Managing family burden through combined family psychoeducation and care decision without pasung therapies

Dewi, Apri Rahma; Daulima, Novy Helena Catharina; Wardani, Ice Yulia

doi:10.1016/j.enfcli.2019.04.012

Cited by 11 publications

(23 citation statements)

References 15 publications

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“…It was also shown to be reliable by the consistency of the responses with an alpha value of .729. That is, responses to the instrument are consistent and are reliable measures of the level of intention of the mentally ill patient's family to use pasung 8 Dewi et al (2019) [32] The study demonstrated that family burden was significantly lower among those who received the combination of the two therapies (family psychoeducation and care decisions without pasung) compared to only family psychoeducation (p < .05). Those therapies decreased the family burden into the low category 9 Eka and Daulima (2019) [33] Ten studies were found.…”

Section: Case Control Studiesmentioning

confidence: 88%

The use of pasung for people with mental illness: a systematic review and narrative synthesis

Hidayat

Lawn

Muir‐Cochrane

et al. 2020

Int J Ment Health Syst

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Background Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. Methods A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment. Result Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. Conclusion The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD

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Section: Case Control Studiesmentioning

confidence: 88%

The use of pasung for people with mental illness: a systematic review and narrative synthesis

Hidayat

Lawn

Muir‐Cochrane

et al. 2020

Int J Ment Health Syst

View full text Add to dashboard Cite

show abstract

“…Burn-out in caring is also felt by families every day (Nihayati et al, 2016;Yunita, Yusuf, Nihayati, & Hilfida, 2019). Burn-out is felt aggravated by feelings of helplessness (Asher et al, 2017;Nihayati et al, 2016;Yunita et al, 2019), no support (Asher et al, 2017), and a long-term treatment process (Dewi, Daulima, & Wardani, 2019;Nurhayati et al, 2020). Families with pasung cases continue to feel responsible for meeting the basic daily needs of schizophrenia patients (Buanasari et al, 2018;Hall et al, 2019) and still have hope for their recovery (Yusuf et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Families with pasung cases continue to feel responsible for meeting the basic daily needs of schizophrenia patients (Buanasari et al, 2018;Hall et al, 2019) and still have hope for their recovery (Yusuf et al, 2017). Concerning the burden of objective family care, financial burdens and damage due to violent behavior are burdens experienced in the family, which led to the decision to pasung (Dewi et al, 2019). The financial burden experienced is because the family cannot meet the medical expenses (Laila et al, 2018;Yunita et al, 2019), and the cost of the daily needs of schizophrenia patients (Laila et al, 2018).…”

Section: Resultsmentioning

confidence: 99%

“…Some cases in Indonesia found that some families get health insurance in the treatment of schizophrenia patients (Laila et al, 2019), but still feel the financial burden of needs outside of treatment. The burden is made worse by patients who cannot fulfill their daily basic needs independently (Yusuf et al, 2017), families who cannot work because they have to accompany patients every day, low economic rates, and low knowledge about patient care (Astuti, 2017;Dewi et al, 2019;Laila et al, 2018;Nurhayati et al, 2020;Shrestha, 2018;Yusuf et al, 2017). The family chooses to do pasung because the family considers it to be cheaper (by gathering wood and iron materials around the house to make a cage) (Yusuf et al, 2017), so they can do pasung to ensure patient safety and can even provide drugs (oral or injection) more easily (Asher et al, 2017).…”

Section: Resultsmentioning

confidence: 99%

“…Although some families can overcome perceived subjective burdens, financial burdens cannot be overcome. Long-term schizophrenia treatment will add to the need for routine medical expenses and basic daily needs, which can increase the prolonged objective burden on the family (Dewi et al, 2019). The cost of mental health services, transportation to access distant mental health services, patient over-eating behavior, the need to supervise patients more than work, compensation for damage caused by the patient's violent behavior and low economic levels are the main factors toward the financial burden felt by the family.…”

Section: Discussionmentioning

confidence: 99%

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Family Burden of Schizophrenia in Pasung During COVID-19 Pandemic: A Scoping Review

Ilmy

Noorhamdani

Windarwati

2020

INJEC

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Introduction: The long-term care in schizophrenia patients can cause care burdens, which will relate to the family's decision to do pasung. The perceived burden will be even heavier because of the COVID-19 pandemic. This review aims to identify the family care burden affecting pasung in schizophrenic patients during the COVID-19 pandemic. Methods: This scoping review was conducted by searching four databases, namely ProQuest, Science Direct, and EBSCO, and Google Scholar in the past ten years. This study uses the PRISMA 2009 protocol in filtering articles from the database. Researchers summarize based on the significance value for quantitative research, based on themes’ qualitative research, and discussed factors mentioned which may influence the family. Thus, we obtained 15 articles for final review. Results: The results obtained that the subjective burden felt by the family is a feeling of worry and sadness due to the patient's aggressive behavior and the safety of the patient, family, and environment. The objective burdens most felt by families are financial burdens, both medical costs, transportation to reach mental health services, and the cost of daily living. The COVID-19 pandemic will affect both types of care burdens, thereby affecting the quality of care for families with schizophrenia patients in pasung. Conclusion: Schizophrenia patients are one of the populations that are vulnerable to COVID-19. Nurse plays a role in the ability to overcome the burden of schizophrenia care and improve adaptation to the current pandemic to create optimal mental health in the community.

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Restraint and confinement of psychiatric patients in community: a scoping review of pasung in Indonesia

Dahniar

Asnurianti

Amna

et al. 2021

MHSI

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Purpose The practice of restraint and confinement of patients with mental disorders is common in Indonesia. This practice is known as pasung and is usually carried out by the family or the villagers in community settings. The previous separated studies have investigated the reasons for, methods, duration and consequences of applying pasung to the patients. A scoping review is needed to study the existing practice of restraint and confinement in Indonesian communities. This study aims to review the published studies on the practice of restraint and confinement of people with mental illness (PWMI) in Indonesia. Design/methodology/approach A scoping review method was used to identify studies on the practices of restraint and confinement of PWMI. A search of Science Direct, PubMed database and Google Scholar for articles was conducted. Findings There is an increasing interest in studying the pasung-related aspects among Indonesian mental health practitioners. The studies included the patients, family, caregivers and community as the research subjects. Various elements of pasung; the actors, duration, reason, the consequences and the challenges in releasing pasung have been reported. Stakeholders should consider many factors related to pasung to achieve the free pasung program in Indonesia. Research limitations/implications Pasung is a practice that exists in a significant number in Indonesia. Although researchers have sounded the importance of the pasung as a problem in the community, much has to be done to alleviate the inhuman treatment of PWMI. Originality/value This paper adds to the literature on the research concerning the practice of restraint and confinement of PWMI. The findings could be uses as the basis of the improvement of policy on mental health services, not only in Indonesia but also in other countries where the practice of restraint and confinements of PWMI in the community settings is existing.

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Managing family burden through combined family psychoeducation and care decision without pasung therapies

Cited by 11 publications

References 15 publications

The use of pasung for people with mental illness: a systematic review and narrative synthesis

The use of pasung for people with mental illness: a systematic review and narrative synthesis

Family Burden of Schizophrenia in Pasung During COVID-19 Pandemic: A Scoping Review

Restraint and confinement of psychiatric patients in community: a scoping review of pasung in Indonesia

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