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Effectiveness of a psycho-educational intervention for reducing burden in latin american families of patients with schizophrenia

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Abstract

Objectives

To explore the effectiveness of a psycho-educational family intervention program for reducing burden in caregivers of patients with schizophrenia in a developing country.

Method

Forty-five caregivers participated, 22 in a psycho-educational family intervention group and 23 in a control group. The family program was held once a week for 5 months. In the control group the caregivers received standard intervention, comprising periodical meetings with the staff to monitor the effects of the medication. Burden was measured before and after the intervention: relatives in the psycho-educational group were evaluated at inclusion and at the end of the program; controls were evaluated at inclusion and 5 months later.

Results

Burden decreased significantly in the psycho-educational group; mean scores on the Zarit Caregiver Burden Scale fell from 85.06 pre-intervention to 52.44 post-intervention, while scores fell only slightly in the control group, from 87.65 to 87.22. Treatment was especially effective in mothers and caregivers with lower educational levels.

Conclusion

This intervention program for reducing caregiver burden in developing Latin American countries was effective. Future investigations should focus on obtaining more precise estimates of the contributions of specific components of these programs to reducing burden.

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Author information

Authors and Affiliations

  1. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Barcelona, Paseo Valle de Hebrón, 171, 08035, Barcelona, Spain

    José Gutiérrez-Maldonado

  2. University of Tarapacá, Arica, Chile

    Alejandra Caqueo-Urízar

Authors
  1. José Gutiérrez-Maldonado
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  2. Alejandra Caqueo-Urízar
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Corresponding author

Correspondence to José Gutiérrez-Maldonado.

Appendices

Appendix: Outline of the material covered in the psycho-educational family intervention

Part I: The family’s experience of schizophrenia

Session 1: Introduction

  • Presentation of the members of the group.

  • Introduction to the workshop.

  • Outline of the potential benefits of psycho-education.

Session 2: Emotions, feelings and behaviors toward schizophrenia

  • Expression of emotions, feelings, experiences and behaviors toward schizophrenia.

  • Achieving understanding and empathy toward the other members of the group.

  • Discussion of experiences with other relatives.

Session 3: Schizophrenia: myths and reality

  • Establishing what relatives know about schizophrenia.

  • Modification of erroneous beliefs.

Part II: Psycho-education

Session 4: Schizophrenia: definition, causes, symptoms and forms

  • Information about the disease, first symptoms and prevalence.

  • Explanation of the causes and main symptoms of schizophrenia.

  • Information about subtypes.

Session 5: Schizophrenia: evolution, prognosis and prevention of relapses

  • Information about the evolution and prognosis of the disease.

  • Information about relapses.

  • Importance of the family in the case of relapse.

Session 6: Sexuality and schizophrenia

  • General information on sexuality.

  • Specific information on sexuality in patients with schizophrenia.

Session 7: Schizophrenia and treatment

  • Information on medical treatment, drugs, types and adverse effects.

  • Doubts concerning medical treatment.

  • Information on psycho-social treatment.

Session 8: Schizophrenia: social aspects and family associations

  • Information about the social implications of the disease.

  • Information about the activities organized by family associations.

Part III: Skills to improve coexistence

Session 9: Coexistence in the family: excessive stimulation and expectations

  • Recommendations for improving coexistence in the family.

  • Understanding the need to reduce excessive stimulation.

  • Review of the family’s expectations in relation to the patient.

Session 10: Coexistence in the family: norms and goals

  • Review of the norms within the home.

  • Strategies to improve the patient’s disruptive behaviors.

  • Discuss the goals to reach with the patient.

Session 11: Coexistence in the family to support the treatment of the patient and to normalize the family routine

  • The importance of family support in the treatment of the patient.

  • The importance of normalizing family life.

Session 12: Communication skills within the family:

  • Understanding communication difficulties.

  • Understanding the concepts of listening and empathy.

  • The importance of clear communication within the home.

Session 13: Problem solving

  • Description of problem-solving strategies.

Part IV: Relatives’ self-care

Session 14: Self-esteem:

  • Identification of feelings of incompetence and inability to cope.

  • Self-assessment of thoughts and positive and negative feelings.

  • Development of self-esteem.

Session 15: Burden of care and self-care

  • Explanation of the concept of burden of care.

  • Importance of self-care.

  • Understanding the need for help.

Session 16: Physical and mental relaxation:

  • Relaxation and elimination of body tensions.

  • The importance of breathing for relaxation.

Part V: Evaluation of the intervention

Session 17: Evaluation and conclusions of the intervention

  • Feedback and suggestions from the relatives.

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Gutiérrez-Maldonado, J., Caqueo-Urízar, A. Effectiveness of a psycho-educational intervention for reducing burden in latin american families of patients with schizophrenia. Qual Life Res 16, 739–747 (2007). https://doi.org/10.1007/s11136-007-9173-9

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  • DOI: https://doi.org/10.1007/s11136-007-9173-9

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