No abstract

There have been several violence-related deaths in Japan due to family violence by persons with severe mental illness against their caregivers. However, it is not often acknowledged that these violent acts are mainly directed at family members. This study aimed to clarify what acts of violence family caregivers experienced from their relative with schizophrenia, and how frequently these violent incidents occurred in their lifetime. We also examined caregivers' thoughts of death about themselves and their relatives, as well as their consultation efforts and escape from the violence perpetrated by their relative. Of the 277 caregivers, 87.7% had experienced psychological violence and 75.8% had experienced physical violence perpetrated by their relative. Of 210 caregivers who had experienced physical violence, 26.7% had thought of murder-suicide and 31.0% had wished for their relative's death. Family violence by persons with schizophrenia is not rare but a common occurrence in Japan and may have fatal consequences.

With the acceleration of deinstitutionalization might increase families' chances of suffering violence by patients. This study clarified parents' coping processes with violence experienced from patients with schizophrenia. The grounded theory approach was used, and 26 parents were interviewed. We identified a four-stage coping process: (1) hope for treatment, (2) living with violence, (3) trying to solve violence, and (4) last solution for violence. This coping process had two illness-related characteristics: (1) a process of coping with two main stressful events (the illness and violence), and (2) the need for long-term appraisal of violence because of its unclear causes.

Background: Family violence committed by persons with schizophrenia is a serious problem in the context of the accelerated deinstitutionalization in Japan. Community nurses could play an important role in resolving family violence by persons with schizophrenia. Objective: This study aimed to clarify the reasons for family violence as perceived by adult children with schizophrenia and ways to resolve this problem. Methods: A qualitative descriptive design was employed. Group interviews with 10 participants—five individuals with schizophrenia and five parents of adult children with schizophrenia-were conducted. Transcriptions were segmented according to the following three research questions: “How do parents recognize and cope with violence committed by persons with schizophrenia?,” “How do persons with schizophrenia perceive committing violence toward their parents and how do they change themselves after doing so?” and “How do persons with schizophrenia perceive ways to resolve the issue of violence toward parents?” The data were categorized and subcategorized based on the similarity of codes and organized in chronological order. Categories concerning reasons for violence and the subsequent changes in persons with schizophrenia made up the stages of their experiences. Results: Parents could not understand the reasons for violence committed by persons with schizophrenia. Experiences of committing violence and changes after violence as perceived by persons with schizophrenia involved the following five stages: complicated causes of occurrence, environment conducive to violence, onset of violence, gaining power, and regret and growth. Persons with schizophrenia wanted to be observed from a distance and were desirous of establishing relationships beyond the home. Conclusion: It is necessary for nurses to bridge the gap between patients and their parents by serving as a communication channel between them. In this way, there is hope to promote recovery even if the patient with schizophrenia commits violent acts toward the parent.