Search

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. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the distress thermometer for caregivers (DT‐C) and document the distress level in primary caregivers of children and adolescents diagnosed with schizophrenia. Design: A validation diagnostic accuracy study and descriptive cross‐sectional survey. Methods: DT‐C was adopted based on Harverman's distress thermometer for parents. The cut‐off score was detected by using receiver operating characteristic analysis with the Depression Anxiety Stress Scale‐21 as a reference standard in a sample of 324 caregivers of children and adolescents diagnosed with schizophrenia in China collected between Jan 2017 and Feb 2018. Results: One‐item DT of DT‐C indicated a good retest reliability (r = 0.86) and one‐item DT and the Problem List (PL) indicated good convergent validity (r = 0.67–0.88). Overall and individual PL domains showed good internal consistency (KR 20 values ranged from 0.70–0.90). Setting seven as the cut‐off score, the values of sensitivity (0.72–0.81), specificity (0.86–0.90), Youden's index (0.61–0.70), positive predictive value (0.67–0.74), and negative predictive value (0.84–0.92) were most satisfactory and area under curve values showed significantly excellent discrimination (0.88–0.90). The average DT score for the 324 participants was 6.34 (SD 2.49), with 46.9% of the participants above the cut‐off. Caregivers above the cut‐off score faced significant multiple problems in practical, family/social, cognitive, emotional, and parenting domains. Conclusion: The DT‐C, with six domains containing 35 items in Problem List and with the cut‐off score at seven, can be a rapid screening tool to measure distress in these caregivers. The level of distress in caregivers was relatively high. Psychoeducation on specific needs and a solid mutual support network are recommended for mitigating caregivers' distress. Impact: This study adapted a reliable DT‐C to measure distress of caregivers, which has the potential to be introduced to caregivers of other types of child and adolescent mental disorders in research, assessments and care planning for health professionals. [ABSTRACT FROM AUTHOR]