Effect of Telenursing on Care Burden and Resilience of Family Caregivers of Schizophrenic Patients
Abstract
Background: Care burden is one of the consequences of caring for schizophrenic patients, caregivers need high resilience to have their best performance in caring for these patients and reduce their care burden. Psychiatric nurses should implement coherent programs to support these caregivers. Therefore, this study aimed to determine the effect of telenursing on the care burden and resilience of family caregivers of schizophrenic patients.
Materials and Methods: This research was a before‑after quasi‑experimental study with a control group. Participants included 44 family caregivers of schizophrenic patients referring to the Razi Educational and Therapeutic Psychiatric Center in Tehran in 2023–2024. Participants were included via purposive sampling method and based on inclusion criteria. Data collection tools included demographic questionnaire, standard Zarit Burden Interview (ZBI), and Connor–Davidson Resilience Scale (CD‑RISC). In addition to routine care, the intervention group also received telenursing care.
Results: Findings of this study showed that between intervention and control group, except for dimensions of positive acceptance of change, secure relationships (p = 0.007) and trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress (p = 0.02) of resilience, there were no statistically significant differences in other discussed variables such as care burden and resilience.
Conclusions: In this study, telenursing did not have a positive effect on all dimensions of resilience and care burden, but considering its potential and its positive effect on some dimensions of resilience, it is recommended that studies with longer intervention periods be conducted on other problems of family caregivers.
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Peng MM, Ma Z, Ran MS. Family caregiving and chronic illness management in schizophrenia: Positive and negative aspects of caregiving. BMC Psychol 2022;10:83.
World Health Organization. Schizophrenia. 2022. Available from: https://www.who.int/news-room/fact-sheets/detail/schizophrenia. [Last accessed on 2024 Mar 15].
Mohammadi M-R, Davidian H, Noorbala AA, Malekafzali H, Naghavi HR, Pouretemad HR, et al. An epidemiological survey of psychiatric disorders in Iran. Clin Pract Epidemiol Ment Health 2005;1:16.
Shamsaei F, Cheraghi F, Bashirian S. Burden on family caregivers caring for patients with schizophrenia. Iran J Psychiatry 2015;10:239-45.
Tamizi Z, Fallahi-Khoshknab M, Dalvandi A, Mohammadi-Shahboulaghi F, Mohammadi E, Bakhshi E. Caregiving burden in family caregivers of patients with schizophrenia: A qualitative study. J Educ Health Promot 2020;9:12.
Karambelas GJ, Filia K, Byrne LK, Allott KA, Jayasinghe A, Cotton SM. A systematic review comparing caregiver burden and psychological functioning in caregivers of individuals with schizophrenia spectrum disorders and bipolar disorders. BMC Psychiatry 2022;22:422.
Rahmani F, Asghari E. The effectiveness of family caregivers as case managers for patients with severe mental illness. Nurs Pract Today 2023;11:1-4.
Harvey C. Family psychoeducation for people living with schizophrenia and their families. BJPsych Adv 2018;24:9-19.
Ran MS, Chan CLW, Guo LT, Ng SM, Xiang MZ. The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychol Med 2015;45:2197-204.
Caqueo-Urízar A, Rus-Calafell M, Urzúa A, Escudero J, Gutiérrez-Maldonado J. The role of family therapy in the management of schizophrenia: Challenges and solutions. Neuropsychiatr Dis Treat 2015;11:145-51.
Akbari M, Alavi M, Irajpour A, Maghsoudi J. Challenges of family caregivers of patients with mental disorders in Iran: A narrative review. Iran J Nurs Midwifery Res 2018;23:329-37.
Lee Y, Bierman A, Penning M. Psychological well-being among informal caregivers in the Canadian longitudinal study on aging: Why the location of care matters. J Gerontol Ser B Psychol Sci Soc Sci 2020;75:2207-18.
Fekih-Romdhane F, Ben Ali S, Ghazouani N, Tira S, Cheour M. Burden in Tunisian family caregivers of older patients with schizophrenia spectrum and bipolar disorders; associations with depression, anxiety, stress, and quality of life. Clin Gerontologist 2020;43:545-57.
Rahmani F, Roshangar F, Gholizadeh L, Asghari E. Caregiver burden and the associated factors in the family caregivers of patients with schizophrenia. Nurs Open 2022;9:1995-2002.
Fernandes JB, Fernandes SB, Almeida AS, Cunningham RC. Barriers to family resilience in caregivers of people who have schizophrenia. J Nurs Scholarsh 2021;53:393-9.
Asgari M, Adib M, Nayeri ND, Rezayat F. Family caregivers’ perspectives on barriers to caring for patients with schizophrenia: A descriptive qualitative study. Nurs Pract Today 2023;10:239-49.
Kolsi S, Charfi N, Gassara I, Feki R, Omri S, Smaoui N, et al. Perceived stress and resilience in family caregivers of patients with mental illness: Relationship and correlates. Eur Psychiatry 2023;66:S1086-S.
Khraisat OMA, Al-Bashaireh AM, Alnazly E. Telenursing implications for future education and practice: Nursing students’ perspectives and knowledge from a course on child health. PloS One 2023;18:e0294711. doi: 10.1371/journal.pone. 0294711.
Saeed SA, Diamond J, Bloch RM. Use of telepsychiatry to improve care for people with mental illness in rural North Carolina. N C Med J 2011;72:219-22.
Pour ER, Aliyari S, Farsi Z, Ghelich Y. Comparing the effects of interactive and noninteractive education using short message service on treatment adherence and blood pressure among patients with hypertension. Nurs Midwifery Stud 2020;9:68-76.
Lohrasebi F, Maghsoudi J, Alavi M, Akbari M. The effect of the web-based psychosocial health promotion program on the burden of care in family caregivers of patients with chronic mental disorders. Iran J Nurs Midwifery Res 2023;2856-74.
Chai LK, Collins CE, May C, Ashman A, Holder C, Brown LJ, et al. Feasibility and efficacy of a web-based family telehealth nutrition intervention to improve child weight status and dietary intake: A pilot randomised controlled trial. J Telemed Telecare 2021;27:146-58.
Hou C, Carter B, Hewitt J, Francisa T, Mayor S. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials. Diabetes Care 2016;39:2089-95.
Sharif F, Shaygan M, Mani A. Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia in Shiraz, Iran. BMC Psychiatry 2012;12:48.
Raesi R, Mirzaei A, Saghari S, Raei M, Bokaie S, Hushmandi K. Investigating the effect of tele-nursing on the care burden of family caregivers of COVID-19 patients. J Crit Care Nurs 2021;14:21-9.
Namjoo M, Nematollahi M, Taebi M, Kahnooji M, Mehdipour-Rabori R. The efficacy of telenursing on caregiver burden among Iranian patients with heart failure: A randomized clinical trial. ARYA Atheroscler 2021;17:1-6.
Aghakhani N, Mohammadikia N, Eghtedar S, Alinejad V. Impact of social media-based (whatsapp) patient care education on the resilience of family caregivers of breast cancer patients. Nurs Midwifery J 2023;21:511-20.
Rotondi AJ, Haas GL, Anderson CM, Newhill CE, Spring MB, Ganguli R, et al. A clinical trial to test the feasibility of a telehealth psychoeducational intervention for persons with schizophrenia and their families: Intervention and 3-month findings. Rehabil Psychol 2005;50:325-36.
Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: A longitudinal study. Gerontologist 1986;26:260-6.
Talebi M, Mokhtari Lakeh N, Rezasoltani P, Kazemnejad Leili E, Shamsizadeh M. Caregiver burden in caregivers of renal patients under hemodialysis. J Holist Nurs Midwifery 2016;25:59-68.
Connor KM, Davidson JR. Development of a new resilience scale: The connor-davidson resilience scale (CD-RISC). Depress Anxiety 2003;18 (2):76-82.
Karimirad MR, Seyedfatemi N, Noghani F, Amini E, Kamali R. Resiliency family caregivers of people with mental disorders in Tehran. Iran J Nurs Res 2018;13:57-63.
Seyedfatemi N, Ahmadzad Asl M, Bahrami R, Haghani H. The effect of virtual social network based psycho-education on resilience of family caregivers of clients with severe mental disorders. Iran J Psychiatr Nurs 2019;6:1-8.
Mueser KT, Achtyes ED, Gogate J, Mancevski B, Kim E, Starr HL. Telehealth-based psychoeducation for caregivers: The family intervention in recent-onset schizophrenia treatment study. JMIR Ment Health 2022;9:e32492. doi: 10.2196/32492.
Ozkan B, Erdem E, Demirel Ozsoy S, Zararsiz G. Effect of psychoeducation and telepsychiatric follow up given to the caregiver of the schizophrenic patient on family burden, depression and expression of emotion. Pak J Med Sci 2013;29:1122-7.
Spaniel F, Novak T, Bankovska Motlova L, Capkova J, Slovakova A, Trancik P, et al. Psychiatrist’s adherence: A new factor in relapse prevention of schizophrenia. A randomized controlled study on relapse control through telemedicine system. J Psychiatr Ment Health Nurs 2015;22:811-20.
Zhang X, Liu B, Zang D, Li Y, Xiao S, Yu Y. Preferences for WeChat-based and hospital-based family intervention among caregivers of people living with schizophrenia. Patient Prefer Adherence 2022;16:635-45.
Uslu E, Buldukoglu K. Randomized controlled trial of the effects of nursing care based on a telephone intervention for medication adherence in schizophrenia. Perspect Psychiatr Care 2020;56:63-71.
Rad M, Rajab Dizavandi F, Rajab Dizavandi A. The effect of education through telenursing on the caregiver burden among family caregivers of COVID-19 patients: A randomized clinical trial. Perspect Psychiatr Care 2023;2023:2545639.
Sadeghmoghadam L, Shahriyan F, Delshad A, Deluee MA. The effect of educational intervention by tele-nursing on caregiver burden in family caregivers of elderly with Alzheimer’s disease. Alzheimers Dement 2020;16:e040961.
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