Schizophrenia cuts across all racial, gender, and socioeconomic lines. Schizophrenia affects 1 percent of the population in Ireland: 35000 people (Schultz & Andreason, 1999); and affects 1.4 - 4.6 percent per 1000 people in the USA: 2.8 million - 9.8 million people (Jabelensky, 2004). In South Africa the figure is approximately 1 percent of the population or 500 000 people (Nicholas, Malcolm, Krosigk & Pillay, 2003). The median age of onset is 21.4 years for men and 26.8 years for women (Daubenton & van Rensburg, 2001), with only 10-20 percent recovering fully after the first psychotic episode (Saddock & Saddock, 2003). The schizophrenic patient is often unable to continue life as before diagnosis, and may progressively need more care as the years pass. Deinstitutionalization over the course of a number of decades has resulted in responsibility for care of mentally-ill individuals shifting to the individual’s family. The struggles faced by such a family can be overwhelming as they struggle with this responsibilty due to lack of training, lack of knowledge and insufficient professional support (Winefield & Harvey, 1994). The stress on the caregivers is often magnified as their support structures around them may ‘shut down’ out of fear of the schizophrenic illness (Williams & Mfoafo-M’Carthy, 2006). The characteristic symptoms used to define schizophrenia include various forms of delusions, hallucinations, thought disorders and abnormalities in emotional expression, social interaction, attention, volition and drives. The functional decline of the schizophrenic individual leads not only to social difficulties, but also economic difficulties that may cripple a family (Fadden, Bebbington & Kuipers, 1987). When first diagnosed, some families may be so overwhelmed by the ‘label’ given to their family member, that they see little hope or way to move forward. One explanation is offered by an American psychiatrist whose own son was diagnosed with schizophrenia, “We experience this terrible feeling of loss and grief for the son we knew. There is also this terrible loss of expectations. We feel cheated out of watching him mature…it is a mourning without end because, of course, Gary is not dead at all. He is very much still with us, seeming eternally twelve years old, needing constant care and attention” (Willick, 1994, p.14). Providing such care is associated with high levels of distress. Accordingly, much attention has been given to understanding the pressures faced by family members, with the hope of understanding how coping resources may be strengthened to sustain these care-giving relationships (Harvey, Burns, Fahy, Manley & Tattan, 2001). However, despite gains in understanding the needs of a schizophrenic family member once out of the hospital environment, care-giving relationships can still break down. The individual with the illness is often left more vulnerable to relapse, recurrent hospitalizations, homelessness and other negative outcomes (Jewel & Stein, 2002). The stress of not only interacting with the afflicted family member, but also with the grief associated with the illness, places an incredible strain on the day-to-day functioning of that family (Pollio, North, Reid, Miletic & McClendon, 2006). From the brief review provided, it is evident that research has been conducted regarding the stressors, strains and difficulties of caregivers of schizophrenic family members. However, the strengths of these families are under-investigated, and the current study will attempt to start filling this void.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:9928 |
| Date | January 2007 |
| Creators | Haddad, Jason |
| Publisher | Nelson Mandela Metropolitan University, Faculty of Health Sciences |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis, Masters, MA |
| Format | 115 leaves, pdf |
| Rights | Nelson Mandela Metropolitan University |
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