Background: Severe mental illnesses (SMI) cause significant impairment for those living with the illnesses and often rely on caregivers for the ongoing care. Available evidence suggests that individuals responsible for caregiving may get distressed due to the caregiving experience, a phenomenon researchers call caregiver burden. Following the shift to community-centered mental health services, several studies on caregiving burden have been conducted in high income countries (HIC). However, there remains scarcity of data on the subject in SubSaharan Africa including Malawi. Therefore, the present study investigated the prevalence and associated factors of caregiving burden among caregivers of individuals with SMI at St John of God Hospitaller Services (SJOGHS) in Mzuzu-Malawi. Methods: The study adopted a hospital based cross sectional study. Recruitment took place at two outpatient departments of SJOGHS. Informal caregivers who were 18 years and above were asked to participate. The study recruited 139 caregivers and two research assistants approached participants at the waiting area. Caregivers who gave consent were asked questions about their caregiving activities using the Zarit Burden Interview (ZBI) (maximum score, 88). Data analysis was done using frequency distributions and descriptive statistics. The study used non-parametric tests such as a chi-square on all categorical measurements to test associations between variables and parametric tests such as t test on all continuous variables. The unadjusted and adjusted associations between socio-demographic factors and caregiving burden was conducted using logistic regression models. Results: On average, most caregivers experienced mild to moderate caregiving burden on the ZBI score (31.5 ± 16.7). In the adjusted model after controlling for caregivers’ gender, caregivers’ age, level of education, social support, care recipients’ age and care recipients’ gender, only caregivers’ age, social support and care recipients’ age remained significantly associated with caregiving burden. Older caregivers were more likely to experience caregiving burden than younger caregivers (OR=1.03, 95% CI 1.00-1.06), caregivers with social support were 71 % less likely to develop caregiving burden than those without social support (OR=0.29, 95% CI 0.14-0.62) and caregivers of older care recipients were less likely to experience caregiving burden than those of younger care recipients (OR=0.26, 95% CI 0.11-0.64). v Conclusion: Even though the caregiving burden found in this study was low compared to other previous studies in some arguably developed countries such as Iran and Turkey, it remains high in other developing countries such as Ghana and Nigeria. The low burden in this study, could be attributed to several factors and context in which the study was conducted. One such factor is the routine psychoeducation that the hospital often conducts for caregivers during the subsequent monthly reviews of their care recipients. An important follow up would be to investigate caregiving burden among caregivers who are unable to access the services at SJOGHS. The results of this study are important to guide policy in the formation of effective community programs that may assist mitigate the burden of informal caregivers. Finally, to understand the importance and implications of informal caregiving, further studies are needed in Malawi.

Šizofrenija yra liga, sukelianti daug sunkumų ne tik pacientui, bet ir jį slaugantiems asmenims. Lietuvoje nėra plačiai tyrinėta šizofrenijos pasekmės asmenims, kurie slaugo sergančius šia liga pacientus, be to labai trūksta valstybės finansuojamos pagalbos psichikos ligonių artimiesiems. Šio darbo tikslas yra nustatyti artimųjų, slaugančių sergančius šizofrenija, patiriamų slaugymo sunkumų sąsajas su šių sunkumų įveikimo strategijomis. Tyrime dalyvavo 98 Panevėžio ir Marijampolės apskričių gyventojai. Tirti sergančių šizofrenija artimieji. Šiame darbe buvo matuoti objektyvūs (asmenų, slaugančių sergančiuosius šizofrenija užduotys, susijusios su paciento būkle) ir subjektyvūs slaugymo sunkumai (savijauta, kurią sukelia šių užduočių atlikimas) bei slaugymo sunkumų įveikos strategijos. Slaugymo sunkumai matuoti dvejomis metodikomis: objektyvūs slaugymo sunkumai - Įsitraukimo įvertinimo klausimynu (angl. Involvement Evaluation Questionnaire; IEQ), kurio pirmoji versija buvo sukurta 1987 m.(autorius - Schene A.H.); subjektyvūs slaugymo sunkumai - Bendru sveikatos klausimynu -12 (angl. General Health Questionnaire – GHQ- 12); pradinis skalės variantas buvo sukurtas 1970 m; autorius - Goldberg D.P.). Slaugymo sunkumų įveikos strategijos matuotos lietuviška streso įveikos vertinimo metodika (Streso įveikos klausimynas: keturių faktorių modelis), sukurta 2006 metais, kurios autoriai yra Grakauskas Ž. ir Valickas G. Tyrimo rezultatai parodė, kad didžiausius... [toliau žr. visą tekstą] / Schizophrenia is an illness, causing lots of difficulties not only to the patient, but also to the persons nursing him. The consequences of schizophrenia to the persons, who are nursing the patients ailing with this illness are not researched in Lithuania generally, besides, the relatives of the mental diseases patients lack financing aid from the state. The goal of the present thesis is to establish the links of the caregiving burden with the caregiving burden overcoming strategies of the relatives caregiving the patients with schizophrenia and the aid received. 98 residents from Panevėžys and Marijampolė counties participated in the research. The relatives of the person ill with schizophrenia were surveyed. In the present thesis I substantiated the objective (tasks of the persons nursing the patients with schizophrenia related to the patient‘s state) and the subjective caregiving burden (the state of health causing performance of the tasks) and the strategies of the caregiving burden overcoming. The caregiving burden were substantiated using two methodologies: the objective caregiving burden -using Involvement Evaluation Questionnaire; IEQ, the first version of which was made-up in 1987 m.(the author - Schene AH); the subjective caregiving burden -12 using the General Health Questionnaire -GHQ 12; the initial variant of the scale was made-up in 1970 m; the author - Goldberg DP). The strategies of the caregiving burden overcoming were substantiated by the... [to full text]

Background: Depression is a common condition that affects the life of the person suffering from depression as well as their surroundings. Relatives of the person suffering from depression are affected by the condition and among these the partner is one of the most affected. The partner can be affected both physically and mentally from living with a person suffering from depression. Aim: The aim of the study was to explore partners’ experiences of living with a person suffering from depression. Method: The chosen method for this study was a literature review. The data was collected through both systematic and unsystematic searches. Eight articles were included, both qualitative and quantitative. The analysis was conducted according to a model made for literature reviews, where the data was compiled and sorted into descriptive themes. Results: The results of this study yielded three themes of experiences, including one with two subthemes. (1) Experience of how the daily life is affected (subthemes: experience of living on another person’s terms, and experience of how the situation affects the mental and physical health). (2) Experience of the need for knowledge. (3) Experience of being able to cope with the situation. Conclusion: The study shows that partners of people with depression need to be more included in the patient’s care. They also need to be offered information and support to make it easier to cope with the situation. The results of the study also shows that more research is needed on the subject.

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Sleep disturbance is common in patients with heart failure (HF) and the family caregivers. Sleep disturbance is known as a predictor of poor quality of life (QoL) in individual level. The manner in which patients’ and caregivers’ sleep disturbances influence each other’s QoL has not been determined. The purpose of this dissertation was to investigate the associations of sleep disturbance and outcomes in patients with HF and their primary family caregivers. The specific aims were to: 1) examine whether sleep disturbance of patients and their family caregivers predict their own and their partners’ QoL; 2) examine the mediator effects of depressive symptoms on the association between sleep disturbance and QoL in patients and family caregivers; and 3) provide evidence of the psychometric priorities of the Zarit Burden Interview (ZBI) as a measure of caregiving burden in caregivers of patients with HF. The three specific aims were addressed using secondary analyses of cross-sectional data available from 143 patients with HF and their primary family caregivers. To accomplish Specific Aim One, multilevel dyadic analysis, actor-partner interdependence model was used for 78 patient- caregiver dyads. Individuals’ sleep disturbance predicted their own poor QoL. Caregivers’ sleep disturbance predicted patients’ mental aspect of QoL. For Specific Aim Two, a series of multiple regressions was used to examine the mediation effect in patients and caregivers separately. Depressive symptoms significantly mediated the relationship between sleep disturbance and mental aspect of QoL in patients. The mediation effect was similar in caregivers. For Specific Aim Three, the internal consistency and convergent and construct validity of the ZBI in 124 family caregivers of patients with HF were examined. The results showed that the ZBI is a reliable and valid measure of caregiving burden in this population. This dissertation has fulfilled important gaps in the evidence base for the QoL outcome in patients with HF and caregivers. The findings from this dissertation provided evidence of the importance of monitoring sleep disturbance for better QoL in both patients and caregivers and the importance of assessing caregivers’ sleep disturbance for improving patients’ QoL. It also provided evidence of the importance of managing depressive symptoms when targeting sleep disturbance to improve QoL in both patients and caregivers.