The Paths to Negative and Positive Experiences of Informal Caregiving in Severe Mental Illness: A Study of Explanatory Models.

Luísa Campos,Carlos Mota Cardoso,João Marques-Teixeira

doi:10.3390/ijerph16193530

Abstract

The experience of caregiving in severe mental illness is a valuable concept for research and clinical practice as it can provide access to the idiosyncratic assessment of negative and positive dimensions of informal caregiving, thus allowing the design of interventions focused on reducing risk factors and promoting protective factors. This study was aimed at testing explanatory models of negative and positive experiences of caregiving considering the role of the caregiver’s perceptions of difficulties, satisfaction, and coping. A convenience sample of 159 informal caregivers of patients with schizophrenia was used in this study. Different variables were considered: (1) perception of difficulties (Caregiver’s Assessment of Difficulties Index); (2) perception of satisfaction (Caregiver’s Assessment of Satisfaction Index); (3) perception of coping (Caregiver’s Assessment of Managing Index); and (4) the experience of caregiving (Experience of Caregiving Inventory). Using structural equation modeling, the results revealed the following: (1) the perception of difficulties and of satisfaction coexist; (2) the negative experiences of caregiving are predominantly explained by the perception of difficulties and of coping with stress; and (3) the positive experiences of caregiving are mainly explained by the perception of sources of intrapersonal satisfaction, while the perception of coping does not have robust predictive value.

Highlights

During the second half of the twentieth century, the direction of public mental health policy was to transfer the care of patients from state mental hospitals to settings in the community, with deinstitutionalization policies and the community mental health movement progressively increasing the number of people with chronic and severe mental illness living in their own homes, with hospital services being used only in situations of acute need [1,2]
With regard to the relationship between perception of coping and perception of satisfaction, strong associations were observed between problem-solving strategies and alternative perception strategies and intrapersonal satisfaction and satisfaction related to results, and dealing with stress strategies and interpersonal satisfaction
(3) Retroactivity between the perception of coping and the perception of satisfaction

Summary

Introduction

During the second half of the twentieth century, the direction of public mental health policy was to transfer the care of patients from state mental hospitals to settings in the community, with deinstitutionalization policies and the community mental health movement progressively increasing the number of people with chronic and severe mental illness (e.g., schizophrenia) living in their own homes, with hospital services being used only in situations of acute need [1,2]. On the one hand, this paradigm shift has brought benefits to the families of the mentally ill, in particular, the chance to be closer to the person and take care of them [3]; on the other hand, the passage of patients into the community has resulted in large costs for families including quantifiable costs in time, Int. J. Public Health 2019, 16, 3530; doi:10.3390/ijerph16193530 www.mdpi.com/journal/ijerph

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