Department of Social Sciences, University of Nicosia, 46 Makedonitissa Avenue, Nicosia 1700, Cyprus.
Int J Ment Health Syst. 2013 May 2;7(1):13. doi: 10.1186/1752-4458-7-13.
The shift from asylum to community care for mental health patients has burdened the providers of primary health care and, more than all, families. As a result, numerous studies [Soc Psychiatry Psychiatr Epidemiol 31:345-348, 1995, J Health Socisl Behav 36:138-150, 1995] have focused on the burden of care experienced by family members living with individuals with severe mental disorders. This kind of provision, also extols a significant cost to the society at large in terms of significant direct and indirect costs. A cost that may be even higher in times of severe socio-economic crisis.
This study, firstly, aims to examine the burden that the family members experience by caring for individuals with schizophrenia and the identification of the parameters, in a micro and macro level, that affect family burden. Secondly, this study aims to investigate whether the welfare state will be fit to help vulnerable groups as the one studied, especially during economic crisis periods when austerity measures are being implemented into welfare systems. For data collection purposes this study employed the Involvement Evaluation Questionnaire [Schizophr Bull 1998, 24(4):609-618]. The sample consisted of caregivers either living in rural or urban areas of the district of Nicosia, the capital of the Republic of Cyprus. These people were attending regular meetings with their allocated Community Psychiatric Nurses (CPN) in Community Mental Health Centres (CMHC).
Analysis of covariance (ANCOVA) was applied with the tension, the supervision, the worry, and the encouragement entering as dependent factors. In each case, participant's age, gender, marital status, income, number of people living in the same house with the participant, degree of relationship between the caregiver and the person suffering from severe mental disorder, the age of the relative, and the gender of the relative, were entered as independent factors. Four ANCOVAs were performed, one for each dimension of the family burden. The results from this analysis produced only one significant main effect of the gender of the relative on supervision [F(1,118) = 4.40, p = .011, etap2 = .053] with male relatives suffering from schizophrenia requiring higher supervision than female ones as their relative caregivers responses indicate.
Consequently, families under great stress due to the reasons derived from the weaknesses of the welfare system described throughout this paper would give up and reject the mentally ill individuals who would become outcasts socially. Therefore, health systems need to aim to the development of psychosocial provisions for both family caregivers and patients as to decrease the family burden rates and increase the possibility of smooth transition to the society.
精神健康患者从庇护所转移到社区护理，这给初级保健提供者带来了负担，而家庭所承受的负担比其他任何方面都要大。因此，许多研究[社会精神病学与精神病流行病学 31:345-348, 1995, J 健康社会行为 36:138-150, 1995]都集中在与严重精神障碍患者一起生活的家庭成员所经历的照顾负担上。这种照顾不仅给整个社会带来了巨大的直接和间接成本，而且成本很高。在严重的社会经济危机时期，这种情况可能更加严重。
本研究首先旨在研究家庭成员在照顾精神分裂症患者时所经历的负担，并确定在微观和宏观层面上影响家庭负担的参数。其次，本研究旨在调查福利国家是否能够帮助弱势群体，特别是在实施紧缩措施的福利制度时期。为了收集数据，本研究采用了参与评估问卷[Schizophr Bull 1998, 24(4):609-618]。样本包括居住在塞浦路斯共和国首都尼科西亚的农村或城市地区的护理人员。这些人定期与他们在社区精神卫生中心的指定社区精神科护士（CPN）会面。
协方差分析（ANCOVA）应用于张力、监督、担忧和鼓励等依赖因素。在每种情况下，参与者的年龄、性别、婚姻状况、收入、与参与者同住的人数、护理人员与严重精神障碍患者的关系程度、亲属的年龄以及亲属的性别都作为独立因素输入。进行了四次协方差分析，每次分析一个家庭负担维度。这项分析的结果只产生了一个相对性别对监督的显著主效应[F(1,118) = 4.40, p = .011, etap2 = .053]，表明男性亲属患有精神分裂症，需要比女性亲属更高的监督，这是根据相对护理人员的反应得出的。
因此，由于本文所述福利制度的弱点导致家庭承受巨大压力的家庭会放弃和拒绝患有精神疾病的个体，使他们成为社会上的弃儿。因此，卫生系统需要致力于为家庭护理人员和患者制定社会心理服务，以降低家庭负担率，并增加顺利过渡到社会的可能性。
