Korean J Schizophr Res.  2016 Oct;19(2):78-88. 10.16946/kjsr.2016.19.2.78.

Factors Affecting Quality of Life and Family Burden among the Families of Patients with Schizophrenia

• Maeng SR
• Kim WH
• Kim JH
• Bae JN
• Lee JS
• Kim CE

• KMID: 2357030
• DOI: http://doi.org/10.16946/kjsr.2016.19.2.78

Abstract

OBJECTIVES
Study aimed to identify factors that may affect family burden and quality of life (QOL) of primary caregivers in schizophrenia family.
METHODS
Among outpatients with schizophrenia undergoing treatment at the psychiatric department of a university hospital, 72 patients and their primary caregivers were investigated. Sociodemographic and clinical data were collected and analyzed.
RESULTS
As a result of multiple regression of primary caregivers' family burden (R²=0.284), primary caregiver's income (p=0.001) and patient's delusional symptoms (p=0.001) significantly explained the total family burden of primary caregivers. In multiple regression on QOL (R²=0.515), primary caregiver's income (p=0.033) and education level (p=0.006), patient's sex (p=0.006), treatment duration (p<0.001), degree of disorganized speech (p=0.008), negative drug attitudes (p=0.026) and the attitude of overcoming stigma against mental patients (p=0.029) all significantly explained the average QOL score.
CONCLUSION
Various factors determining primary caregiver's QOL, including Clinical symptoms such as patient's disorganized speech and clinically correctable factors such as negative drug attitude and insight into disease. Therefore, provision of education regarding drug and disease for patients and caregivers will be helpful to effectively reduce burden and improve the QOL of primary caregivers.

Keyword

Schizophrenia; Caregiver burden; Quality of Life

MeSH Terms

Caregivers
Delusions
Education
Humans
Mentally Ill Persons
Outpatients
Quality of Life*
Schizophrenia*

Figure

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  Fig. 1. Flow chart of study participants.

Reference

References

1. Lee JS, Kim KI, Oh DY. Family's burden of psychotic in-patient. J Korean Neuropsychiatr Assoc. 1991 May; 30:517–531.

2. Lefley HP. Family burden and family stigma in major mental illness. Am Psychol. 1989 Mar; 44:556–560.

3. Scazufca M, Kuipers E. Links between expressed emotion and burden of care in relatives of patients with schizophrenia. Br J Psychiatry. 1996; 168:580–587.

4. Rössler W, Salize HJ, Cucchiaro G, Reinhard I, Kernig C. Does the place of treatment influence the quality of life of schizophrenics? Acta Psychiatr Scand. 1999; 100:142–148.

5. Hoenig J, Hamilton MW. The schizophrenic patient in the community and his effect on the household. Int J Soc Psychiatry. 1966; 12:165–176.

6. Dillehay R, Sandys M. Caregivers for Alzheimer's patients: What we are learning from research? Int J Aging Hum Dev. 1990; 30:263–285.

7. Provencher HL, Mueser KT. Positive and negative symptom behaviors and caregiver burden in the relatives of persons with schizophrenia. Schizophr Res. 1997; 26:71–80.

8. Schene AH, Van Wijngaarden B, Koeter MW. Family caregiving in schizophrenia: Domains and distress. Schizophr Bull. 1998; 24:609–618.

9. Woltraus J, Dingemans P, Schene A, Linszen D, Wiersma D, Van Den B, et al. Caregiver burden in recent-onset schizophrenia and spectrum disorders: The influence of symptoms and personality traits. J Nerv Ment Dis. 2002; 190:241–247.

10. Wu E, Birnbaum H, Shi L, Ball D, Kessler R, Moulis M, et al. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005; 66:1122–1129.

11. Knapp M, Mangalore R, Simon J. The global costs of schizophrenia. Schizophr Bull. 2004; 30:279–293.

12. Foldemo A, Gullberg M, Ek AC, Bogren L. Quality of life and burden in parents of outpatients with schizophrenia. Soc Psychiatr Epidemiol. 2005; 40:133–138.

13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington DC, American Psychiatric Association;2013.

14. Kim CK, Seo JM, Lee GZ, Kim JW, Kim GJ, Byun WT. Family burden of schizophrenics in the primary caregivers and siblings. J Korean Neuropsychiatr Assoc. 2000; 39:113–127.

15. Yoon BH, Bahk WM, Lee KU, Hong CH, Ahn JK, Kim MK. Psychometric properties of Korean version of drug attitude inventory (KDAI-10). Korean J Psychoparmacol. 2005; 16:480–487.

16. Hwang TY, Lee WK, Han ES, Kwon EJ. A study on the reliability and validity of the Korean version of internalized stigma of mental illness scale (K-ISMI). J Korean Neuropsychiatr Assoc. 2006; 45:418–426.

17. Chung S, Bahk WM, Kwon JS, Park JH, Ahn JH, Goh J, et al. Symptom remission and functional outcomes in patients with recent-onset schizophrenia: A one-year prospective observational study. J Korean Neuropsychiatr Assoc. 2007; 46:480–491.

18. Haro JM, Kamath SA, Ochoa S, Novick D, Rele K, Fargas A, et al. The Clinical Global Impression-Schizophrenia scale: A simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand Suppl. 2003; 416:16–23.

19. Song JY, Kim KT, Lee SK, Kim YH, Noh JH, Kim JW, et al. Reliability and validity of the Korean version of the scale to assessment unawareness of mental disorder (SUMD-K). J Korean Neuropsychiatr Assoc. 2006; 45:307–315.

20. Kim CK, Cho JS, Seo JM, Kim YK, Kim HC, Kim HS, et al. A preliminary study for the development of the family burden scale of the schizophrenia. J Korean Neuropsychiatr Assoc. 1999; 38:539–553.

21. Min SK, Lee CI, Kim KI, Suh SY, Kim DK. Development of Korean version of WHO quality of life scale abbreviated version (WHO-QOL-BREF). J Korean Neuropsychiatr Assoc. 2000; 39:571–579.

22. Sadock BJ, Sadock VA. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 10th ed.Lippincott Williams & Wilkins;2011. p. p467–488.

23. Gopinath PS, Chaturvedi SK. Distressing behavior of schizophrenics at home. Acta Psychiatr Scand. 1992; 86:185–188.

24. Noh S, Turner BJ. Living with psychiatric patients: Implications for the mental health of family members. Soc Sci Med. 1987; 25:263–271.

25. Gibbons JS, Horn SH, Powell JM, Gibbons JL. Schizophrenic patients and their families. A survey in a psychiatric service based on a DGH unit. Br J Psychiatry. 1984; 144:70–77.

26. Alejandra CU, Jose GM, Claudia MC. Quality of life in caregivers of patients with schizophrenia: A literature review. Health Qual Life Out. 2009; 7:84.

27. Kwang DH, Kim CH, Byun WT. The objective and subjective family burden of schizophrenic patient. J Korean Neuropsychiatr Assoc. 1995; 34:193–203.

28. Sibitz I, Unger A, Woppmann A, Zidek T, Amering M. Stigma resistance in patients with schizophrenia. Schizophr Bull. 2011; 37:316–323.