Caregiver burden among caregivers of mentally ill individuals and their coping mechanisms A facility based study

Abstract

Problem: Mental illnesses not only affect the individual concerned but also the caregivers. Caregiver burden is a complex phenomenon. Caregivers who perceive high level of burden are those who lack both family and social support. They require tireless endeavor, sympathy and energy. Mostly family members fail to recognize it and caregiver’s own physical, mental and social health is often ignored. Care givers adopt various coping mechanism. A Mechanism, adopted in a positive way would lessen the amount of burden.6 Mal adaptive strategy in turn would affect the well being.7The study was done to measure and analyze caregiver burden and factors associated with the burden respectively. The study was also intended to explore coping mechanisms adapted by the caregivers in response to burden perceived by them. Approach: A cross sectional analytical study was conducted among 60 caregivers of patients with mental illnesses attending psychiatric medicine outpatient department in a tertiary care hospital, at Karur(India) between July 2022 and Dec 2022. After obtaining Institutional Ethics clearance and informed consent, study tool was administered. It consisted of 4 parts. Part 1 dealt with socio-demographic details of the participants. Part 2 enquired about clinical information of care recipient. Part 3 included the Burden Assessment Schedule. Part 4 was the brief COPE assessment scale. Data entry was done in Microsoft Excel. Entered data were exported to SPSS software version 20 for analysis. Appropriate descriptive and inferential statistics were done. Independent T test, one way ANOVA, Pearson’s correlation and Chi square tests were applied. Findings: Among caregivers other than spouses, male caregivers perceive higher burden (mean score +/- SE = 28.75 +/- 2.272) than the female caregivers (mean score +/- SE = 26.25 +/- 2.192). Perceived severity of disease was higher among Care givers residing in urban area (mean score +/- SE = 8.0385 +/- 0.36577) than those residing in rural area (mean score +/- SE = 6.9118 +/- 0.28438). Among caregivers other than spouses, caregivers who had completed higher secondary schooling or diploma holders perceive higher level of burden (mean – 28.75) than those who completed primary schooling (mean – 24.75). Impact of chronic mental illness of care recipients on well being of caregivers was higher among spousal caregivers than the others. A Positive correlation existed between burden perceived among spousal caregivers and problem focused, emotional focused and adaptive coping. All these associations were statistically significant at p value 0.05, 0.01 or 0.001. Distribution of moderate to severe burden among caregivers other than spouses (52.3%) is slightly higher than that of spousal caregivers (50%) and the difference is not statistically significant (p = 0.876). Conclusion: Among various factors, gender, education, residence and chronic nature of care recipient’s mental illness were found to be significantly associated with either one or another component of burden or the whole. Mental health professionals should broaden their vision so that burden perceived by the caregivers would also be attended. Public health personnel should take measures to implement family as well as community level approach to attend caregivers along with their mentally ill care recipients.