Family Burden Interview Schedule Research Articles

Comparison of caregiver burden in schizophrenia and obsessive–compulsive disorder

Aim of the study1.To assess and compare the burden of care and psychiatric morbidity in caregivers of patients with schizophrenia and Obsessive-Compulsive Disorder (OCD). 2.To study burden with relation to socio-demographic characteristics and disease related factors.Subject or material and methodsStudy was conducted at tertiary care general hospital psychiatry department in India.Fifty consecutive patients and their primary caregivers each, of schizophrenia and OCD, were assessed. Burden of care was assessed by Family Burden Interview Schedule (FBIS). Psychiatric morbidity was assessed by General Health Questionnaire-28 (GHQ-28). The collected data was analyzed by SPSS, Chi-Square test, T-test and Pearson correlation.ResultsBurden of care was higher in caregivers of schizophrenia in 5 domains - Financial burden, Disruption of family routine, Disruption of family leisure, Disruption of family interaction and Effect on physical health. However, statistically significant higher score was observed only for domain of disruption of family routine. Caregivers with schizophrenia had higher psychiatric morbidity but anxiety and insomnia were significantly higher in caregivers of OCD. Suicidality was significantly higher in caregivers of schizophrenia. Spouses of schizophrenia had higher burden and distress. As family burden increased, psychiatric morbidity in caregiver also increased.DiscussionOCD imposes considerable burden on caregivers comparable to that of schizophrenia. Both disorders cause significant psychosocial problems for the family.ConclusionsThough the extent of burden of care and psychiatric morbidity were higher in caregivers of schizophrenia, caregivers of OCD had also considerable burden of care as well as psychiatric morbidity. Key words: Schizophrenia, Obsessive-Compulsive Disorder, Caregiver, Burden

Reported family burden of schizophrenia patients in rural China.

We aim to assess the level of family burden of schizophrenia patients and identify its predicting factors in a rural community sample of China. A sample of 327 primary caregivers was recruited through a one-stage cluster sampling in Ningxiang County of Hunan province, China. Family burden was assessed using the Family Burden Interview Schedule (FBIS) of Pai and Kapur. Our results showed that the mean score of FBIS was 23.62±9.76 (range, 0–48), with over half (52%) caregivers reported their family burden being moderate and severe. Among the six domains of family burden, financial burden (76%) was the commonest burden, while disruption of family interactions (37%) was the least mentioned. A multivariate analysis of family burden revealed that patient being admitted for over 3 times, caregiver being female, having a middle school education, and with additional dependents, as well as higher care network function were positive predictors of family burden, while higher patient function and family function, and increasing patient age were negative predictors of family burden.Intervention to decrease family burden may be best served by improving family function and exploring alternative care model instead of hospitalization.

A comparative study of family burden and quality of life between caregivers of schizophrenia and dementia patients

Background: In chronic mental diseases, as the disease progresses, it carries with tremendous burden both physically and psychologically on the family members, who are usually in the process of caregiving. The quality of life (QOL) of these caregivers is directly related to the subjective and objective burden of the illness. The objective of the study was to assess and compare the level of family burden and QOL between caregivers of Schizophrenia and Dementia patients as well as to find out the relationship between family burden and QOL.Methods: A total of 128 key caregivers (64 caregivers of each group) fulfilling the inclusion criteria purposely selected from the OPD of MHI, S. C. B. Medical College and Neuropsychiatric Consultation Centre, Cuttack. The impact of family burden on key caregivers of dementia and schizophrenia patients was assessed by using family burden interview schedule and the quality of life of key caregivers was assessed by using WHOQOL BREF scale. Data was analysed by using chi-squre, t test and pearson correlation. Data analysis was performed by SPSS.Results: Statistical significant differences (p <0.05) were found in the areas of financial burden, disruptions of family routine activities, family leisure and family interaction between dementia and schizophrenia caregivers. Whereas there was no statistical significant difference (p >0.05) found in different domains of quality of life between these two groups of caregivers. There were significant negative correlations found between family burden and psychological, social relationships and environment domains of quality of life.Conclusions: Caregivers perceived subjective and objective burden ultimately affecting their QOL.

Family Burden and Health Related Quality of Life of HIV Infected Individuals in Madurai, South India

Introduction: With the advent of Highly Active Antiretroviral Therapy (HAART) in 1996, HIV-infected patients are living longer and are concerned not only with treatment’s ability to extend their life butalso with the quality of the life they are able to lead, because, efficacy of treatment is strongly relatedto meaningful outcome i.e., better Quality of Life. Especially Health related quality of life has not been studied well. Hence, this study was necessitated with the objectives to evaluate Health Related Quality of Life (HRQoL) in HIV infected persons on ART. The secondary objectives were to assess the family burden experienced by the families of HIV infected, and measure influence of family burden on overall quality of life.Methodology: The HIV infected individuals who were started on treatment six months prior to date of interview were considered for the study The SF36 (Short Form with 36 questions) was used to evaluate function and mental Health while Pai and Kapur’s Family Burden Interview schedule was used to assess family burden. Interview schedule was pre-tested on 10 HIV infected individuals for consistency. Data analysis was performed using SPSS version 11 (SPSS inc. Chicago, IL, USA). Pearson product moment Correlation were computed to explore the relationships of SF36 with SLI, Family Burden and BMI. Further, Independent student “t” – test was performed to see the association between HRQoL and gender.Results: Of 91 participants interviewed 51.6% were women. Median age (years) of the respondents was 33. The overall mean score for Physical health was 45.13 SD (12.40) and for Mental health 56.91 SD (15.52). Age of HIV infected persons had significant influence in scores in social functioning (p-value .015), emotional well being scores (.015), and Mental health (.010). Socio life Index was directly related to physical health, mental health, Vitality, social functioning and emotional scores on HRQoL. Physicalhealth score was negatively affected by the Family burden score. Similarly, BMI status of the respondents correlated with Mental health, Body Pain, Vitality and Role emotional scores of HRQoL scale SF 36.Conclusion: Socio Life Index and BMI appear to be the two important predictors of HRQoL. Therefore, special attention may be required to HIV infected persons with lower SLI and BMI. Nutritional supplements, in addition to ART drugs, may be provided to ensure some improvements in physical functioning.SAARC J TUBER LUNG DIS HIV/AIDS, 2016; XIII(1), Page: 1-8

SU126. The Burden of Caregiving in a Brazilian Sample of Outpatients With Schizophrenia

Abstract The care of patients with schizophrenia imposes a significant objective e subjective burden for caregivers (Caqueo-Urizar , 2014). This study aims to evaluate the burden in a sample of Brazilian outpatients with schizophrenia. Cross-sectional observational study. Patients with diagnosis of schizophrenia (DSM-5), 18–50 years, both sexes, and a relative/caregiver, both sexes, aged 18–70 years, living in contact with the patient at least 30 h/wk. Family burden was evaluated using the Brazilian version of the Family Burden Interview Schedule (FBIS-BR), a semistructured interview, considering objective and/or subjective burden, distributed in 5 subscales (assistance to the patient in daily life [objective and subjective burden]; supervision of patients’ problematic behaviors [objective and subjective burden]; financial burden [objective and subjective]; impact on family routine [objective]; worries about the patients’ present and future life [subjective]). The objective burden is assessed in a Likert scale (1 = never to 5 = every day) and subjective burden, in Likert scale (1 = not at all to 4 = very much). Patients: = 23, mean age: 34.5 ± 8.2 years, 78.3% male, 95.7% single, 56.6% with elementary or middle school, age at onset of disease: 19.4 ± 5.3 years, number of hospitalizations: 1.91 ± 2.02, duration of disease: 16.48 ± 7.97 years, 73.9% without social security. Caregivers: = 23, mean age: 59.22 ± 11.0 years, 69.6% female, 60.9% mothers, 39.1% married, 69.6% with elementary or middle school, 56.5% without social security, most of them live with patients. The mean total score of the objective burden was 2.80 ± 1.26 and the subjective burden was 2.21 ± 0.54. The assistance to the patient in daily life (objective) was 3.32 ± 0.77 and its subjective aspect was 1.96 ± 0.95; supervision of patients’ problematic behaviors (objective) was 1.86 ± 0.53 and it subjective aspect was 0.97 ± 0.59. The financial burden was 2.78 ± 1.47; the impact on family routine (objective) was 1.89 ± 0.81 and worries about the patients’ present and future life (subjective) 3.72 ± 0.61. In our sample, most of the patients were single and taken care by their mothers. Our scores were high in both objective and subjective burden, with similar results compared to a Brazilian sample of relatives of patients with severe mental disorders (Bandeira , 2005). Worries about the patients’ future impose the highest burden for mothers as the patients are single, without any other caregiver.ReferencesCaqueo-Urizar A, Miranda-Castillo C, Lemos Giraldez S, . 2014;26(2):235–243.Bandeira M, Calzavara MGP, Varella AAB. . 2005;54(3):206–214.

Quality of Life and Burden of Care in Glaucoma Patients and Their Families in a South Asian Population

Purpose: To study the quality of life and burden of care in glaucoma patients and their families and to compare it with cataract patients. Methods: This was an observational, prospective, cross-sectional study in which 100 glaucoma patients and 50 patients with age -related cataract as controls, 40 years of age or older were enrolled. Patients were interviewed to obtain information on visual disability and vision-specific quality of life using NEI VFQ-25 and on general quality of life using WHOQoL-BREF. Burden of care of glaucoma was assessed using Family Burden Interview Schedule. Scores of these three questionnaires were taken as main outcome measures. Results: Scores for patients with glaucoma were significantly lower than those with cataract in visual function, social function, mental health, role difficulties and dependency sub-scales in NEI VFQ-25 questionnaire (P<0.05). General quality of life scores were significantly poor in glaucoma as compared to cataract patients in all domains of WHOQoL-BREF questionnaire including general well-being, physical health, psychological, social relationship and environment (P<0.05). There was more burden of care in glaucoma patients and their families as compared to cataract patients in Family Burden Interview Schedule questionnaire for all sub-scales including financial burden, disruption of routine family activities, family leisure, family interaction, physical health and mental health (P<0.05). Conclusions: The general quality of life was poor, and influence of limitation in visual functioning on health related quality of life, and burden of care was significantly higher in glaucoma patients as compared to cataract patients.

Burden and Distress in Caregivers of Patients With Panic Disorder and Agoraphobia.

We estimated the prevalence, severity, and correlates of burden and distress in caregivers of patients with panic disorder and agoraphobia. The instruments used in this cross-sectional study with 40 caregivers and 40 outpatients were Carer Burden Interview (CBI), Family Burden Interview Schedule (FBIS-BR), Self-Reporting Questionnaire (SRQ), Panic and Agoraphobia Scale (PAS), and Mini-international Neuropsychiatric Interview. Bivariate analyses were followed by regression analyses. The patients' mean PAS score was 29.6, and the mean scores in the caregivers' burden scales were 27 (CBI) and 1.64 (FBIS-BR). Distress (or common mental disorder [CMD]) occurred in 37.5% and was associated with higher burden. In the multivariate analysis, the SRQ score was predicted by female sex and worse self-evaluation of health, the CBI score by CMD and public service, the FBIS-BR score by CMD and not living with the patient, the FBIS-objective score by CMD and being employed, the FBIS-subjective score by CMD, and the level of worry by the severity of patients' avoidance and panic attacks.

Development and validation of the Vellore Occupational Therapy Evaluation Scale to assess functioning in people with mental illness.

Available occupational therapy assessment scales focus on specific areas of functioning. There is a need for comprehensive evaluation of diverse aspects of functioning in people with mental illness. To develop a comprehensive assessment scale to evaluate diverse aspects of functioning among people with mental illness and to assess its validity and reliability. Available instruments, which evaluate diverse aspects of functioning in people with mental illness, were retrieved. Relevant items, which evaluate specific functions, were selected by a committee of mental health experts and combined to form a comprehensive instrument. Face and content validity and feasibility were assessed and the new instrument was piloted among 60 patients with mental illness. The final version of the instrument was employed in 151 consecutive clients, between 18 and 60 years of age, who were also assessed using Global Assessment of Functioning (GAF), Occupational Therapy Task Observation Scale (OTTOS), Social Functioning Questionnaire (SFQ), Rosenberg Self Esteem Scale (RSES) and Pai and Kapur Family Burden Interview Schedule (FBIS) by two therapists. The inter-rater reliability and test-retest reliability of the new instrument (Vellore Occupational Therapy Evaluation Scale (VOTES)) were also evaluated. The new scale had good internal consistency (Cronbach's alpha = .817), inter-rater reliability .928 (.877-.958) and test-retest reliability .928 (.868-.961). The correlation between the general behaviour domain (Pearson's Correlation Coefficient [PCC] = -.763, p = .000), task behaviour (PCC = -.829, p = .000), social skills (PCC = -.351, p = .000), intrapersonal skills (PCC = -.208, p = .010), instrumental activities of daily living (IADL) (PCC = -.329, p = .038) and leisure activities (PCC = -.433, p = .005) scores of VOTES with the corresponding domains in the scales used for comparison was statistically significant. The correlation between the total score of VOTES and the total scores of OTTOS, SFQ and RSES was also statistically significant suggesting convergent validity. The correlation between the total score of VOTES with the total score of FBI is not statistically significant, implying good divergent validity. VOTES seems to be a promising tool to assess overall functioning of people with mental illness.

Burden among Caregivers of Persons with Dementia

Caring for a person who has dementia is not an easy task and requires a lot of understanding and patience and it impose a lot of burden on caregivers. So this study was carried out to see the level of burden experienced by caregivers of patients with dementia. The sample comprised of 50 Caregivers of persons with dementia. The data collected from NIMHANS Geriatric Clinic. The patients who fulfilled the inclusion and exclusion criteria were identified using simple random sampling. The following tools were used for the current study: Socio-demographic data sheet and family burden interview schedule. The result found that caregivers of patients with dementia experienced mild to moderate level of burden especially in the areas of financial burden, disruption of family activities, and disruption of family life.

Extent and pattern of burden of care and its associated factors among Eritrean families of persons living with schizophrenia: a cross-sectional study.

PurposeTo assess the caregiving burden and its associated factors among Eritrean families of persons living with schizophrenia.MethodsA cross-sectional study was conducted for 146 caregivers with their respective known patients with schizophrenia of Saint Mary's Neuropsychiatric National Referral Hospital (SMNNRH). Data were collected using Pai and Kapur's Family Burden Interview Schedule (FBIS), the Positive and Negative Syndrome Scale (PANSS) and self-prepared sociodemographic sheet. Data were analysed using SPSS V.21. Descriptive statistics, independent t-tests, one-way analysis of variance (ANOVA) and multiple regression analysis was employed to analyse the data.ResultsIn this study, 84 (57.5%) were males and 62 (42.5%) were females. The mean age was 33.96+10.37 (median=31) for the patients and 46.76+13.96 (median=48) for the caregivers. Total mean objective score was 29.47+6.67. Family caregivers who were single (F=3.224, p<0.005, effect size (ES)=0.064), had educational level at elementary (F=5.647 p=0.001, ES=0.11), had low monthly income (t=7.727, p<0.001, ES=0.01) and were dissatisfied with family support (t=2.889, p<0.01, ES=0.01) experienced greater burden relative to the counterparts. Caregiver's age (β=0.156; p<0.05), duration of caregiving (β=0.131; p<0.05), monthly household family income (β=−0.298; p<0.001), history of self-injury (β=0.151; p=0.05), positive scale (β=0.344; p<0.001), negative scale (β=0.278; p<0.001) and general psychopathological scale (β=0.146; p<0.01) emerged as significant predictors of objective burden.ConclusionsFamily caregivers of a person living with schizophrenia experience a significant burden of care. Our findings highlight that there is a need of strengthening social and psychological support to reduce the caregiving burden.

Relationship between Family Interaction pattern, Family Burden and Quality of Life among Caregivers of Patients with Alcohol Dependence

Alcohol and drug use disorders have devastating physical, mental, and socio-economic consequences not only for patients but also for their families. Their illness substantially affects the quality of life of other family members, including financial security, mental health, social networks, and productivity. So the present study was an attempt to assess the relationship between family interaction pattern, family burden and Quality of life among caregivers of individuals with alcohol dependence. This study was conducted at the Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi. It was a cross sectional study and purposive sampling was used. The present study consisted of 60 caregivers of alcohol dependence, those who were willing to participate and those who have satisfied with inclusion and exclusion criteria have been included in the study. The socio demographic data sheet had been used for collecting socio demographic details of the caregivers of individuals with alcohol dependence. To assess the alcohol severity of the patient, the alcohol severity index scale was applied. Family interaction pattern scale, family burden interview schedule and WHO Quality of life scale were applied on the caregivers of individuals with alcohol dependence. The findings indicated that there is significant positive correlation exist between family interaction pattern, Family burden and quality of life among caregivers of individuals with alcohol dependence.

Family burden in schizophrenia: the influence of age of onset and negative symptoms.

To investigate the determinants of family burden in a sample of patients with schizophrenia and their caregivers. Thirty-one stable patients with schizophrenia and their main caregivers were recruited. Sociodemographic variables were assessed in a semi-structured interview, and positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed with the Schizophrenia Cognition Rating Scale (SCoRS). Levels of burden on caregivers were assessed with the Family Burden Interview Schedule (FBIS). Interactions among variables were analyzed using Pearson correlations and linear regression analysis. Objective and subjective FBIS scores were 1.9 (standard deviation [SD] = 0.5) and 2.4 (SD = 0.6) respectively. Objective burden correlated positively with positive and negative symptoms, and cognitive impairment. Subjective burden correlated positively with positive symptoms and negatively with mean age of disease onset. Positive, negative and cognitive symptoms accounted for 47.6% of the variance of objective burden, with negative symptoms accounting independently for 30.3%. Age of onset, parents as caregivers and positive symptoms accounted for 28% of the variance of subjective burden, with age of onset independently explaining 20.3%. Patients' clinical and sociodemographic variables are important determinants of family burden in schizophrenia. Objective burden is predicted by symptoms, particularly negative ones. Subjective burden is predicted by symptoms and sociodemographic variables, particularly age of disease onset.

RELATIONSHIP BETWEEN FAMILY INTERACTION, FAMILY BURDEN AND QUALITY OF LIFE AMONG CAREGIVERS OF PATIENTS WITH EPILEPSY

Living with epilepsy imposes great challenges on both patients and their family caregivers but most researchers only explored the impact on patients, with less attention given to family caregivers. Our study intended to explore the needs and problems of epilepsy family caregivers of epilepsy patients encountered during the caregiving process. The present study was an attempt to assess the relationship between Family interaction pattern, family burden schedule and Quality of life of the caregivers of individuals with epilepsy. This study was conducted at the Ranchi Institute of Neuro-Psychiatry and Allied Sciences, Ranchi. It was a cross sectional study and purposive sampling was used. The present study was conducted among 60 caregivers of epilepsy, those who were willing to participate and those who have satisfied with inclusion and exclusion criteria have been included in the study. The socio demographic data sheet had been used for collecting socio demographic details of the caregivers of individuals with epilepsy. Family interaction pattern scale, family burden interview schedule and WHO Quality of life scale were applied on the caregivers of individuals with epilepsy. Statistical analysis was performed by using the SPSS programme 16.0 version. The result found that family interaction pattern has effect on family burden and quality of life. Likewise family burden has greater impact on quality of life. The study highlights the need for family interventional programs to address the specific issues related to family interaction, burden and quality of life of caregivers.

Social, Psychological and Financial Burden on Caregivers of Children with Chronic Illness: A Cross-sectional Study.

To explore social, psychological and financial burden on caregivers of chronically diseased children. Participants were recruited from ambulatory and hospital areas in pediatrics department following informed consent. Parents who were caregivers of children 18 y or below in age with chronic illness were included. Socio-demographic details were collected using a semi structured questionnaire, adapted from Family Burden Interview Schedule (FBIS). The psychological well-being of caregivers was assessed using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Descriptive analysis and ANOVA was done for comparing mean scores of responses to analyze financial, psychological and social burden across different diagnosis. A total of 204 (89 females:115 males) participated. Only 27% were receiving some benefits from government or hospital side. No depressive symptoms were reported by 25% caregivers, while 37% reported mild and 38% moderate to severe depressive symptoms. No anxiety symptoms were reported by 33%, while 50% reported mild and 17% moderate to severe anxiety symptoms. No association was seen between gender of the caregiver and depressive or anxiety symptoms. Significantly higher financial and social burden was seen in cerebral palsy and cancer groups vis-a-vis other diseases, being least in thalassemia. Disruption of routine life was highest in cancer group caregivers followed by those in cerebral palsy group. Most caregivers reported moderate depressive symptoms and mild to moderate anxiety symptoms. Cerebral palsy caused more social and financial burden on family vis-a-vis thalassemia. Social and financial burden on families of remaining diseases was comparable.

Perceptions of Subjective Burden Among Latino Families Caring for a Loved One with Schizophrenia.

The purpose of this study was to explore perceptions of subjective burden among Latino family members providing care for a loved one with schizophrenia. Data were collected from outpatient community mental health centers and featured 64 Latino family members who were primarily Spanish speaking and of Mexican origin. We used qualitative methods to examine subjective burden based on an open section of the Family Burden Interview Schedule. Five salient themes emerged capturing family members' subjective burden experience: (a) interpersonal family relationships, (b) emotional and physical health, (c) loss of role expectations, (d) religion and spirituality, and (e) stigma. Overall, findings illustrated that families perceived numerous challenges in their caregiving. Implications for research and practice among Latino family members are discussed.

A comparative study of caregivers’ perceptions of health-care needs and burden of patients with bipolar affective disorder and schizophrenia

Background: Although many studies in schizophrenia have evaluated health-care needs, there is a lack of data on the needs of patients with bipolar affective disorder (BPAD), with only occasional studies evaluating them, and no study has evaluated the relationship of health-care needs of patients with caregiver's burden. Aim: To study the relationship of caregiver's burden and needs of patients as perceived by caregivers of patients with BPAD and schizophrenia. Method: Caregivers of patients with BPAD and schizophrenia were assessed using the Camberwell Assessment of Needs – Research version (CAN-R) and Supplementary Needs Assessment Scale (SNAS), the Family Burden Interview schedule (FBI) and the Involvement Evaluation Questionnaire (IEQ). Results: Mean total needs of patients on CAN-R were 7.54 (SD 3.59) and 7.58 (SD 4.24) for BPAD and schizophrenia respectively. Mean total needs for SNAS were 7.24 (SD 3.67) and 7.68 (SD 5.02) for BPAD and schizophrenia groups, respectively. Total objective and subjective burden as assessed on FBI was significantly more for the schizophrenia group. Caregivers of patients with BPAD perceived significantly less disruption of routine family activities and lower impact on the mental health of others. On IEQ, the mean score on the domain of supervision was significantly higher for the BPAD group. In the schizophrenia group, positive correlations were seen between the total number of unmet and total (met and unmet) needs and certain aspects of burden, but no such correlations emerged in the BPAD group. Conclusion: There is no correlation between number of needs and burden in the BPAD group; however, in the schizophrenia group the number of needs correlated with the perceived burden. Accordingly, orienting services to address needs of patients with schizophrenia can lead to reduction in burden among caregivers.

Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore

Dementia is a global health issue and the effects on caregivers are substantial. The study aimed to examine the associations of burden, coping, self-efficacy with quality of life among family caregivers of persons with dementia in Singapore. Structured interviews were conducted in a convenience sample of 84 family caregivers caring and seeking clinical care for the persons with dementia in an outpatient clinic of a public hospital in Singapore. The outcome measures included the Family Burden Interview Schedule, Family Crisis Oriented Personal Evaluation Scale, General Perceived Self-Efficacy Scale, and World Health Organization Quality of Life Scale - Brief Version. In general, significant correlations were observed between the quality of life scores with coping strategy and family burden scores, but not between the coping strategy and family burden scores. Compared to demographic factors such as caregiver age and household income, psychosocial factors including family burden, coping strategies, and self-efficacy demonstrated greater association with quality of life in the participants. However, the dynamics of these associations will change with an increasing population of persons with dementia, decreasing nuclear family size, and predicted changes in family living arrangements for the persons with dementia in future. As such, it necessitates continuous study examining the needs and concerns of family caregivers and the relevance of ongoing interventions specific to caregivers of persons with dementia.

Caregiver burden and its determinants among family members of patients with chronic viral hepatitis in Shanghai, China: a community-based survey

BackgroundIn China, caregivers of chronic viral hepatitis patients experience considerable burdens, stress and disruption of their own well-being and social activities. Measurement of the effect on caregivers is an under-researched area. The Family Burden Interview Schedule (FBIS) was primarily devised for the caregivers of schizophrenia patients, and the adverse effect of the disease was similar to the effect of chronic viral hepatitis on family caregivers. In this study, we prospectively evaluated the psychometric properties of FBIS in the field of chronic viral hepatitis and used it to determine the factors affecting the caregiver burden on the family members of chronic viral hepatitis patients in Shanghai, China.MethodsA representative sample of patients (n = 1478) and caregivers (n = 1478) was randomly obtained through a multi-stage cluster sampling in Shanghai, China. Reliability and validity tests were used to verify the psychometric properties of the instrument. The two-level random intercept model was applied to determine the factors of the caregiver burden between the household and the community level.ResultsCronbach’s alpha coefficient was 0.90 for the overall instrument with statistical significance. Factor analysis suggested a three-factor model for the FBIS and confirmed that the adjusted unidimensional model and the second-order multidimensional model had better fit statistics. The average score of the caregiver burden in Shanghai was 12.62 ± 10.74, and financial burden constituted the major effect. The two-level random intercept model demonstrated that the risk factors were hospitalisation (β 1.69, 95%CI 0.48 to 2.90), elevated serum alanine aminotransferase levels (β 1.05, 95%CI 0.15 to 1.95), HCV infection (β 4.49, 95%CI 1.22 to 7.77), and acceptance of the hepatitis B vaccine (β 2.20, 95%CI 0.56 to 3.85), whereas the protective factors were no consumption of alcohol (β -2.69, 95%CI −5.19 to −0.19), average monthly costs for patients less than or equal to 100 US dollars (β -2.96, 95%CI −5.83 to −0.09), and good health status of family caregivers (β -9.91, 95%CI −12.76 to −7.05).ConclusionsFBIS can accurately measure the caregiver burden for chronic hepatitis. Targeting interventions toward the conditions associated with the caregiver burden is of great importance.

Cross-sectional survey of the relationship of symptomatology, disability and family burden among patients with schizophrenia in Sichuan, China.

BackgroundSchizophrenia is a chronic condition that leads to high rates of disability and high levels of family burden but the interactive relationship between these variables remains unclear, particularly in low- and middle-income countries where the vast majority of patients live with their families.AimAssess the symptom severity, level of disability, and family burden among clinically stable outpatients with schizophrenia in Sichuan, China.MethodsA total of 101 clinically stable outpatients with schizophrenia who had a median duration of illness of five years were assessed using the World Health Organization Disability Assessment Scale 2.0 (WHODAS II), the Positive and Negative Syndrome Scale (PANSS) and the Family Adaptation, Partnership, Growth, Affection and Resolve Index scale (APGAR); and their caregivers were surveyed using the Family Burden Interview Schedule (FBIS).ResultsAmong the 101 patients, 92 lived with their immediate family members, 74 had clinically significant disability, and 73 were unemployed. The level of disability was associated with the severity of symptoms (r=0.50, p<0.001), duration of illnesses (r=0.22, p=0.028), age of onset (r=-0.22, p=0.024) and patients’ level of satisfaction with family support (r=-0.30, p=0.020). Disability was also associated with the overall level of family burden (r=0.40, p<0.001), and with several subtypes of family burden: financial burden (r=0.21, p=0.040), the degree of disruption in family routines (r=0.33, p=0.001), the effect on family leisure activities (r=0.31, p=0.001) and the quality of family interactions (r=0.43, p< 0.001). Four variables remained significantly associated with the level of disability in the stepwise multivariate linear regression: duration of illness, severity of symptoms, patient satisfaction with family support, and the overall burden of the illness on the family.ConclusionsEven after adjusting for the severity of patients’ symptoms, patient disability is independently associated with family burden. This highlights the importance of targeting both symptoms and disability in treatment strategies for this severe, often lifelong, condition. In countries like China where most individuals with schizophrenia live with their families, family burden is an important component of the impact of the illness on the community that should be included in measures of the relative social and economic importance of the condition.

Caregiving appraisal in schizophrenia: A study from India

This study evaluated caregiving experience in the caregivers of patients with schizophrenia within the framework of the stress-appraisal-coping model. By purposive random sampling, 100 Indian patients with schizophrenia and their primary caregivers were assessed. The patients were assessed on Positive and Negative Symptom Scale (PANSS). Caregivers completed the Scale for Positive Aspects of Caregiving Experience (SPACE), Involvement Evaluation Questionnaire (IEQ), Family Burden Interview (FBI) Schedule, Coping Checklist, Social Support Questionnaire, and General Health Questionnaire (GHQ-12). Path analysis showed that psychological morbidity is mainly determined by subjective experience of burden, which in turn is significantly influenced by severity of psychopathology, time spent per day (in hours) in caregiving and the coping strategies used. Although coping strategies and PANSS do influence objective burden, objective burden itself has no influence on the level of psychological morbidity. Total PANSS score has no direct influence on subjective burden, but acts indirectly through total time spent in caregiving and coping. Caregiver's gain in positive experiences on SPACE scale positively influences subjective burden. The present findings suggest that better control of patients' symptoms would lead to less demand on the caregivers in the form of time and strain on coping abilities and would thus reduce subjective burden and psychological morbidity in the caregivers.