Duke Global Health Institute, Duke University, Durham, NC, USA.
School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMC Psychiatry. 2022 Jan 4;22(1):10. doi: 10.1186/s12888-021-03560-0.
BACKGROUND: Globally, families play a critical role in providing care and support for persons living with schizophrenia. It is important to identify potentially modifiable factors that influence perceived caregiver burden in order to properly address the needs of caregivers. This is especially relevant in low-resource settings where psychiatric services are scarce and interventions could be most effective if targeted to both the individual living with schizophrenia and their caregiver. This study examines correlates of perceived burden among informal caregivers of individuals with schizophrenia in Tanzania, in particular, the association between burden and caregiver-reported family functioning. METHODS: This study used baseline data from an individually randomized controlled trial with 65 pairs of individuals with schizophrenia and their informal caregivers in Dar es Salaam and Mbeya, Tanzania. Caregiver burden was measured using the Burden Assessment Scale. Univariable and multivariable regression analyses were performed to determine the relationship between caregiver burden and family functioning and to explore other correlates of burden. RESULTS: Sixty-three percent of caregivers reported experiencing high burden as a result of caring for a relative with schizophrenia. Multivariable regression analyses revealed that poor family functioning and the caregiver being employed were associated with high caregiver burden, while higher levels of hopefulness in the caregiver was associated with low caregiver burden. CONCLUSION: Caregivers who were employed, reported poor family functioning, and/or had low levels of hopefulness were more likely to perceive high caregiver burden. Future interventions aiming to reduce caregiver burden may benefit from improving family functioning and nurturing hope among caregivers of individuals living with schizophrenia. Policies and programs should be cognizant of the needs of caregivers that work in addition to providing care for a relative with schizophrenia in order to better support them.
背景：在全球范围内，家庭在为精神分裂症患者提供护理和支持方面发挥着至关重要的作用。确定可能影响照顾者负担感的可改变因素对于满足照顾者的需求至关重要。在资源匮乏的环境中，这一点尤为重要，因为那里精神科服务稀缺，如果干预措施能够同时针对患有精神分裂症的个体及其照顾者，那么它们可能会最有效。本研究考察了坦桑尼亚精神分裂症患者的非正式照顾者的负担感的相关因素，特别是负担感与照顾者报告的家庭功能之间的关系。
方法：本研究使用了来自坦桑尼亚达累斯萨拉姆和姆贝亚的一项个体随机对照试验的基线数据，共有 65 对精神分裂症患者及其非正式照顾者参与了该试验。使用负担评估量表来测量照顾者的负担感。进行单变量和多变量回归分析，以确定照顾者负担感与家庭功能之间的关系，并探讨负担感的其他相关因素。
结果：63%的照顾者报告说，由于照顾患有精神分裂症的亲属，他们感到负担沉重。多变量回归分析显示，家庭功能不良和照顾者受雇与高照顾者负担感相关，而照顾者的希望水平较高则与低照顾者负担感相关。
结论：受雇、报告家庭功能不良和/或希望水平较低的照顾者更有可能感到照顾者负担沉重。未来旨在减轻照顾者负担的干预措施可能受益于改善家庭功能和培养照顾者对精神分裂症患者的希望。政策和方案应意识到照顾者的需求，这些照顾者除了要照顾患有精神分裂症的亲属外，还要工作，以便更好地支持他们。
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