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Needs, challenges, and coping strategies among primary caregivers of schizophrenia patient: A systematic review & meta-synthesis

Published:September 08, 2022DOI:https://doi.org/10.1016/j.apnu.2022.09.001

      Highlights

      • The increase in deinstitutionalization and community-based mental health services has increased the roles and responsibilities of primary caregiver of schizophrenia.
      • The unmet needs and challenges of primary caregiver could guide in intervention development and the prioritization of resources to address the deficiency.
      • Meeting the needs and enhancing the coping strategies of the primary caregivers has the potential to alleviate the suffering of the patient and the caregiver.

      Abstract

      Introduction

      Deinstitutionalization and rising psychiatric care in society have led to an increase in the role of caregivers of persons diagnosed with schizophrenia.

      Objective

      The objective of this systematic review was to identify and synthesize qualitative research findings that explored the needs, challenges, and coping strategies among the primary caregivers of a schizophrenia patient.

      Methodology

      The electronic databases namely PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Scopus, Web of Science, ProQuest, and ClinicalKey were searched to identify relevant articles published from 2005 to October 2021. The quality of the included articles was independently appraised by two reviewers using Walsh and Downe criteria and was analysed thematically. The meta-synthesis was modelled on Lucas framework.

      Results

      The richness of information across 38 papers involving 543 participants was noteworthy. The needs of the primary caregivers were rehabilitation and vocational centre, information and education, self-help groups, augmented healthcare services, and communication and collaboration. The challenges reported were treatment expenses, bizarre beliefs, self and other directed harm and violence, therapeutic noncompliance, onerous caregiving task, crumbling family relations, misconception and discrimination, and self-stigmatization. The coping strategies adopted were problem-focused coping, emotional coping, behavioural coping, coping through social support, religious coping and cognitive reappraisal.

      Conclusion

      The primary caregivers provide unparalleled service to the health system and for the patient. The healthcare providers need to give undue attention to the unmet needs and challenges of the caregivers, which would benefit the health system by enabling the caregivers in providing long-term care for the schizophrenic.

      Keywords

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