Perceived burden of care and reported coping strategies and needs for family caregivers of people with mental disorders in Zimbabwe

Abstract

BackgroundMental health service resources are inadequate in low-income countries, and families are frequently expected to provide care for their relative with a mental disorder. However, research on the consequences of caregiving has been limited in low-income countries, including Zimbabwe.ObjectiveThe study explored the perceived impact of mental illness, reported coping strategies and reported needs of the family members of persons diagnosed with bipolar affective disorder or schizophrenia attending a psychiatric hospital in Harare, Zimbabwe.MethodsA purposive sample of 31 family members participated in in-depth interviews and focus group discussions using standardised study guides. Participants were also screened for common mental disorders (CMDs) using the 14-item Shona Symptom Questionnaire. Qualitative data were analysed thematically using NVivo 8 qualitative data analysis software. Statistical Package for Social Sciences (SPSS version 16) was used for descriptive quantitative data analysis.ResultsCaregivers experienced physical, psychological, emotional, social and financial burdens associated with caregiving. They used both emotion-focused and problem-focused coping strategies, depending on the ill family members’ behaviours. Seeking spiritual assistance emerged as their most common way of coping. Twenty-one (68%) of the caregivers were at risk of CMDs (including three participants who were suicidal) and were referred to a psychiatrist for further management. Caregivers required support from healthcare professionals to help them cope better.ConclusionCaregivers of patients attending psychiatry hospitals in Zimbabwe carry a substantial and frequently unrecognised burden of caring for a family member with a mental disorder. Better support is needed from health professionals and social services to help them cope better. Further research is required to quantitatively measure caregiver burden and evaluate potential interventions in Zimbabwe.

An ethnography exploring the quality of life of people living with schizophrenia in Zimbabwe: Implications for health service policy and practice

“…This is consistent with previous studies [44,45]. As our study showed, participants' symptoms and behaviours, changes in household routines, and family or social relations, negatively affected family functioning, findings also echoed in other studies [20,46]. Relapse of symptoms of schizophrenia were compounded by variable access to medication due to inconsistent supply and lack of money causing further tension and conflict between partners and/or relatives on how best to manage those symptoms and behaviours.…”

“…One of the main findings of this study was that growing up with a family member, such as a parent or sibling, diagnosed with schizophrenia contributed to a difficult childhood, family dislocation and upheaval, and the negative effects of those past experiences being felt into adult life. By focusing on schizophrenia, we have extended the evidence from another Zimbabwean study that explored the impact of caring for a family member with a mental disorder [20].…”

“…Certain cultural experiences and beliefs have been thought to precipitate the onset of schizophrenia and the content of delusions and hallucinations [17,18]. To provide and understand culturally appropriate treatments and interventions and inform decision-making, there is a need to address the gap in knowledge about what it is like for people living with schizophrenia in lowincome countries such as Zimbabwe [19,20].…”

Pengalaman Caregiver dalam Merawat Klien Skizofrenia di Kota Sungai Penuh

“…Tingkat beban yang dialami oleh caregiver dalam merawat klien skizofrenia berada di tingkat menengah hingga tinggi (He & Hua, 2014:Geriani, et al, 2015. Penelitian Marimbe et al (2016) menyatakan bahawa akibat dari tingginya beban yang dialami oleh caregiver, 68% caregiver mengalami gangguan mental secara umum hingga mempunyai ide untuk bunuh diri. Beban yang dialami oleh caregiver dapat berupa beban fisik, psikologis dan sosial (Ellah, et al, 2013).…”

“…Beban fisik yang dirasakan oleh caregiver adalah adanya keluhan dalam pola tidur seperti kesulitan tidur dan insomnia, akibatnya caregiver mengalami berbagai gangguan kesehatan seperti nyeri diarea tubuh, gastritis dan sakit kepala. Penelitian Marimbe et al (2016) menyatakan bahwa caregiver mengeluhkan kesehatan fisik yang terganggu, seperti nyeri pada punggung dan peningkatan tenan darah.…”