Abstract
BackgroundGlobally, families play a critical role in providing care and support for persons living with schizophrenia. It is important to identify potentially modifiable factors that influence perceived caregiver burden in order to properly address the needs of caregivers. This is especially relevant in low-resource settings where psychiatric services are scarce and interventions could be most effective if targeted to both the individual living with schizophrenia and their caregiver. This study examines correlates of perceived burden among informal caregivers of individuals with schizophrenia in Tanzania, in particular, the association between burden and caregiver-reported family functioning.MethodsThis study used baseline data from an individually randomized controlled trial with 65 pairs of individuals with schizophrenia and their informal caregivers in Dar es Salaam and Mbeya, Tanzania. Caregiver burden was measured using the Burden Assessment Scale. Univariable and multivariable regression analyses were performed to determine the relationship between caregiver burden and family functioning and to explore other correlates of burden.ResultsSixty-three percent of caregivers reported experiencing high burden as a result of caring for a relative with schizophrenia. Multivariable regression analyses revealed that poor family functioning and the caregiver being employed were associated with high caregiver burden, while higher levels of hopefulness in the caregiver was associated with low caregiver burden.ConclusionCaregivers who were employed, reported poor family functioning, and/or had low levels of hopefulness were more likely to perceive high caregiver burden. Future interventions aiming to reduce caregiver burden may benefit from improving family functioning and nurturing hope among caregivers of individuals living with schizophrenia. Policies and programs should be cognizant of the needs of caregivers that work in addition to providing care for a relative with schizophrenia in order to better support them.
Highlights
In low- and middle-income countries, family involvement in psychiatric care plays a crucial role in the recovery of individuals living with schizophrenia due to a global shift away from institutionalized psychiatric care and limited availability of community-based psychiatric services and mental health resources [1, 2]
A systematic review of studies done in multiple African countries, including Ghana, Ethiopia, and South Africa, reported moderate to severe caregiver burden characterized by financial constraint, productivity loss, and lost employment [9]
The present study aimed to address this gap in the literature by examining caregiver burden and family functioning in a subSaharan African country
Summary
In low- and middle-income countries, family involvement in psychiatric care plays a crucial role in the recovery of individuals living with schizophrenia due to a global shift away from institutionalized psychiatric care and limited availability of community-based psychiatric services and mental health resources [1, 2]. There is extensive evidence from high-income countries indicating that informal caregiving for an individual with schizophrenia is associated with poor mental, physical, social, and financial outcomes for the caregiver [3,4,5,6,7]. It is important to identify potentially modifiable factors that influence perceived caregiver burden in order to properly address the needs of caregivers. This is especially relevant in low-resource settings where psychiatric services are scarce and interventions could be most effective if targeted to both the individual living with schizophrenia and their caregiver. This study examines correlates of perceived burden among informal caregivers of individuals with schizophrenia in Tanzania, in particular, the association between burden and caregiver-reported family functioning
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