Caregiving experiences of families of persons with serious mental health problems in the Niger Delta region of Nigeria

Mental health services are provided at Rumuigbo Hospital, a single facility that renders psychiatric services in Rivers State and surrounding states in the Niger Delta region of Nigeria. Psychiatric services are not provided at primary health‐care clinic or district hospitals, and access to this service can be problematic for many caregivers due to the time and costs involved. Therefore, this study explored the family caregiving experiences of persons with serious mental health problems in terms of the mental health‐care policy and health systems environment. A qualitative study using a purposive sampling technique was conducted among 20 caregivers attending a neuropsychiatric clinic in Port Harcourt, Rivers State, Nigeria. The results show that 78% of caregivers lived outside Port Harcourt and 65% had no regular monthly income. Stigma, poor knowledge in managing symptoms of ill relatives, financial implications, lack of support network, and absence of community outreach clinics were found to affect family caregiving experiences. Policies need to be developed and implemented that provide mental health care through primary health‐care services to ameliorate families' financial burden, enable early diagnosis and treatment, reduce the need to travel, and improve the quality of life of family caregivers.     

流动人口精神病患者家属心理健康状况调查及心理干预效果评价

目的：探讨流动人口精神病患者家属的心理健康状况及心理干预效果。方法对100名流动人口精神病患者家属于患者入院时采用焦虑自评量表和抑郁自评量表评定心理健康状况,根据测评结果予以有针对性的心理干预,于患者出院时再次进行测评分析。结果本组62．0％的患者家属存在不同程度的焦虑抑郁情绪;心理干预前焦虑自评量表和抑郁自评量表总分显著高于国内常模（ t＝21．19、19．14,P＜0．01）,心理干预后较心理干预前显著降低（ t＝14．92、11．08,P＜0．01）,但仍显著高于国内常模（ t＝6．93、6．34,P＜0．01）。结论流动人口精神病患者家属存在不同程度的焦虑抑郁情绪,对其开展有针对性的心理干预能缓解其焦虑抑郁情绪,提高心理健康水平。     

Towards relational recovery: Nurses’ practices with consumers and families with dependent children in mental health inpatient units

Facilitating parent–child and family connections during parental hospitalization provides important opportunities for mental health services to support individual and family recovery. Nurses are often the primary point of contact for families in the inpatient context. They play an integral role in the care provision of consumers and families and in supporting consumers’ recovery. The aim of the present qualitative study was to explore nurses’ practice with families in inpatient mental health settings in the context of designated family rooms. Three themes were derived from the thematic analysis of semistructured interviews with 20 nurses from four mental health inpatient units. Nurses experienced tensions within their roles in balancing safety and risk, a lack of confidence in family‐focused practices in relation to role expectations, and challenges in juggling nursing care ideals with the contemporary realities of inpatient practice. A family‐centred relational recovery approach is recommended for mental health services, which is underpinned by family‐focused policies and processes, and supported at an organizational, managerial, and local‐unit level. At an individual level, nurses need professional development on the models of care they practice in, explicit role clarity on their practice with families, and education on evidence‐based brief family interventions.     

开放式病房精神障碍患者家属心理健康状况的调查分析

目的 调查开放式病房住院精神障碍患者家属的心理健康状况,分析其相关的影响因素.方法 采用症状自评量表(symptom checklist-90,SCL-90)对152名精神障碍患者家属的心理健康状况进行调查.结果 SCL-90评分总分、总均分、阳性项目数与国内常模比较,差异无统计学意义(均P＞ 0.05),人际关系、敌...     

Family group conferences in public mental health care: an exploration of opportunities

Family group conferences are usually organized in youth care settings, especially in cases of (sexual) abuse of children and domestic violence. Studies on the application of family group conferences in mental health practices are scarce, let alone in a setting even more specific, such as public mental health care. The present study reports on an exploratory study on the applicability of family group conferencing in public mental health care. Findings suggest that there are six reasons to start family group conference pilots in public mental health care. First, care providers who work in public mental health care often need to deal with clients who are not motivated in seeking help. Family group conferences could yield support or provide a plan, even without the presence of the client. Second, conferences might complement the repertoire of treatment options between voluntary help and coercive treatment. Third, clients in public mental health care often have a limited network. Conferences promote involvement, as they expand and restore relationships, and generate support. Fourth, conferences could succeed both in a crisis and in other non-critical situations. Sometimes pressure is needed for clients to accept help from their network (such as in the case of an imminent eviction), while in other situations, it is required that clients are stabilized before a conference can be organized (such as in the case of a psychotic episode). Fifth, clients who have negative experiences with care agencies and their representatives might be inclined to accept a conference because these agencies act in another (modest) role. Finally, the social network could elevate the work of professionals.     

首发精神分裂症患者家属心理健康状况及心理干预效果评价

目的：探讨首发精神分裂症患者家属的心理健康状况及心理干预效果。方法对80名首发精神分裂症患者家属采用症状自评量表评定心理健康状况,并予以有针对性的心理干预。于心理干预2周末再次测评,并与国内常模进行对比分析。结果干预前患者家属症状自评量表的躯体化、人际关系敏感、抑郁、焦虑、恐惧因子分显著高于国内常模（P＜0．01）,干预后均较干预前显著降低（P＜0．01）,但躯体化、焦虑、恐惧因子分仍显著高于国内常模（P＜0．05或0．01）。结论精神分裂症患者家属存在不同程度的心理问题,心理干预能有效缓解或消除其心理问题,提高其心理健康水平。     

农村居民对精神卫生问题认知状况调查

目的：了解农村居民对精神卫生问题的认知状况。方法对680名农村居民采用自制精神卫生问题认识及态度调查问卷进行测评分析。结果80．9％的居民通过周围的真实病例了解精神卫生知识,94．2％的居民知晓精神疾病临床症状为幻觉、冲动伤人,仅18．8％的居民认为冷淡孤僻、注意障碍也是精神病的症状。认为精神疾病不具传染性、可以治愈、不会遗传的比例分别为97．0％、85．5％、66．1％。＞80．6％的居民对与少年儿童有关的精神卫生知识了解较好,67．1％的居民认为精神病人受到歧视。文化程度越高的居民对精神卫生问题的认知越高。结论农村居民对精神卫生问题有不同程度的认知,文化程度越高,对精神卫生问题的认知水平越高。     

执行处突救治任务的医务人员及家属心理状态调查

目的 调查执行处突救治任务的医务人员及家属心理健康状况.方法 采用症状自评量表,对某部参与执行处突救治任务的384名医务人员及488名家属进行问卷调查.结果执行处突救治任务的医务人员焦虑、强迫、人际关系敏感、敌对4个因子得分高于中国常模(P<0.01或P<0.05);医务人员家属焦虑、敌对2个因子得分高于中国常模(P<...     

Determinants of perceived health in families of patients with heart disease

BACKGROUND: Heart disease is a severe long-term illness, which often requires lifestyle changes and self-care and affects the life of the whole family. Perceived family health is highly complex. It combines people's values and everyday experiences, such as knowledge about their own health, what they do to promote their health, how their life progresses, and how they feel physically and emotionally. AIM: The aim of this paper is to report a study to describe the perceived health of families of patients with heart disease and to ascertain factors related to family health. METHODS: Data were collected by questionnaire with a convenience sample of 161 family members of patients receiving treatment on two medical wards of a university hospital in southern Finland. Data were analysed using means and medians and tested by parametric and non-parametric tests. A stepwise regression analysis was also used. RESULTS: The most important predictors of family health were family structural factors, effect of illness symptoms on daily life, and family relationships. The strongest predictor was family structural factors. It was found that the better the family structure and relationships, the better the family health. Similarly, the greater the effect of the illness on the patient's daily life, the worse the family health. CONCLUSION: The findings suggest that supporting family functioning in the families of people with heart disease is an important challenge for family nursing.     

Mothers with mental health problems: a systematic review

Mothers with mental health problems meet challenges in coping with their condition, the responsibility of child rearing, and fulfilling their role as a mother. The aim of this study was to create a synthesis of the previous research on mothers with mental health problems and the challenges they face. A systematic literature search of international databases was undertaken, covering the period between January 1998 and April 2009. Nineteen articles met the inclusion criteria. The analysis process involved skimming, comprehending, analyzing, and synthesizing. Three themes emerged: the vulnerability of mothers with mental health problems, the fear of being perceived as not good enough as a mother, and concern that the children might develop mental health problems. In conclusion, the focus of the research field is shifting from viewing the mother's mental health problems from an individualistic perspective to considering them in a broader context of relational, economic, and environmental factors and on the basis of the mother-child relationship being characterized by interdependence.     

精神发育迟滞儿童家属心理健康状况调查

目的 探讨精神发育迟滞儿童家属的心理健康状况,为制定有效的心理干预措施提供依据.方法 将56例精神发育迟滞儿童的父母设为研究组,抽取同期50名健康儿童的父母设为对照组,采用症状自评量表对两组进行测评分析.结果 研究组症状自评量表评分,除恐怖因子分与对照组差异无显著性外,其他因子分均显著高于对照组(P＜0.05);研究组母亲症状自评量表躯体化、抑郁、焦虑、恐怖因子分显著高于父亲(P＜0.05),强迫、敌对、偏执因子分显著低于父亲(P＜0.05或0.01).结论 精神发育迟滞儿童对其家属的心理健康有负性影响,对家属积极地开展有针对性的心理干预,有助于缓解压力,改善心理健康状况.     

A phenomenological exploration of the lived experience of mental health nurses who care for clients with enduring mental health problems who are parents

This paper is a report of a study to explore mental health nurses' lived experience of caring for adults with enduring mental health problems who are parents. With the advent of community care, more people with enduring mental health problems have contact with their families and are parents. Ultimately, rehabilitative strategies for parents with mental health problems are focused towards functioning effectively within their own family unit and hopefully enabling them to fulfil their parental role. Mental health nurses working with this client group have competing demands to reconcile. For example, advocating for client rights versus protecting the child and supporting the family. This phenomenological study took place within adult mental health services in the UK. Semi-structured interviews were conducted with six nurses. A thematic analysis was conducted on the data. Five themes were identified from the data: support, remaining impartial, addressing the specific needs of a client who is a parent, models of care and interagency communication. The findings suggest that neither a family-centred nor a person-centred approach to care completely meets the needs of this client group. An integrated model of care is proposed that applies person-centred and family-centred approaches in tandem.     

酒精所致精神障碍住院患者家庭负担研究

目的 评价酒精所致精神障碍住院患者的家庭负担.方法 采用家庭负担量表对216例酒精所致精神障碍住院患者的家庭负担进行评定分析.结果 入组患者家庭负担量表总分、家庭经济负担、家庭关系、家庭成员心理健康、家庭日常活动、家庭娱乐活动阳性回答率分别为72.2%、67.6%、81.9%、85.2%、58.3%、59.3%;患者因住院或其他疾病等原因每年贻误工作时间为125.09 d,照料者因照顾患者每年贻误工作时间为50.02 d.结论 酒精所致精神障碍造成严重的家庭负担,应作为精神障碍重点干预的对象.     

Family dynamics in families of severe COPD patients

Aim and objectives. The purpose of this study was to describe family dynamics in families with severe chronic obstructive pulmonary disease (COPD) on the basis of Barnhill's framework for healthy family systems. The sample consisted of 35 severe COPD patients and 30 family members at Tampere University Hospital, Finland or in the neighbouring regions. Background. Chronic obstructive pulmonary disease is a public health problem worldwide. It is a slowly progressive airway disease, producing a decline in lung function which is not fully reversible. Design. The sample included the families of patients without oxygen therapy and the families of patients who had long-term oxygen therapy (LTOT). The data were collected using the Family Dynamics Measure 2 (FDM2) and the Family Dynamics Questionnaire (FDQ). Method. A quantitative research method was employed in the study. Frequency and percentage distributions, as well as cross-tabulations, were used to describe the data. Mean values and standard deviations were calculated for the sum variables of six dimensions of the FDM2. Results. In the dimensions of individuation, mutuality and flexibility, dynamics in the families of patients with LTOT was significantly better than of the patients without oxygen therapy. Especially in the dimension of mutuality, the families of LTOT patients functioned very well, while in the dimensions of communication and roles, family dynamics in these families was notably worse, although still good. Conclusion. Poor self-identity – enmeshment, isolation from others and lack of flexibility to varying conditions – in families with severe COPD can weaken the ability of the families to manage in everyday life. Relevance to clinical practice. Families need family nursing to adapt to alterations occurring when a family member has severe COPD. Nurses can give support and help for these families for their roles of patient and caregiver, as well as opportunities to speak with someone about their situation.     

Family coping with mental illness: a comparative study

Two studies were conducted by the same researcher, one in Canada, the other in Japan, looking at families' reactions to their relatives' mental illness. The focus was placed on family caregivers' transformation processes, which are a unitary process of pattern appraisal and deliberate mutual patterning based on a unitary transformative paradigm within Newman's theory of health as expanding consciousness.