The influence of burden of care and perceived stigma on expressed emotions of relatives of stable persons with schizophrenia in Nigerian semi-urban/urban settings
RESUMO: Schizophrenia’s burden defines experience of family members and is associated with high level of distress. Courtesy stigma, a distress concept, worsens caregivers’ burden of care and impacts on schizophrenia. Expressed emotion (EE), another family variable,
impacts on schizophrenia. However, relationship between EE, burden of care and stigma has been little explored in western literature but not in sub-Saharan Africa particularly Nigeria. This study explored the impact of burden of care and courtesy stigma on EE among caregivers of persons with schizophrenia in urban and semi-urban settings in Nigeria.
Fifty caregivers each from semi-urban and urban areas completed a socio-demographic
schedule, family questionnaire, burden interview schedule and perceived devaluation and discrimination scale.
The caregivers had a mean age of 42 (± 15.6) years. Majority were females (57%),
married (49%), from Yoruba ethnic group (68%), monogamous family (73%) and
Christians (82%). A higher proportion of the whole sample (53%) had tertiary education.
Three out of ten were sole caregivers. Seventy three (73%) lived with the person they cared for. The average number of hours spent per week by a caregiver with a person with schizophrenia was 35 hours.
The urban sample had significantly higher proportion of carers with high global
expressed emotion (72.7%) than the semi-urban sample (27.3%). The odds of a caregiver in an urban setting exhibiting high expressed emotion are 4.202 times higher than the odds of caregiver in a semi-urban setting. Additionally, there was significance difference between the urban and semi-urban caregivers in discrimination dimension. High levels of
subjective and objective burden were associated with high levels of critical comments.
In conclusion, this study is the first demonstration of urban-semi-urban difference in expressed emotion in an African country and its findings provide further support to
hypothesized relationship between components of EE and burden of care
