between caregiving experience and subjective and objective burden. Interviews were conducted with 80 people caring for, or assisting, an elderly relative. The findings indicate that different factors are related to subjective burden than are related to objective burden. The age and income of the caregiver were found to be the best predictors of subjective burden. Caregiving tasks that confine the caregiver either temporally or geographically were found to be the best predictors of objective burden. It was concluded that the level of objective burden could best be reduced through the introduction of personal aid services, supportive equipment that enables greater self-care, and respite services. [ABSTRACT FROM AUTHOR]

With deinstitutionalization, families have acquired a care-giving responsibility for their mentally ill relatives. This study examined the costs families bear after assuming their recently acquired responsibilities. A random sample of 125 families who had one post-hospital member at home revealed relatives paying a high price. The impact on the family was separated into two types of burden, objective and subjective. The significance of the high prevalence of families experiencing adjustment problems is discussed in terms of who supports the support system. [ABSTRACT FROM AUTHOR]

This paper reviews 2 aspects of obsessive-compulsive disorder (OCD): impairment in functioning and family burden associated with OCD. Impairment is evident from epidemiological and clinical studies in several areas, particularly in occupational and social maladjustment. Clinic outpatients show a range of impairment associated with OCD, while hospitalized patients exhibit consistently severe disabilities that rival those of patients with schizophrenia. Although behaviourally and medication-treated patients improve in adjustment levels, there is some evidence of persistent impairment, particularly in social and work functioning. Several studies support extensive family involvement and accommodation of OCD symptoms, as well as the considerable burden placed on families who reduce their social activities and increase their isolation and distress. Findings are equivocal regarding OCD and marital distress. Predictors of treatment outcome do not include marital dissatisfaction, but may include expressed anger and criticism. With regard to treatment, family support groups are popular but untested interventions, and family-assisted individual and group behaviour therapy have demonstrated good outcomes in limited trials. [ABSTRACT FROM AUTHOR]

The experience of the application of McFarlane's multiple family group intervention in seven schizophrenic patients and their eight caregivers in a middle-stay unit in order to improve burden and social support for the caregivers and to improve patient functioning is reported. A baseline evaluation and another post-intervention evaluation were made. Improvement in the knowledge about the disease and in the family burden was observed. Social support for the family and general functioning of the patient was not changed after family intervention. [ABSTRACT FROM AUTHOR]

Introduction: Obsessive compulsive disorder (OCD) is a severe mental disorder associated with high levels of personal, social and family burden. Several interventions have been developed to support patients and their family members, and the Fallon psychoeducational family intervention has been found one of the most effective. Objectives: The present study aims to: 1) adapt the psychoeducational family intervention according to the Falloon model to the context of OCD patients and their family members; 2) to evaluate the effectiveness of the experimental intervention in terms of reduction of the level of family burden, family accommodation and maladaptive coping strategies. Methods: The experimental intervention has been developed on the basis of the Falloon psychoeducational model The intervention covers the following topics: information on OCD; pharmacological and non-pharmacological treatments; family accommodation; communication skills and problem-solving strategies. The efficacy of the intervention will be tested in a randomized controlled trial implemented at the Department of Psychiatry of the University of Campania "L. Vanvitelli". In particular, at least 10 OCD patients and their family members will be recruited and consecutively allocated to the experimental group or to a waiting list group. Results: Patients and family members allocated to the experimental group are expected to report a low level of family burden and family accommodation and an improvement in problem-oriented coping strategies compared to those allocated to the waiting list. Conclusions: The new psychoeducational family intervention could be useful to improve the long-term outcome of OCD patients and of their family members. [ABSTRACT FROM AUTHOR]