The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia

Zebeda Abdelgwad Elsherif^1, , Sahar Behilak² and Ayat Saif Elyazal Abdelraof¹

¹Psychiatric Nursing and Mental Health, Tanta University, Egypt

²Psychiatric and Mental Health Nursing, Mansoura University, Egypt

Cite this paper:
Zebeda Abdelgwad Elsherif, Sahar Behilak and Ayat Saif Elyazal Abdelraof. The Relationship of Relatives’ Illness Perception, Expressed Emotion and Their Burden in Caring for Patients with Schizophrenia. American Journal of Nursing Research. 2020; 8(6):624-631. doi: 10.12691/ajnr-8-6-5

Abstract

Background: The chronic burden of care to a patient with schizophrenia which produce negative emotions. As a result of de-institutionalization, caregivers have greater burden for the care of their mentally ill relatives. Objective of this study was to explore the relationship of relatives’ illness perception, expressed emotion and their burden in caring for patients with schizophrenia. Design: This study followed a correlation descriptive research design. Setting: This study conducted at inpatient and outpatient psychiatric department of Tanta University Hospital. Subject: The study subjects consist of 100 relatives of patient with schizophrenia. Tools: Tool 1 consisted of 2 parts: Part 1 Socio-demographic and general characteristics of studied participants, Part 2 Illness Perception Questionnaire-Schizophrenia Carers Version (IPQ-SCV), Tool 2 Family Questionnaire (FQ), Tool 3 Caregiver Burden Interview. Results: it was found that the studied participants had poor illness perception total score, it was found that the studied subjects (47%) had high emotional over- involvement level while it was observed that the two thirds of the studied relatives (61%) had high level of family criticism. majority of studied participants had moderate level of family burden. Conclusion: The results concluded that there was a significant positive correlation between family illness perception and family expressed emotion, also there was a significant positive correlation between family emotional expression and family burden level. Recommendations: this study recommended future studies to investigate distress and burden among caregivers with high emotion expression for intervention, reducing family stress and burden.

Keywords:
caregivers burden emotional expression illness perception

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Kareem A. Impact of Family Expressed Emotion upon Schizophrenic. Journal of Kufa for Nursing Science, 2013; Vol. (3), (2): 2-8.
[2]	American Psychiatric Association. Diagnostic and statistical Manual of Mental Disorders, fifth edition. Arlington, VA: American Psychiatric Association; 2013: 105-110.
[3]	Vaughn, C., and Duda, K.: Attribution and expressed emotion in the relatives of the patients with schizophrenia. Journal of Abnormal Psychology, Vol.100, 2003, pp. 546-554.
[4]	Haidl, T., Rosen, M., Schultze-Lutter, F. Expressed emotion as a predictor of the first psychotic episode -results of the European prediction of psychosis study. Schizophrenia Research, 2018, 199: 346-52.
[5]	Bharti J. Expressed Emotion among Caregivers of Person with Schizophrenia and Obsessive Compulsive Disorder: A Comparative Study. The International Journal of Indian Psychology, 2015, Volume 3, Issue 1, No.4, 190-200.
[6]	McNab C., Haslam N. & Burnett P. (2007) Expressed emotion, attributions, utility beliefs, and distress in parents of young people with first episode psychosis. Psychiatry Research 151, 97-106.
[7]	Lowenstein J.A., Butler D.W. & Ashcroft K. (2010). The efficacy of a cognitively orientated carers group in an early intervention in psychosis service - a pilot study. Journal of Psychiatric and Mental Health Nursing 17, 628-635.
[8]	Medina-Pradas, C., Navarro, J.B., Pousa, E., Montero, M.I., Obiols, J.E., 2013. Expressed and perceived criticism, family warmth, and symptoms in schizophrenia. Spanish Journal of Psychology 16, 1-8.
[9]	Vansconcelos, D., Wearden, A., Barrowclough, C., 2013. Expressed emotion, types of behavioural control and controllability attribution in relatives of people with recent-onset psychosis. Social Psychiatry and Psychiatric Epidemiology 48, 1377-1388.
[10]	Gómez-de-Regil, L., Kwapil, T.R., Barrantes-Vidal, N., 2014. Predictors of expressed emotion, burden and quality of life in relatives of Mexican patients with psychosis. Journal of Psychiatric and Mental Health Nursing 21, 170-179.
[11]	Möller-Leimkühler AM, Jandl M. Expressed and perceived emotion over time: does the patients’ view matter for the caregivers’ burden? Eur Arch Psychiatry Clin Neurosci. 2011; 261(5): 349-355.
[12]	Awad A.G. & Voruganti L.N.P. (2008). The burden of schizophrenia on caregivers: a review. PharmacoEconomics 26, 149-162.
[13]	Caqueo-Urízar A., Gutiérrez-Maldonado J. & Miranda-Castillo C. (2009). Quality of life in caregivers of patients with schizophrenia: a literature review. Health and Quality of Life Outcomes 7, 84.
[14]	Möller-Leimkühler AM, Obermeier M. Predicting caregiver burden in first admission psychiatric patients. Eur Arch Psychiatry Clin Neurosci. 2008; 258(7): 406.
[15]	Bianca T. Villalobos, Caregiver Criticism, Help-giving and the Burden of Schizophrenia Among Mexican American Families Br J Clin Psychol. 2017 September; 56(3): 273-85.
[16]	Lobban, F., Barrowclough, C., & Jones, S. A review of models of illness in severe mental illness. Clinical Psychology Review, 2003; 23, 171-196.
[17]	Izona E , Berrya K, Lawb H, Frencha P . Expressed emotion (EE) in families of individuals at-risk of developing psychosis: A systematic review Psychiatry Research , 2018: 661-672.
[18]	Barrowclough, C., Lobban, F., Hatton, C., Quinn, J., 2001. An investigation of models of illness in carers of schizophrenia patients using the Illness Perception Questionnaire. British Journal of Clinical Psychology 40, 371-385.
[19]	Wiedemann, G., Rayky, O., Feisnstein, E., Hahlweg, K., 2002. The family Questionnaire: development and validation of a new self-report scale for assessing expressed emotion. Psychiatr. Res. 109, 265-279.
[20]	Zarith S.H., Reever K.E. & Bach‐Peterson J. (1980) Relatives of impaired elderly: correlates of feelings of burden. The Gerontologist. 20, 649-655.
[21]	Xia Wang, Qiongni Chen, Min Yang. Effect of caregivers’ expressed emotion on the care burden and re-hospitalization rate of schizophrenia. Patient preference and adherence 2017: 11, 1505-1511.
[22]	L.Gómez-de-Regil, Thomas R. Kwapil, & N. Barrantes-Vidal. Predictors of expressed emotion, burden and quality of life in relatives of Mexican patients with psychosis. Journal of Psychiatric and Mental Health Nursing, 2014, 21(2), 170-179.
[23]	Nuralita N S, CamelliaV, and Loebis B. Relationship between Caregiver Burden and Expressed Emotion in Families of Schizophrenic Patients. Journal of Medical Science. 2019 Aug 30; 7(16): 2583-2589.
[24]	B. P. Nirmala, M. N. Vranda, and Shanivaram Reddy. Expressed Emotion and Caregiver Burden in Patients with Schizophrenia. Indian J Psychol Med. 2011 Jul-Dec; 33(2): 119-122.
[25]	Martínez D T, Pradasb C M,. Kwapil T R, and Vidal N B. Relatives' expressed emotion, distress and attributions in clinical high-risk and recent onset of psychosis. Psychiatry Research (2017) 247, 323-329.
[26]	Domínguez-Martinez, T., Medina-Pradas, C., Kwapil, T.R., & Barrantes-Vidal, N. Relatives’ illness attributions mediate the association of expressed emotion with early psychosis symptoms and functioning. Psychiatry Research, 2014, 218, 48-53.
[27]	Kuipers E , Watson P , Onwumere J , Bebbington P, Dunn G , Weinman J, Fowler D, Freeman D, Hardy A,& Garety P. Discrepant illness perceptions, affect and expressed emotion in people with psychosis and their carers. Soc Psychiatry Psychiatr Epidemiol (2007) 42:277-283.
[28]	Carrà G, Cazzullo C L, and Clerici M. The association between expressed emotion, illness severity and subjective burden of care in relatives of patients with schizophrenia. Finding from an Italian population. BMC Psychiatry 2012, 12:140, 1-8.
[29]	Bianca T. Villalobos , Jodie Ullman, Tracy Wang Krick, Darcy Alcántara, Alex Kopelowicz, and Steven R. López .Caregiver Criticism, Help-giving and the Burden of Schizophrenia Among Mexican American Families. Br J Clin Psychol. 2017 September; 56(3): 273-285.
[30]	Darwin P, Hadisukanto G, Elvira SD. Beban perawatan dan ekspresi emosi pada pramurawat pasien skizofrenia di rumah sakit jiwa. J Indon Med Assoc. 2013; 63(2): 46-51.