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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 3  |  Page : 268-280

Relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients


Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig, Egypt

Date of Submission27-Aug-2018
Date of Acceptance16-Oct-2018
Date of Web Publication28-Dec-2018

Correspondence Address:
Rehab Fathy Abdel Hady Ghaith
Psychiatric and Mental Health Nursing, Faculty of Nursing, Zagazig University, Zagazig
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ENJ.ENJ_17_18

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  Abstract 


Background Family caregivers of patients with chronic mental illness experience psychological stresses. Such stresses affect the psychological well-being of relatives, who have moderately high levels of burden and frequently get inadequate support from mental health professionals.
Aim The aim of this study is to examine the relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients.
Research design A descriptive correlational design was used in this study.
Setting This study was conducted at the psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate.
Patients A purposive sample of 150 mentally ill patients’ caregivers, who accompany their patients to the psychiatric outpatient clinics, was recruited.
Tools of data collection Four tools were utilized for data collection: sociodemographic data sheets, family burden scale, psychological well-being scale, and multidimensional scale of perceived social support.
Results More than half of the caregivers aged from 40 to 60 years. Most of the patients were diagnosed as having schizophrenia. More than two-fifths of the caregivers were parents and had high level of burden. Nearly two-thirds had moderate level of psychological well-being, and approximately half of the caregivers had moderate level of social support.
Conclusion There were negative statistically significant correlations among family burden, psychological well-being, and social support. However, a positive statistically significant correlation was detected between social support and psychological well-being.
Recommendations It is recommended that training programs should be designed for caregivers to enhance psychological well-being and social support and decrease the level of burden among caregivers of mentally ill patients.

Keywords: burden, caregivers, mental ill patients, psychological well-being, social support


How to cite this article:
Mahmoud Mohammed SF, Abdel Hady Ghaith RF. Relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients. Egypt Nurs J 2018;15:268-80

How to cite this URL:
Mahmoud Mohammed SF, Abdel Hady Ghaith RF. Relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients. Egypt Nurs J [serial online] 2018 [cited 2019 Jan 17];15:268-80. Available from: http://www.enj.eg.net/text.asp?2018/15/3/268/248960




  Introduction Top


Family caregivers play a main role in providing care and assistance to mentally ill individuals and their families. The influence of stressors on family members caring for an ill individual in the family has been mentioned as caregiver’s burden. Chronic illnesses place a major burden on family caregivers who take the sole responsibility of caring for chronically ill patients (Sahoo et al., 2010). Chronic mental illness has a distressing effect on the patient as well as his or her family members. The ability for social relationship is frequently lessened, and employment opportunities are diminished (Gupta et al., 2015).

Family caregivers of patients with a severe mental illness complain of psychological stresses, and such stresses affect the psychological well-being of relatives; they have moderately high levels of burden, and frequently have insufficient support from mental health professionals. For families who are already challenged with a range of day-to-day problems that distress all aspects of their lives, a member with a severe mental illness may have a significant consequence on the entire family system (Settineri et al., 2014).

Burden may be defined as the problems, difficulties, and negative life events influencing the life of family members concerned with a loved one with a mental illness (Swaroop et al., 2013). Caregivers of mentally ill patients experience both subjective and objective types of burden. Subjective burden refers to the psychological reactions the caregivers experience, for example, a feeling of loss, sadness, anxiety, embarrassment in social situations, the stress of coping with disturbing behaviors, and the frustrations caused by altering relationships (Raj et al., 2016). Objective burden refers to outwardly measurable demands placed on family members. These include financial difficulties, strain on interpersonal relationships, a reduction in social support, physical violence, and disruption of routines in cares and in households of relatives as well as leisure time (Oshodi et al., 2012).

The burden of care not only influences the physical, emotional, and psychological well-being of the caregiver but also produces feelings of guilt, shame, self-blame, and embarrassment on part of the caregiver, thus, affecting the caregivers’ physical, psychological, and social functioning in a negative way (Shakeel et al., 2015).

According to Franklin (2003), psychological well-being is the ability for good decision making, effective stress management, good communication skill, effective parenting, and caring for one and others emotionally. Moreover, psychological well-being is frequently defined as some combination of positive affective states such as pleasure and functioning with optimal effectiveness in individual and social life (Winefield et al., 2012).

Social support is significant for the psychological well-being of the family influenced by mental illness (Iseselo et al., 2016). Providing social support for family members in caring for loved ones with a mental illness has been shown to improve health outcomes for both the family and the ill loved ones. Family support accelerates client recovery from mental illness and addiction, lowers the risk of death, reduces reliance on health care services, reduces the rate of rehospitalization and relapses, enhances medication compliance, and improves client interpersonal functioning and family relationships (Hussein and Khudiar, 2013).

Social support for families giving care for their mentally ill patients is accompanied by increased family functioning and recovery, whereas the lack of social support is connected to impairment functioning and increased psychiatric symptoms and diminished potential for full community integration (McCorkle, 2007). In addition, social support was the best predictor of caregiver burden. Studies in the past have reported that the families that perceived a higher level of caregiver burden were associated with low social support (Raj et al., 2016). According to Gupta et al. (2015), caregivers who were higher on burden reported lower level of psychological well-being.

Mental health nurses have an important duty to recognize the burden of caregivers. They are in a position to render support and refer them to get further support through social workers and community agencies. Such procedures would ensure family psychological well-being for caregivers with mentally ill patients. For that also, the mental health nurse needs to assess the burden of caregivers and recognize the support they should receive during their period of caregiving in the hospital (Sharma, 2017).


  Significance of the study Top


Caring for a family member with a mental disorder places an enormous burden on family caregivers and has been shown to have a significant effect on the family’s well-being (Derajew et al., 2017). According to Singh and Dubey (2016), nearly 30% of caregivers described that their psychological well-being had been influenced by caregiving and that they were frequently worried or depressed. Therefore, caregiver burden, psychological well-being, and social support and the interface between them need to be examined to develop strategies to aid in caregiving.

As nurses play a pivotal, multifaceted role in the assessment and treatment of mentally ill and the caregivers, this study could provide nurses and other health professionals with an in-depth understanding related to this category of population which could relate positively on the quality of caregiver’s life. It is hoped that the findings of this study can help the mental health professionals to device certain support and self-help strategies as interventional device which can help caregivers to take a better choice of their own health and well-being.

In addition, the present study findings can help the mental health professionals in motivating the social support networks and encourage caregivers to make use of these helpful facilities in coping with the problems of patient care, adapting to their roles and providing relief from isolation. Moreover, it can help understand the problems, difficulties, and negative life events influencing caregivers and develop strategies to help in solving these problems.


  Aim of the study Top


This study was aimed to examine the relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients.


  Research questions Top


What is the relation between burden, psychological well-being, and social support among caregivers of mentally ill patients?


  Patients and methods Top


Research design

A descriptive correlational design was used in this study.

Study setting

The study was conducted at psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate.

Sample

A purposive sample of 150 mentally ill patients’ caregivers who accompany their patients were recruited from the psychiatric outpatient clinics at Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate according to the following criteria:
  1. Caregiver who is actively involved in the care of the patient and living with the patients for at least 6 months before the assessment.
  2. Caregiver who is 18 years or older.


Sample size

Assuming that the total number of caregivers at psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital is 720, the prevalence of burden among caregivers is 12.3% (Mathers and Loncar, 2006), at confidence level 95%. So the total sample size is 135 caregiver, and 10% is added for nonresponse, leading to a sample size of 150 caregiver calculated by Epi info 7.1 (Epi-Info software statistical package created by WHO and Center for Disease Control and Prevention, Atlanta, Georgia, USA, version 2002), 30.

Tools for data collection

Four tools were used in this study.

Tool I: sociodemographic and personal data sheet

This tool was designed by the researchers after revising the related literature and opinions of expertise for content validity and included the following:
  1. Sociodemographic data of the caregivers, such as age, degree of relation to the patient, residence, and educational level.
  2. Personal data of the patient, such as age, residence, marital status, educational level, occupation, and diagnosis.
  3. Characteristics of care provided to the patients by caregivers, such as number of caring hours for patient per day and help provided to caregivers by other family members.


Tool II: assessment of family burden scale

This scale was constructed by Rudnick (2004) to assess the burden of caregivers caring for mentally ill patients. The original tool composed of 28 items, which was divided as follows: physical burden (14 items) and emotional burden (14 items).

This scale was translated into Arabic language and modified by Metwaly (2007). Four items have been omitted to avoid repetition of items which have the same meaning in Arabic version. Two subscales concerning family burden have been taken from Camberwell Family Interview (Vaughn and Leff, 1976), translated and added to this scale. These two categories include the following: familial responsibilities (four items) and financial affairs (three items). The final scale after modification composed of 31 items, which is used for the current study. This scale was measured on a four-point Likert scale: always (4), usually (3), rarely (2), and never (1). A higher score means greater level of burden. The alpha Cronbach reliability of the scale was 0.70.

Tool III: psychological well-being scale

Psychological well-being scale is a structured, self-report instrument that includes 42 items based on the six dimensions of psychological well-being and developed by Ryff (1995). The six component of the scale are autonomy (seven items), positive relationships with others (seven items), environmental mastery (seven items), self-acceptance (seven items), personal growth (seven items), and purpose in life (seven items).

This scale was rated on a five-point Likert scale: strongly disagree (1), disagree (2), neutral (3), agree (4), and strongly agree (5). For each category, a high score indicates that, a respondent has a mastery of his areas of life, and conversely, a low score shows that the respondent struggles to feel comfortable with that particular concept.

The scale contains 20 negative or reverse sentences numbers: 3, 5, 10, 13, 14, 15, 16, 17, 18, 19, 23, 26, 27, 30, 31, 32, 34, 36, 39, and 41. They were scored as follow: that is, if the scored is 5 in one of these items, the adjusted score is 1, and if the scored is 4, the adjusted score is 2, etc. The alpha Cronbach reliability of the scale was 0.75.

Tool IV: multidimensional scale of perceived social support

The multidimensional scale of perceived social support assesses an individual’s perception of the social support that he/she receives from friends, family, and significant others and was developed by Zimet et al. (1988). This scale is a self-report measure and composed of 12 items, rated on a five-point Likert scale, ranging from strongly disagree (1) to strongly agree (5). Moreover, the family have to rate their approval or disapproval with how well an item describes their feeling. The greater the score, the higher the perceived social support. The alpha Cronbach reliability of the scale was 0.88.

Cutoff level of psychological well-being, social support, and family burden

  • Low level less than or equal to 60%.
  • Moderate more than 60–80%.
  • High level more than 80%.


Pilot study

A pilot study was carried out on 10% (15 caregivers) fulfilling the selected criteria to test the tools for clarity, relevance, comprehensiveness, understanding, applicability, and ease of implementation. The results of the data obtained from the pilot study helped in modification of the tools; items were then corrected or added as needed. Those who participated in the pilot study were eliminated from the main study sample.

Ethical considerations

An official letter was submitted from the dean of the Faculty of Nursing, Zagazig University, to the directors of Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate to take permission to conduct the study. The approval for participation of the patients was obtained after the aim of the study was explained to them; they were given a chance to refuse to participate, and also they were assured that the information would be confidential and used for the research purpose only.

Content validity

Content validity of the tools was tested by five psychiatric nursing and medicine professors, who revised the tools for clearness, relevance, applicability, inclusiveness, understanding, and ease of application, and according to their opinion, minor changes were applied.

Data collection procedure

Data were collected from 150 caregivers after obtaining formal permission from administrative people and participants. The researchers interviewed the caregivers and introduced themselves to them and briefly explained the nature of the study. The filling of questionnaire took 30–45 min by participants. The researchers spent 3 days every week, and on each day, they interviewed approximately five caregiver maximally. Data were collected across 3 months, starting from the beginning of March 2017 to the end of May 2017.

Statistical analysis

All data were organized, categorized, tabulated, entered, and analyzed by using statistical package for the social sciences, version 20, which is a software program. Qualitative data were presented as number and percentage, and quantitative continuous groups were expressed by mean±SD. Percent of categorical data was compared by χ2 test. Spearman’s rank correlation coefficient was calculated to assess the relationship between various study variables. P value less than 0.05 was considered significant.


  Results Top


[Table 1] shows that more than half of the caregivers (52.7%) aged from 40 to 60 years, and slightly more than half were female caregivers (52%). Among them 42% were parent caregiver, and less than two-thirds resided in rural areas (60%). Nearly three-quarters (73.3%) had more than three children. Majority of caregivers (77%) were married. More than one-third was illiterate (37%). As for occupation, 38.5% were not working.
Table 1 Sociodemographic characteristics of the studied caregivers (N=150)

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[Table 2] reveals that the number of caring hours for patient was more than 12 h per day in more than half of the studied caregivers (55%), and 58% were not caring for other members of the family. More than half of the studied caregivers (51%) had other persons helping caregivers in caring for their mentally ill patients. Help in treatment expenses by family constituted the highest frequency (90%).
Table 2 Characteristics of care provided to the patients by caregivers (N=150)

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[Table 3] indicates that less than two-thirds of the patients (64.7%) aged from 23 to 40 years. Most of the patient’s diagnosis (69%) was schizophrenia, and less than two-thirds resided in rural areas (60%), and more than half of them (53%) were unmarried. As for the educational level, more than one-third of the patients had secondary education (36%), and the majority were not working (78%).
Table 3 Demographic characteristics of the studied patients (N=150)

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[Table 4] demonstrated that 44.6% of caregivers had high level of burden, with mean±SD of 89±15. Nearly two-thirds (64.6%) had moderate level of psychological well-being, with mean±SD of 135±17, and approximately half of the caregivers had moderate level of social support (49.4%), with mean±SD of 41±10.
Table 4 Levels of family burden, psychological well-being, and social support among caregivers of mentally ill patients

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[Table 5] shows that there were statistically significant relationships between caregiver burden and sex, degree of relation, occupation, number of caring hours for patient/day, and help in treatment expenses (P>0.05).
Table 5 Relation between demographic characteristics, care provided to the patients, and family burden of caregivers of mentally ill patients

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[Table 6] demonstrated that there was a statistically significant relationship between caregiver social support and residence (P>0.05).
Table 6 Relation between demographic characteristics, care provided to the patients, and social support of caregivers of mentally ill patients

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[Table 7] demonstrates that there were statistically significant relationships between caregiver psychological well-being and sex, degree of relation, family member, marital status, educational level, occupation, and number of caring hours for patient/day (P>0.05).
Table 7 Relation between demographic characteristics, care provided to the patients, and psychological well-being of caregivers of mentally ill patients

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[Table 8] and [Figure 1] and [Figure 2] demonstrate a negative highly statistically significant correlation among social support, psychological well-being, and family burden. However, there was a positive highly statistically significant correlation between social support and psychological well-being among caregivers of mental ill patients (P>0.05).
Table 8 Correlation matrix of family burden, psychological well-being, and social support for the studied caregivers

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Figure 1 Correlation between social support score and family burden score among caregivers of mentally ill patients.

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Figure 2 Correlation between family burden score and psychological well-being among caregivers of mentally ill patients.

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  Discussion Top


Family burden has become an important indicator for mental health service provision; however, alterations in social networks and culture could result in difference in the experience of burden among caregivers of mentally ill individual in diverse countries (Zahid et al., 2010).

Regarding characteristics of the patients and caregivers, the present study results revealed that the mean age of the patients was 36 years and ranged from 16 to 69 years. This low mean age may be related to the early onset of mental illness in late adolescence or early adulthood. This result agrees with those of Kate et al. (2013) who found that the mean age of the patients in their study was 31 years.

The current study results found that more than half of patients were unmarried and the majority of them were unemployed. This may be owing to the early onset and the nature of mental illness that hinder normal social life such as establishing relationships, developing their social skills, and maintenance of work. Similar findings were also reported by Aggarwal et al. (2011), who found that a significant percentage of the patients were unmarried and unemployed.

The present study also showed that less than two-thirds of patients had a rural background. This can be attributed to the place of data collection, which serves more rural areas than urban. This result goes in line with the results of Gupta et al. (2015) who found that approximately three-fourths of the patients had a rural background.

The present study showed that the mean age of the caregivers was 48 years, the majority of caregivers were married, and less than two-thirds of them were employed. This elevated mean age and marriage rate might be owing to the fact that significant percentages of caregivers in this study were parents. This result agrees with those of Kate et al. (2013), who found that the mean age of the caregivers was approximately 46 years, and the majority of caregiver were married and employed.

Regarding caregiver’ sex, the present study results revealed that slightly more than half of caregivers were females. The higher percentage of female over male caregivers indicates the woman nature, as by venture of their position and characteristics are taking the major responsibility of caring for their ill relative. This result agrees with Metwaly (2007) who indicated that the majority of caregivers were females. Moreover, Navidian et al. (2012) found that most caregivers in their study were women who also were housewives. Contradictory findings were found by Kate et al. (2013) and Gupta et al. (2015), who reported that the majority of the caregivers were males.

Regarding the degree of relation, the current study revealed that more than two-fifths of caregivers were parents, less than one-third were son and daughter, one-fourth were spouse and only 4% of caregivers were siblings. The higher percentages of caregivers were parents can be explained, as the early onset of mental illness hinders the patient from marriage and establishing his own family, so parents becomes the main caregivers. In this regards, Aggarwal et al. (2011) found that approximately half of the caregivers were parents, whereas less than one-fourth were spouses and one-fifth were siblings.

The present study demonstrated that more than half of the patients required care for 12 h/day or more. This may be because of the chronic nature and severity of symptoms that characterize mental illness, which require constant care and supervision.

However, Metwaly (2007) found that most patients required care for less than 12 h/day.

Concerning help in treatment expenses, results of the current study showed that the family played an essential role in bearing treatment expenses among majority of the sample. Similar findings were reported by Metwaly (2007). This result goes along with WHO (2001) which reported about expenses for the treatment of mental illness are often borne by the family either because insurance is unavailable or because mental disorders are not covered by insurance.

The present study found that most caregivers had high and moderate level of burden. This elevated level of burden might be owing to the physical and emotional drain and exhaustion of caregiving process that leads to this burden. Similar findings were reported by Caqueo-Urizar et al. (2011) and Kaur (2014).

The present study revealed that less than one-third of the caregivers had low level of psychological well-being and more than two-thirds of them had moderate level of psychological well-being. This may be owing to the responsibility of caregiving may force the caregivers to leave their work and career, their hobbies, their leisure time, and most recreation aspects and concentrate their efforts in caring for the patient, and this may be reflected negatively on their feeling of happiness and well-being. However, a study by Sharma (2017) found that only 6% of caregivers had low level of psychological well-being and less than half of them had moderate level of well-being.

The result of the current study revealed that less than one-third of the study patients had low social support and approximately half of them had moderate level of social support. This can be interpreted as a significant percent of caregivers were from rural area that provides social support more than urban areas. This result is inconsistent with the results of Magliano et al. (2006) and Kaur (2014), who found that most of caregivers of schizophrenic patients had low acuity of social support.

The result of the present study revealed that there was no relationship between caregiver burden and their age. This may be due to as caregiving is a heavy duty for all relatives regardless their age, as younger persons are occupied with their other responsibilities and older persons suffer from decline in physical health. Similar findings were also reported by Srivastava (2005) and Kaur (2014). This result is inconsistent with the result of Juvang et al. (2007) and Gupta et al. (2015), who found that the level of burden increases with the age of caregiver. When caregiver becomes older, they are worried about who will take care of their ill family member in the future. Older caregiver also cannot provide good care to the ill member. On the contrary, Alzahrani et al. (2017) found in their study that burden was experienced more in the younger age group. They interpreted their result as the relatively lower burden among older caregivers could be explained by the acquired cumulative experience in dealing with illness and crisis among people with mental illness.

The present study showed that female caregivers showed higher burden compared with male caregivers, and there was a highly statistically significant relationship between sex and caregiving burden. This can be interpreted as commonly the female relatives engage in caregiving and have been reported as experiencing most of the associated burden. These findings were in agreement with many studies as those of Nehra et al. (2006), Kaur (2014), and Kumar and Gupta (2014), who indicated that female caregivers showed a significantly higher level of burden. However, contradictory findings were reported by Oshodi et al. (2012) and Gupta et al. (2015).

The current study revealed that there were highly statistically significant relationships between caregiver burden and degree of relation. It is evident that spouses reported higher burden compared with other degrees of relation. This indicated that a partner shares his/her life with the patient more than the parents who nurture and care for the patient, and also more than sons, daughters, and siblings. This finding was similar to those reported by Gupta et al. (2015). However, Caqueo-urizar et al. (2009) found in their study that parents perceived more burden than spouses.

The present study found that there was a highly significant relationship between caregiver burden and their occupation, as the nonworker caregivers and caregivers who have governmental work experienced higher burden compared with other caregivers. This can be attributed to the extra time the caregiver spends with the patient as a result of nonworking or short-time governmental work increases their feeling of burden. These findings are in agreement with the study of Hastrup et al. (2011) and Abdul Mulud and McCarthy (2017), who showed that caregivers who are unemployed experience a higher level of burden compared with caregivers who have a full-time job. In this respect, Bialon and Coke (2012) found that caregivers commonly give up their jobs, or, in some extreme cases, caregivers have been dismissed from their full-time positions. However, Yusuf et al. (2009) and Kaur (2014) stated that there was no statistically significant effect of employment on caregiving burden.

The current study stated that, there was a highly statistically significant relationship between caregiver burden and number of caring hours for patients per day. This can be explained as caregivers who spent 12 h or more per day in caring for their patients reported higher burden compared with other caregivers. Similar findings were reported by several studies as those of Oshodi et al. (2012), Kumar and Gupta (2014), Gupta et al. (2015), Alzahrani et al. (2017), and Abdul Mulud and McCarthy (2017).

The present study also revealed that, there was a statistically significant relationship between caregivers’ burden and help in treatment expenses, as caregivers who received help in treatment expenses from work reported higher burden compared with caregivers who received help in treatment expenses from family and relative. This emphasizes the role of socioeconomic factor in complicating life and adding more burdens. This result contradict with the results of Andren and Elmstahl (2007), Yusuf et al. (2009), and Kaur (2014), who stated that family income had no statistical significant effect on caregiving burden.

The present study revealed that there was a statistically significant relationship between residence and social support provided to caregivers, as rural caregivers received higher social support compared with urban ones. This might be interpreted as an urbanized lifestyle brings in its own loneliness, and urbanization has been shown to lead to isolation related to absence of extended families in these areas that provide plenty of care and support for their members. In this respect, Raj et al. (2016) found in their study that most caregivers are from nuclear family and semiurban areas who had less social support compared with caregivers from rural areas.

The current study showed that female caregivers showed lower psychological well-being compared with male caregivers, and there was a highly statistically significant relationship between sex and psychological well-being among them. This can be interpreted as females in general are more sensitive toward stressors and caregiving load, and this atmosphere may affect their mood negatively and make them more liable to psychiatric morbidity. This result goes in line with the study of Marimuthu et al. (2000), who reported that 53% of the caregivers with psychiatric morbidity were females. However, contradictory findings were found by Gupta et al. (2015).

The current study revealed that there was a statistically significant relationship between psychological well-being and degree of relation, as spouses showed lower psychological well-being compared with parents, sons and daughters, and siblings. This could be attributed to frustration that the spouse experiences when reality differs from his expectation that he well live in a happy marriage with a healthy partner. This result goes in line with the study of Gupta et al. (2015), who found that parents as a caregiver reported higher well-being compared with spouses but lesser than siblings. However, Rammohan et al. (2002) reported psychological well-being to be significantly more in spouses when compared with parents.

The present study indicated that there was a highly statistically significant relationship between psychological well-being among caregivers and their educational level, as illiterate caregiver showed lower psychological well-being compared with other caregivers. This can be interpreted as the more education the person obtains the more his ability to read about and search for a solutions to manage his problems which may lead to an increase in his well-being. This result is consistent with the study of Gupta et al. (2015) and Marimuthu et al. (2000), who found that low educational level of the caregiver was reported as a correlate of psychiatric morbidity. However, this finding contrasted with the result of Gopinath and Chaturved (1992).The result of the current study found that there was a negative highly statistically significant correlation between family burden and social support. These findings were in agreement with several studies as those of Pratima-Bhatia and Jena (2011), Kaur (2014), and Sharma (2017), who found that there was a negative correlation between caregivers’ burden and social support. Social support was the best predictor of caregiver burden. Studies in the past have reported that the families that perceived a higher level of caregiver burden were those that lived in a family with poorer functioning, poor health status, and minimal social support (Raj et al., 2016).

The current study also revealed that there was a negative highly statistically significant correlation between family burden and psychological well-being. This can be attributed also to the role of elevated psychological well-being in alleviating the feelings of burden among caregivers. Similarly, Sharma (2017) found that there was a negative correlation between caregivers’ burden and family well-being. In this regard, Gupta et al. (2015) reported that caregivers who were higher on burden reported lower level of well-being. This is in accordance with a study by McCleery et al. (2007) who showed psychological well-being to be inversely proportionate to the caregiver burden.

Lastly, the present study showed that there was a positive highly statistically significant correlation between social support and psychological well-being. The finding emphasizes the role of proper social support in enhancing psychological well-being among caregivers and vice versa. This result goes in line with the study of Sharma (2017) who stated that there was a positive correlation between social support and family well-being scores.


  Conclusion Top


The study concluded that more than half of the caregivers aged from 40 to 60 years. More than two-fifth of caregivers were parents and had high level of burden. Nearly two-thirds had moderate level of psychological well-being, and approximately half of the caregivers had moderate level of social support. There are negative statistically significant correlations detected between social support, psychological well-being, and family burden. However, there is a positive statistically significant correlation between social support and psychological well-being.

Recommendations

  1. It is recommended that training programs should be designed for caregivers to enhance psychological well-being and social support and decrease levels of burden in caregivers.
  2. Nurses should pay attention to the emotional need and provide social support for caregiver of patients with chronic mental illness.
  3. Providing caregivers with information about the nature of the disorder and ways of managing patients’ problems can improve their psychological well-being and reduce feeling of burden.
  4. Creating family support groups for caregivers that would increase in social support and family function leading to decrease in their burden and an increase in life satisfaction.
[45]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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