Severity of illness and distress in caregivers of patients with schizophrenia : Do internalized stigma and caregiving burden mediate the relationship?

Journal article

Guan, Ziyao, Wang, Yuwei, Lam, Louisa, Cross, Wendy, Wiley, James A., Huang, Chongmei, Bai, Xiaoling, Sun, Mei and Tang, Siyuan. (2021). Severity of illness and distress in caregivers of patients with schizophrenia : Do internalized stigma and caregiving burden mediate the relationship? Journal of Advanced Nursing. 77(3), pp. 1258-1270. https://doi.org/10.1111/jan.14648
AuthorsGuan, Ziyao, Wang, Yuwei, Lam, Louisa, Cross, Wendy, Wiley, James A., Huang, Chongmei, Bai, Xiaoling, Sun, Mei and Tang, Siyuan
Abstract

Aims
To test a multiple mediation model of internalized stigma and caregiving burden in the relationship between severity of illness and distress among family caregivers of persons living with schizophrenia.

Design
This is a cross-sectional study.

Methods
Data were collected from a consecutive sample of 344 Chinese family caregivers of persons living with schizophrenia between April-August 2018. Instruments used in this research included the Clinical Global Impression-Severity of Illness, the Internalized Stigma of Mental Illness Scale, the Caregiver Burden Inventory, and the Distress Thermometer. Data analysis was conducted using descriptive statistics, the Spearman correlation, and regression analysis to estimate direct and indirect effects using bootstrap analysis.

Results
This research found that internalized stigma and caregiving burden can separately and sequentially mediate the relationship between severity of illness and distress. Moreover the mediation of internalized stigma plays the largest role among the multiple mediations.

Conclusion
The severity of illness, internalized stigma, and caregiving burden are significant factors of distress among family caregivers of persons living with schizophrenia. The future intervention studies which be designed aiming at the three factors may be beneficial for family caregivers of persons living with schizophrenia.

Impact
This research examined the psychosocial development of distress and indicated that interventions improving patients’ symptoms and decreasing internalized stigma and caregiving burden can help to prevent or reduce distress among family caregivers.

Keywordscaregiving burden; distress; family caregiver; internalized stigma; mediation analysis; nursing; schizophrenia; severity of illness
Year2021
JournalJournal of Advanced Nursing
Journal citation77 (3), pp. 1258-1270
PublisherJohn Wiley & Sons Ltd
ISSN0309-2402
Digital Object Identifier (DOI)https://doi.org/10.1111/jan.14648
PubMed ID33231315
Scopus EID2-s2.0-85096636384
Page range1258-1270
FunderHunan Women Research Association
Hunan Provincial Key Laboratory of Nursing Research Fund
Central South University
Nature Science Foundation of Hunan Province
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online24 Nov 2020
Publication process dates
Accepted29 Oct 2020
Deposited14 Aug 2023
Grant ID198YB01
2017TP1004
2018zzts883
2020JJ5791
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