The aim of this study was therefore to explore the caregiving burden as perceived by family members of people with severe mental illness and the relationship between their coping strategies and the perceived burden. Method: An exploratory-descriptive, non-experimental quantitative study was adopted to describe and explore perceptions of caregiving burdens in family members and the relationship between the perceived burden and family coping strategies.
INTRODUCTION AND BACKGROUND TO THE STUDY
According to Van Der Voort, et al., (2007); Chang & Horrocks, (2006) reported family members exposed to social stigmatization associated with serious mental illness social deprivation and a high burden of care. Ekwall, Sivberg and Hallman (2006) and Van Der Voort, et al., (2007) believe that the relationship between family members and the individual with a serious mental illness influences the perception of burden.
PROBLEM STATEMENT
The present study is the first study within uThukela District to seek to describe the perceptions of caring roles towards family members of persons with serious mental illness and to explore the coping strategies used by family members to adapt to the demands arising from context of caregiving.
PURPOSE OF THE STUDY
OBJECTIVES OF THE STUDY
RESEARCH QUESTIONS
SIGNIFICANCE OF THE STUDY
DEFINITION OF KEY CONCEPTS
In this study, coping strategies will be defined as any attempt by family members of individuals with severe mental illness to reduce, alleviate problems arising from a stressful situation Lazarus & Folkman (1984) (as cited in Knussen et al. 2008). . Caregiving is the act of providing unpaid assistance to a relative with severe mental illness by family members who often lack formal training in caregiving roles.
CONCEPTUAL FRAMEWORK
A change in a family stability due to the presence of an illness is influenced by the availability of resources (coping orientations) and the effective use of these resources by the family members. According to Rakesh, et al., (2007), family members as caregivers perceive higher levels of burden when they have limited resources.
CONCLUSION
Since good research does not exist in a vacuum, Polit & Hungler, (2002), a global review of literature within the perception of caregiving and family coping strategies will provide the foundation for this study. Family burden, caregiver burden, coping strategies, stressors and stigma in the caregiving context, family adjustment, interventions that reduce the burden of caregiving.
Deinstitutionalization
It has been pointed out by various researchers that the deinstitutionalization process lacks plans for the provision of funds for accommodation of the individuals with severe mental illness who will be released from the institutions, funds to implement psychosocial rehabilitation programs and for training and employment of staff which will provide support to family members to whom the responsibility of care has been shifted (Michael, 2001; Sheth, 2009). Discharged individuals are released to their family members who find it difficult to meet the demands of caregiving.
Family burden
This is mainly due to disabilities, lack of resources resulting in caregiving being perceived as a burden by family members (Perlick, et al., 2007; Van Der Voort, et al., 2007). According to Mengdan, et al., (2007); Van Der Voort, et al., (2007), Objective burden is more related to the duration of caregiving, the severity of symptoms, and the amount of care required, which is influenced by the number of family members who participate in caring for a the individual with mental seriousness. disease.
Stigmatization
Communities need to be involved in these mental illness education programs because they sometimes intensify the burden of care by stigmatizing individuals with serious mental illness and their families. Mak & Cheung 2008). Seloilwe (2006) also pointed out that family members' social activities tend to decrease due to perceived stigmatization that affects their leisure activities as well as their socialization needs. Mak & Cheung, 2008, pointed out that family members with high levels of relationship stigma develop negative attitudes toward caregiving.
Coping strategies
In a study conducted by Huang, et al., (2008) three social coping strategies that emerged from the study were spiritual support, social support from friends and family members, and professional support. According to Huang, et al., (2008) family members with low social support tend to use spiritual coping strategies more than those who receive support in providing their caregiving roles.
Research design
Research setting
It explains the sampling procedure, how data was collected from the participants and the data analysis. The district regional hospital is the only hospital in the district with a dedicated psychiatric unit and 72-hour admission facility for the district.
Research population
The hospital has a psychiatric clinic attached to it, which receives referrals from psychiatric departments and other units within the hospital, as well as from stationary clinics, mobile clinics and local authority clinics in both municipalities.
Sampling
- Sample inclusion criteria
- Sample size
- Sampling procedure
Family members who accompanied their relatives to the clinic during the three-week data collection period constituted the population of the study. The clinic nurse was asked to assist the researcher in identifying the family members who were currently living with their relative with a serious mental illness among the people who accompanied clients to the clinic.
Data collection instruments
Part B addressed perceptions of caregiving by family members of persons with serious mental illness and Part C examined ways in which family members cope with caregiving responsibilities. Family members' coping strategies (section C) were measured using the Carer's Assessment of Management Index (CAMI) scale, also referred to as ways of coping.
Validity and reliability of the instruments
- Content validity
To describe the factors that influence the perceived burden of family members as caregivers. To explore the coping strategies used by family members in their care giving roles.
Data collection procedure
Family members who agreed to participate in the study were given a consent form to sign. Participants were informed that they were free to discontinue their participation at any time if they felt uncomfortable with the questions.
Data analysis
Ethical considerations
- Informed consent
- Rights to self–determination and confidentiality
The researcher explained the purpose of the study and how the data would be collected in a way that the participants could understand. The researcher informed the participants that they could withdraw from the study at any time if they felt uncomfortable (De Vos, 2001).
Data management
Prior to data collection, permission to conduct the study was simultaneously sought from the Health Research and Knowledge Management Department of the Provincial Ministry of Health, as well as from the ethics committee of the health institute. Informed consent was obtained before the start of data collection and participants voluntarily participated in the study.
Dissemination of findings
The final research report will be bound and submitted to the library of the University of KwaZulu-Natal. An article will be prepared and submitted for publication in the African Journal of Nursing and Midwifery.
Limitations of the study
Conclusion
Introduction
Sample description
- Age Distribution of Participants
- Education Level
- Relationship with an individual with serious mental illness
- Monthly household income in ZAR
- Condition of the individual with serious mental illness in the past three months
- ZBI: Respondents’ perceptions of the burden of care giving
Just under half of the sample in this study lived below the poverty line. According to figure 4.6, n=52 (44.%) of the participants reported that the condition of their relatives with severe mental illness has improved during the last three months, which is equal to the number of family members who reported the condition of to their relatives as deteriorated. during the last three months.
CAMI: Family coping strategies
This was used by 46.7% of participants while 40.8% found it helpful to ignore the problem and hope it would go away. Almost half of the sample found the coping strategy of trying to cheer you up by eating, drinking, smoking, or similar helpful (50.8%).
Association between perceived burden, coping strategies and demographic variables
- Association between perceived burden and demographic variables
- Associations between coping strategies and socio-demographic variables
- Gender and coping strategies
- Age and coping strategies
- Education and coping strategies
- Relationship to the client
- Monthly household income and coping strategies
- Condition of a client in the past three months and coping strategies
- Association between perceived burden and coping strategies
Do you feel that your social life has suffered because you are caring for your family member. Do you feel that you do not have enough money to take care of your family member in addition to the rest of your expenses.
Conclusion
External resources such as seeking support from friends, health professionals and from other family members were less utilized and or not found useful by a higher percentage of the participants. The next chapter will discuss the findings, limitations of the study and make appropriate recommendations.
Introduction
Discussion
- Factors that influence the perception of care giving burden by family members According to the family adjustment and adaptation model an occurrence of a negative life
- Coping strategies used by family members in their care giving roles
- Relationship between perceived family burden, coping strategies and socio- demographic characteristics
- Gender and coping strategies
- Age and coping strategies
- Education and coping strategies
- Relationship to the client and coping strategies
- Monthly household income and coping strategies
In contrast to the findings of this study, other researchers concluded Chien, (2006); Papastavrou, (2007) Van Der Voort, et al., (2008) who reported on the relationships between gender, age, education, family income and the perceived burden. The current findings are in contrast to the findings of the study conducted by Papastavrou, et al. (2007), which indicated that compared to women, men were more problem-oriented and reported less burden of caregiving.
Recommendations of the study
- Policy Makers
- District health management team
- Nursing Practice
- Nursing Education
- Nursing Research
Psychosocial rehabilitation can help to increase the skills of individuals with severe mental illness in general life skills to reduce dependency and improve the social network for the family members (Uys & Middleton, 2004). The findings of the study revealed that there is overdependence of individuals with severe mental illness on their family members.
Limitations of the study
Further training and workshops on mental health issues should also be planned for other non-professional workers, to increase their knowledge about the support needs of family members as partners in the care delivery context. Gender inequality in the sample composition could have an impact on the results obtained; in this study there were 53.3% more women than male participants.
Conclusion
The results of this study may not be generalizable to the entire district as it is limited to two municipalities out of the five municipalities that make up uThukela District.
2008). The burden of anxiety in caregivers of older dementia patients and its relationship to coping strategies. nd'). The theory of family stress and adjustment. Kim, H.W., Greenberg, J.S., Seltzer, M.M., & Krauss, M.W. (2003). The role of coping in maintaining the psychological well-being of mothers of adults with intellectual disability and mental illness.
Section A Demographic Information
IMIBUZO NEZIMPENDULO ISIHLOKO SOCWANINGO
Hlola imicabango yemindeni enesibopho sokunakekela ilungu eligula ngengqondo eMkhandlwini woThukela, esifundazweni saKwaZulu-Natal. Imibuzo ihlukaniswe yaba izingxenye ezintathu. Uyacelwa ukuthi uphendule konke.
Section B Zarit Burden Interview Scale
Do you feel that you do not have as much privacy as you would like because of your family member? Do you feel that you will not be able to take care of your family member much longer?
ISIGABA: B isipiliyoni sokuthwala kanzima
Uzizwa sengathi othandekayo wakho ulindele ukuthi kube nguwena ozomnakekela, sengathi uwena kuphela umuntu athembele kuye. Uzizwa sengathi awunayo imali eyanele yokunakekela othandekayo wakho lapho uhlanganisa noma unakekela izidingo zakho zezimali.
Section C Ways of coping using the Carers Assessment Management Index (CAMI)
Ethical clearance for study from the health care institution in the
Letter of approval from the Department of Health of KwaZulu-Natal
Patient information document and declaration of consent to participate in HEALTH
Do you feel that you do not have enough money to take care of your relative in addition to the rest of your expenses. Do you feel that because of the time you spend with your relative, you do not have enough time for
