Publication: Impact of caregiving experience and Social support on the outcome of Patients with schizophrenia.
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Date
2012-07
Authors
Hariani Ishak
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Abstract
IMPACT OF CAREGIVING EXPERIENCE AND SOCIAL SUPPORT ON THE OUTCOME OF SCHIZOPHRENIA PATIENTS. Schizophrenia is a chronic mental illness which requiring consistent support from a caretaker in order to provide medication’s supervision, aid in activity of daily living and also for emotional support. Ironically, in view of the chronic course of the illness, it also leads to burden and breakdown among the caretakers. Irrespective of both interrelation factors, the most important issue is the health outcome of the patients. To assess the association between care giving experience and social support towards the outcome of Schizophrenia patients. The present study consisted of two parts. The first part involved the validation of Experience of Care giving Inventory (ECI) Scale for future use in the local population. The scale was translated into Malay language and a pilot study was done among 132 caregivers of Schizophrenia patients in the Psychiatry Clinic of Hospital Universiti Sains Malaysia (HUSM), Kelantan. The data of the pilot study were analyzed and showed that the Cronbach’s alpha was ranged from 0.6-0.9. In second part of the study, 60 caregivers and Schizophrenia patients were selected based on inclusion and exclusion criteria in the Psychiatry Clinic, HUSM. The participants were selected using non probability random sampling. The data was collected using the validated ECI scale obtained from Part 1 study, and also with the validated Multidimensional Scale of Perceived Social Support (MSPSS). The outcomes of the patients were assessed using Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance Scale (PSP). The majority of the caregivers were Malays (95%), female (57%), married (80%) with mean age of 53.4 (SD 13.55). Sixty six percent of them were parents and almost 80% had more than 10 years of care giving. Whereas, for the schizophrenia patients, the mean age was 32.4 (SD 9.90), females (58%) and 48% of them had chronic course of illness with duration of illness more than 10 years. About 70% of the patients were on oral antipsychotic medication and 20% of them were on combination of both depot injection and oral antipsychotic medication. Both caregivers and patients received secondary education level. The mean total score of PANSS was 64.82, where the negative scale was higher than the positive scale; 19.67 (SD 5.11) and 12.92 (SD 3.72), respectively. Meanwhile the mean total score of PSP was 63.65 (SD 12.86). The negative care giving experience was higher than the positive care giving experience with the mean score of 62.45 and 32.45, respectively. Among the demographic and clinical characteristics of the study subjects, only educational level was significantly associated with the negative appraisal of care giving. Result also showed that the negative care giving experience was significantly associated with the perceived social support among Schizophrenia patients. Regarding the factors associated with the outcome of the schizophrenia patients, the positive and negative care giving experience were found highly related to the scores in PANSS and PSP, although no significant finding was observed in the perceived social support. This study reports educational level of caregivers is associated with negative care giving experience. This care giving experience impairs social support toward Schizophrenia patients and indeed worsens the outcome of the patients.