A cross-sectional study on spouse and parent differences in caregiving experiences of people living with schizophrenia in rural China

Abstract

Background: Conflicting evidence exists on whether parent or spouse caregivers experience better outcomes when caring for family members with schizophrenia. The current study aims to examine relative caregiving experiences and impacts of spouse and parent caregivers for people living with schizophrenia (PLS) in China. Methods: A cross-sectional study was conducted in a sample of 264 community-dwelling primary family caregivers of PLS. Face-to-face interviews were conducted to collect information on family caregiving activities; negative caregiving impacts including objective and subjective burden, and caregiver psychological distress such as depression and anxiety; positive caregiving impacts including caregiving rewarding feelings, and family functioning for spouse and parent caregivers. Results: Both types of caregivers report engaging in similar caregiving activities and report comparable levels of objective burden. However, parent caregivers report significantly higher subjective burden than spouse caregivers (b = 7.94, 95%CI:2.08, 13.80, P < 0.01), which is also reflected in significantly higher depression (b = 3.88, 95%CI:1.35, 6.41, P < 0.01) and anxiety (b = 2.53, 95%CI: 0.22, 4.84, P < 0.05), and lower family functioning (b = − 1.71, 95%CI: − 2.73, − 0.49, P < 0.01). Despite these differences, both groups of caregivers report comparable rewarding feelings about caregiving. Conclusions: Our findings have implications for family caregivers globally, but especially for countries that adhere to Confucian cultural values and provide guidance for future family intervention programs. Such programs may do well to incorporate cultural values and beliefs in understanding caregiving and kinship family dynamics so as to support family caregivers, and in particular, the specific vulnerabilities of parent caregivers.

Associations of Caregiving Knowledge and Skills With Caregiver Burden, Psychological Well-Being, and Coping Styles Among Primary Family Caregivers of People Living With Schizophrenia in China

“…In this study, we demonstrated that improved caregiving knowledge and skills were associated with more caregiving rewarding feelings among the caregivers, an observation that may be explained, in part, by the Chinese culture. Under the influence of Confucianism, the dominant concept of collectivism is deeply rooted in the Chinese culture ( 13 ). Family members usually consider care for PLSs as their responsibility, and they may make every effort to facilitate the patient's recovery.…”

“…), several multivariate linear regressions were separately performed to examine the associations between KSCS score and seven types of caregiving experiences among primary family caregivers. Potential multicollinearity between predictor variables was checked by variance inflation factor (VIF), with VIF > 5 indicating collinearity ( 13 ). The difference was considered statistically significant at P < 0.05.…”

“…PLSs usually have reduced life expectancy in comparison with individuals from the general population ( 11 ). This disorder afflicts both PLSs and their family caregivers ( 12 ), particularly in countries with insufficient mental health resources and community health service systems ( 13 ). In China, more than 90% of PLSs live with their family members and receive family care because of insufficient community health resources ( 14 ).…”

Internalised stigma, social support, coping and care‐giving burden among Chinese family caregivers of adults diagnosed with schizophrenia: A parallel mediation analysis

“…Given limited mental health resources, the heavy burden of schizophrenia usually falls on the family, and people suffering from schizophrenia may develop a strong dependency on family members (Peng et al., 2019). Family caregivers usually provide sustained assistance to the ill relative to ensure effective treatment and recovery, including medication supervision, management of symptoms and daily care, which can be a high cost of time and energy and an endless task (Olagundoye et al., 2017; Yu et al., 2020). This may further pose a considerable care‐giving burden on family caregivers.…”

Status and clinical influencing factors of involuntary admission in chinese patients with schizophrenia

“…In the latest national survey, weighted lifetime prevalence of schizophrenia and other psychotic disorder is 0.7% in China [2]. It's estimated that there are more than 15 million schizophrenic patients in China, which results in heavy social and economic burden [3][4][5]. However, due to inadequate access of community mental health services, hospitalization remains the main way in China's majority of families caring for mental illness patients [6,7].…”