Attitudes and burden in relatives of patients with schizophrenia in a middle income country

BACKGROUND: Most studies of family attitudes and burden have been conducted in developed countries. Thus it is important to test the generalizability of this research in other contexts where social conditions and extended family involvement may be different. The aim of this study was to assess the relationship between the attitudes of caregivers and the burden they experience in such a context, namely Arica, a town located in the northernmost region of Chile, close to the border with Peru and Bolivia. METHODS: We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components) and burden (including subjective distress, rejection and competence) in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica. RESULTS: Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers) exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000).This was also the case for caregivers with a low educational level (t = 3.27; p < 0.003), for the oldest caregivers (r = 0.546; p = 0.000) and for those who had spent more time with the patient (r = 0.377; p = 0.015). Although attitudes had significant association with burden, their explanatory power was modest (R2 = .104, F = 4,55; p = .039). CONCLUSIONS: Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context

The effect of rehabilitation of schizophrenic patients on their family atmosphere and the emotional well-being of caregivers

Background: In family members with a schizophrenic patient emotional problems, stressful situations, significant life changes are often observed. On the other hand rehabilitation of these patients is an integral part of their aftercare and community tenure. Aims: In this study the effect of the participation of schizophrenic patients in rehabilitation programmes, on the atmosphere of their families and the emotional well-being of their caregivers are examined. Method: Sixty six caregivers of patients in rehabilitation (group A) were compared with seventy caregivers of patients, not attending any rehabilitation programme (group B), in terms of their family atmosphere and emotional well-being, assessed by the Family Atmosphere Scale and the CES-D scale respectively. Results: The family atmosphere of the patients who were participating in a rehabilitation programme was found to be more positive (higher degree of patient&apos;s acceptance, autonomy and compliance as well as fewer economic problems) than that of their counterparts, not in rehabilitation. Group A caregivers were also found to exhibit less depressive symptomatology. Conclusions: It seems that psychosocial rehabilitation and its vanous therapeutic activities has a positive impact on several components of family atmosphere of the participating patients and the emotional status of their caregivers

Is psychosocial rehabilitation of schizophrenic patients preventing family burden? A comparative study

This study examined the dimensions of perceived burden by caregivers-relatives of patients suffering from schizophrenia and participating in a rehabilitation programme (group A) compared to a group of patients and their corresponding caregivers who were maintained in regular treatment procedure (group B). Subjective and objective burden perceived by caregivers group A patients attending a rehabilitation programme, was found to be lower compared to that of group B of caregivers of patients in regular maintenance treatment. Low level of functioning of patients was correlated with higher degree of family burden and the more psychological distress of the caregiver. The patient&apos;s compliance with medication and psychosocial functioning as well as the participation in a rehabilitation programme, the diagnostic subtypes and the mean daily hours spent with the patient were found to predict the presence of burden of caregiver. It seems that the various socio-therapeutic activities of rehabilitation improve patient&apos;s levels of psychosocial functioning, and alleviate the serious psychosocial and emotional problems of caregivers caused by their relative&apos;s chronic and severe illness. © 2005 Blackwell Publishing Ltd

Major depression across West Bank: A cross-sectional general population study

Background: In recent decades entire populations have been living under chronic strain, apprehension and violence. This is the case for Palestinians. Despite the increased volume of mass media attention on this situation, little is known about the psychological effects of this condition on this population. Aims: The study was designed to investigate the lifetime and one-month prevalence of major depression episode (MDE) in a multi-stage sample of 916 adult Palestinians drawn from the Al-Aqsa Intifada. Methods: The survey was based on personal interviews and was carried out from February to September 2007. The clinical examination used DSM-IV criteria for the detection of MDE, extracted from SCID-I. Data, suicidal behaviour, previous help seeking, medication use and exposure to trauma were also collected. Results: Lifetime and one-month prevalence of MDE was found to be 24.3% and 10.6%, respectively. Male Palestinians suffered from slightly higher rates of MDE than their female counterparts, but this difference was not statistically significant. Being widowed and living in towns in West Bank also increased the likelihood to develop MDE. A comparison of prevalence rates in refugee and non-refugee populations showed no significant differences. This could be explained by the fact that though refugees were forcibly displaced, they were living among compatriots (non-refugees), thus both groups were experiencing the same sociopolitical adversities. Being also exposed to traumatic events increased the risk of suffering from MDE. Conclusions: This study provides evidence that a population under continuous strain and apprehension, living in unremitting socioeconomic deprivation, is more likely to suffer from major depression

&quot;on the spot&quot; Interventions by mental health nurses in inpatient psychiatric wards in Greece

The objective of this research was to explore the on-the spot clinical interventions mental health nurses make in critical incidents on inpatient psychiatric wards. Mental health nurses play a key role in the management of psychiatric critical incidents. Nurses&apos; autonomy, decision-making, and training in clinical interventions are important issues in psychiatric nursing practice. A descriptive study was conducted among mental health nurses working on inpatient wards of three major psychiatric hospitals in the greater Athens area, using semi-structured interviews. Nurses&apos; personal views also were documented. Semi-structured interviews were conducted with 103 mental health nurses, who were encouraged to make personal remarks. The results of this study show that in the majority of critical incidents, the nurses were found to be in contact with the psychiatrist on call; physical restraints were used frequently in violent episodes; reassurance and support were common interventions; the majority of nurses would have preferred not to intervene with critical incidents; and nurses expressed a need for skills training and higher autonomy. The nurses implemented a specific number of interventions in confronting the various types of crises. The need for specialized training was noticed and problems like accountability, autonomy, and medication administration, were considered crucial by the mental heath nurses

Mental Health Nursing in Greece: Nursing Diagnoses and Interventions in Major Depression

The aim of the study was to assess nursing diagnoses and nursing interventions that were accordingly implemented during the care of inpatients with major depression in Greece. Twelve nurses working in three major psychiatric hospitals were recruited. Semi-structured interviews were used and audio-recorded data indicated that risk for suicide, social isolation, low self-esteem, sleep problems, and imbalanced nutrition are the nursing diagnoses most commonly reported. Establishing trust and rapport is the primary intervention, followed by specific interventions according to each diagnosis and the individualized care plan. The findings of the study also highlight the need for nursing training in order to teach nurses initial assessment procedures and appropriate evidence-based intervention techniques. © 2016, Copyright © Taylor &amp; Francis Group, LLC

Posttraumatic stress disorders comorbid with major depression in west bank, palestine: A general population cross sectional study

Background and Objectives: The prevalence of Post Traumatic Stress Disorders (PTSD) comorbid with Major Depressive Episodes (MDE) were explored in four areas of West Bank of Palestine in the aftermath of the second intifada. Methods: The sample consisted of 916 adult Palestinians representative of the general population. The interview was personal with the use of DSM IV criteria for PTSD and MDE (the SCID I modules). Results: The prevalence of chronic PTSD comorbid with lifetime MDE and chronic PTSD alone were found 18.7% and 26.5% respectively. Another 6.1% were diagnosed as suffering from lifetime MDE. Higher numbers of refugees were found to suffer from PTSD comorbid with MDE. The majority of respondents who reported previous suicidal behavior were co-morbid cases of PTSD/MDE. The predictors differentiating between MDE alone and no diagnosis and between comorbid PTSD/MDE and no diagnosis were almost identical. Conclusions: This sample of adult Palestinians living under conditions of mass violence and continuous economic deprivation were found suffering from high rates of post PTSD and comorbid PTSD with MDE, a common finding among populations under serious traumatic exposure

Security rules and banned items in psychiatric acute admission wards in Athens, Greece

Mental health nurses play a key role in maintaining the safety of patients, themselves, and others during hospitalization. The aim of the research was to evaluate the safety measures that are taken by mental health nurses to identify the security policies that exist in acute mental health wards. The Ward Safety and Security Rules Survey was used as a method of data collection. Descriptive analysis and content analysis were carried out in order to identify nurses&apos; practices. The total sample consisted of 172 mental health nurses and nurses&apos; assistants who worked in 14 acute inpatient psychiatric wards in three psychiatric hospitals in the greater area of Athens, Greece. The results show a minimum number of security features existing in the wards. Only one of the 14 wards had an intercom system. In only nine wards, there was a panic alarm in the office, and in eight, an emergency response telephone extension. A wide range of practices were noted concerning banned items and patient searches upon admission and return from leave. The results indicate the significant lack of protocols and specific safety rules to guide nurses&apos; actions across psychiatric acute admission wards in Athens. © 2010 Australian College of Mental Health Nurses Inc