Makanjuola Osuolale John, Ngcobo Winnie Baphumelele
School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, 238 Masizi Kunene Road, Glenwood, Durban, 4041, South Africa.
BMC Nurs. 2025 Sep 1;24(1):1133. doi: 10.1186/s12912-025-03777-4.
The chronic and severe nature of schizophrenia places a significant burden on caregivers. These include financial strain, lack of access to healthcare, and inadequate knowledge about illness. The study aimed to develop, and pilot test an intervention model to address the caregiver burden faced by families caring for elderly individuals with schizophrenia in Southwest Nigeria. Using a convergent mixed-methods design, quantitative data were collected from 340 caregivers via the Zarit Burden Interview and WHOQOL-BREF and qualitative insights from 20 in-depth interviews. Findings revealed a high caregiver burden, with 52.6% reporting a severe burden. Financial constraints and emotional stress were the key drivers. 34.4% reported frequent shortages of moderators such as social support. The Family Caregivers of Older People with Schizophrenia Model (FCOPSM), integrating psychoeducation, skills training, support groups, financial advocacy, and stigma reduction tailored to the Nigerian context, was guided by the design and development model and validated through an expert review with a Scale Content Validity Index of 0.96. Pilot testing with one psychiatric nurse and nine caregivers across two stages demonstrated feasibility, with caregivers reporting improved knowledge, stress management and reduced burden score (p < 0.05). The FCOPSM provides a preliminary, culturally tailored framework that may help empower family caregivers of older people with schizophrenia and health workers in managing caregiving burden. However, further validation is needed to assess scalability in resource-limited settings.
精神分裂症的慢性和严重性给照料者带来了巨大负担。这些负担包括经济压力、难以获得医疗保健以及对疾病的了解不足。该研究旨在开发并试点测试一种干预模式,以解决尼日利亚西南部照顾老年精神分裂症患者的家庭所面临的照料者负担问题。采用聚合混合方法设计,通过扎里特负担访谈和世界卫生组织生活质量简表从340名照料者那里收集了定量数据,并通过20次深入访谈获得了定性见解。研究结果显示照料者负担较重,52.6%的人报告负担严重。经济限制和情绪压力是主要驱动因素。34.4%的人报告经常缺乏社会支持等调节因素。针对尼日利亚国情整合了心理教育、技能培训、支持小组、财务宣传和减少污名化的老年精神分裂症患者家庭照料者模式(FCOPSM),以设计和开发模式为指导,并通过专家评审进行了验证,量表内容效度指数为0.96。在两个阶段与一名精神科护士和九名照料者进行的试点测试证明了该模式的可行性,照料者报告称他们的知识有所提高、压力管理能力增强且负担得分降低(p < 0.05)。FCOPSM提供了一个初步的、符合文化背景的框架,可能有助于增强老年精神分裂症患者家庭照料者和卫生工作者应对照料负担的能力。然而,需要进一步验证以评估其在资源有限环境中的可扩展性。