Changes in family functioning among primary family caregivers of patients with schizophrenia

Abstract

IntroductionFamily functioning, particularly among primary family caregivers for patients with schizophrenia, is a global concern that poses unprecedented challenges. The family unit is a pivotal agent for the preservation of the integrity of individual members. Little attention has been paid to the changes in family functioning and their predictors in primary family caregivers. This study aimed to examine the changes in and the correlates of family functioning in primary family caregivers of individuals with schizophrenia over a 6‐month post‐discharge period.DesignA prospective, longitudinal study was conducted.MethodsA total of 58 primary family caregivers of patients with schizophrenia were recruited from two psychiatric hospitals in Taiwan. Data were collected four times, including 1 week before hospital discharge and at 1‐, 3‐, and 6‐month intervals post‐discharge. Demographic and clinical questionnaires, the Affiliate Stigma Scale, the Family Empowerment Scale, and the General Functioning subscale were used to collect data. Generalized Estimating Equations were applied for data analysis.ResultsApproximately 59.6%–77.6% of primary family caregivers presented unhealthy family functioning during the 6‐month post‐discharge period. Significant reductions in family functioning of primary family caregivers were noted in the group with unhealthy family functioning; however, family functioning of primary family caregivers remained unchanged in the group with healthy family functioning over 6 months. Affiliate stigma and family empowerment significantly accounted for the changes in family functioning of primary family caregivers in the groups with unhealthy and healthy family functioning, respectively.ConclusionThis study highlights affiliate stigma and family empowerment as long‐term predictors of changes in family functioning for primary family caregivers and as pivotal targets of mental health care.Clinical RelevanceFamily‐centered interventions with a focus on ameliorating affiliate stigma and enhancing family empowerment are recommended to improve family functioning for primary family caregivers of patients with schizophrenia at different periods after hospital discharge.

Changes in Psychosocial Variables Among Caregivers of Patients With Schizophrenia: A Short-Term Follow-Up Study

“…It is possible that, with time, the caregivers modulated their communication after introspection and harmonized the expression of their emotions with the patient. There is some evidence to suggest that unhealthy family functioning reduces with time, as reported by caregivers of patients with schizophrenia [ 27 ], and that expressed emotions and emotional overinvolvement reduce over a period of time [ 28 ]. Coping largely did not change, except for emotion-focused distraction-positive coping, which reduced somewhat.…”