Research Article
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The impact of family functioning and expressed emotion on caregiver burden

Year 2017, Volume: 3 Issue: 1, 55 - 61, 04.03.2017
https://doi.org/10.18621/eurj.2017.5000190725

Abstract












Objectives. Expressed emotion and family functioning have been reported as negative impacts of the caregiver burden, mostly in mental disorders. There are limited data available to explain how these factors affect caregiver
burden particularly for those caring for rehabilitation patients. In this study, the relationship of family
functioning and expressed emotion with the caregiver burden was examined.
Methods. A total of 103 caregivers
with a mean age of 43.1±13.8 years were participated in the study. The caregivers’ demographic data,
psychiatric symptomatology, subjective burden, expressed emotion, and family functioning were assessed
using structured and semi-structured scales.
Results. Expressed emotion level (R2=0.361, p<0.001), family
functioning (
R2=0.275, p=0.003) and caregiver gender (R2=0.361, p=0.004) were determined as significant
contributory factors with the subjective burden.
Conclusion. Psychological intervention programs focused on
both expressed emotion and communication skills in family should be developed to reduce the caregiver burden. 




References

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  • [2] Sartorius N. Lessons from a 10-year global programme against stigma and discrimination because of an illness. Psychol Health Med 2006;11:383-8.
  • [3] Loeb ME, Eide AH. Living conditions among people with activity limitations in Malawi: a national representative study. Oslo: SINTEF Report No.: STF78-A044511, 2004.
  • [4] Ko JY, Aycock DM, Clark PC. A comparison of working versus nonworking family caregivers of stroke survivors. J Neurosci Nurs 2007;39:217-25.
  • [5] Donelan K, Hill CA, Hoffman C, Scoles K, Feldman PH, Levine C, et al. Challenged to care: informal caregivers in a changing health system. Health Aff (Millwood) 2002;21:222-31.
  • [6] Zola IK. Toward the necessary universalizing of a disability policy. Milbank Q 1989;67(Suppl 2):401-28.
  • [7] Bevans M, Sternberg EM. Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. JAMA 2012;307:398-403.
  • [8] Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA 1999;282:2215-9.
  • [9] Chadda RK, Singh TB, Ganguly KK. Caregiver burden and coping. Soc Psychiatry Psychiatr Epidemiol 2007;42:923-30.
  • [10] Van Humbeeck G, Van Audenhove C, Pieters G, De Hert M, Storms G, Vertommen H, et al. Expressed emotion in the client-professional caregiver dyad: are symptoms, coping strategies and personality related? Soc Psychiatry Psychiatr Epidemiol 2002;37:364-71.
  • [11] Epstein BN, Ryan CE, Bishop DS, Miller IW, Keitner GI. The McMaster model: A view of healthy family functioning. In: Walsh F, editor. Normal family process. 3rd ed. New York: Guilford Press; 2003. pp. 581-607.
  • [12] Tremont G, Davis JD, Bishop DS. Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dement Geriatr Cogn Disord 2006;21:170-4.
  • [13] Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1987;1:6-18.
  • [14] Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260-6.
  • [15] Ozlu A, Yildiz M, Aker T. [A reliability and validity study on the Zarit caregiver burden scale]. Arch Neuropsychiatry 2009;46:38-42. [Article in Turkish]
  • [16] Inci FH, Erdem M. [Validity and reliability of the burden interview and its adaptation to Turkish]. Ataturk Universitesi Hemsirelik Yuksekokulu Dergisi 2008;11:85-95. [Article in Turkish]
  • [17] Epstein BN, Baldwin L, Bishop DS. The McMaster family assessment device. J Marit Fam Ther 1983;9:171-80.
  • [18] Bulut I. [Family Functioning Scale Handbook]. Ankara; 1990. [Book in Turkish]
  • [19] Berksun O. Sizofrenide aile faktoru: expressed emotion olcek gelistirme ve uyarlama denemesi (Thesis). Ankara University; 1992.
  • [20] Dag I. Turkiye'de kullanilan psikolojik olcekler 1: Disa vurulan duygulanim duzeyi olcegi. Psikiyatri Psikoloji Psikofarmakoloji Dergisi, 1993; 1(Supp 2):29-30.
  • [21] Spitzer RL, Williams JBW, Gibbon M, First M. Structured Clinical Interview for DSM-IV (SCID). Washington DC: American Psychiatric Association; 1996.
  • [22] Lin I-F, Fee HR, Wu H-S. Negative and positive caregiving experiences: a closer look at the ıntersection of gender and relationship. Fam Relats 2012;61:343-58.
  • [23] Nomura H, Inoue S, Kamimura N, Shimodera S, Mino Y, Gregg L, et al. A cross-cultural study on expressed emotion in carers of people with dementia and schizophrenia: Japan and England. Soc Psychiatry Psychiatr Epidemiol 2005;40:564-70.
  • [24] Christine B, Hooley JM. Attributions and expressed emotion: a review. Clin Psychol Rev 2003;23:849-80.
  • [25] Christine B, Ward J, Wearden A, Gregg L. Expressed emotion and attributions in relatives of schizophrenia patients with and without substance misuse. Soc Psychiatry Psychiatr Epidemiol 2005;40:884-91.
  • [26] Greenley JR. Social control and expressed emotion. J Nerv Ment Dis 1986;174:24-30.
  • [27] Hooley JM. The nature and origins of expressed emotion. In: Hahlweg K, Goldstein MJ, editors. Understanding major mental disorder: The contribution of family interaction research. New York: Family Process Press, 1987. pp. 176-94.
  • [28] Barrowclough C, Tarrier N, Johnston M. Attributions, expressed emotion and patient relapse: An attributional model of relatives’ response to schizophrenic illness. Behav Ther 1994;25:67-88.
  • [29] Pitschel-Waltz G, Leucht S, Bauml J, Kissling W, Engel RR. The effect of family interventions on relapse and rehospitalisation in schizophrenia--a meta-analysis. Schizophr Bull 2001;27:73-92.
  • [30] Wearden AJ, Nicholas T, Christine B, Zastowny TR, Rahill AA. A review of expressed emotion research in health care. Clin Psychol Rev. 2000;20:633-66.
  • [31] Denno MS, Gillard PJ, Graham GD, DiBonaventura MD, Goren A, Varon SF, et al. Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity. Arch Phys Med Rehabil 2013;94:1731-6.
  • [32] Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med 2012;40:618-24.
  • [33] Norup DA, Elklit A. Post-traumatic stress disorder in partners of people with epilepsy. Epilepsy Behav 2013;27:225-32.
  • [34] Elklit A, Reinholt N, Nielsen LH, Blum A, Lasgaard M. Posttraumatic stress disorder among bereaved relatives of cancer patients. J Psychosoc Oncol 2010;28:399-412.
  • [35] Martín-Carrasco M, Dominguez-Panchon AI, Gonzalez-Fraile E, Munoz-Hermoso P, Ballesteros J, The EDUCA Group. Effectiveness of a psychoeducational intervention group program in the reduction of the burden experienced by caregivers of patients with dementia: The EDUCA-II Randomized Trial. Alzheimer Dis Assoc Disord 2014;28:79-87.
Year 2017, Volume: 3 Issue: 1, 55 - 61, 04.03.2017
https://doi.org/10.18621/eurj.2017.5000190725

Abstract

References

  • [1] World Report on Disability 2011. Geneva: WHO Press, 2011. p325.
  • [2] Sartorius N. Lessons from a 10-year global programme against stigma and discrimination because of an illness. Psychol Health Med 2006;11:383-8.
  • [3] Loeb ME, Eide AH. Living conditions among people with activity limitations in Malawi: a national representative study. Oslo: SINTEF Report No.: STF78-A044511, 2004.
  • [4] Ko JY, Aycock DM, Clark PC. A comparison of working versus nonworking family caregivers of stroke survivors. J Neurosci Nurs 2007;39:217-25.
  • [5] Donelan K, Hill CA, Hoffman C, Scoles K, Feldman PH, Levine C, et al. Challenged to care: informal caregivers in a changing health system. Health Aff (Millwood) 2002;21:222-31.
  • [6] Zola IK. Toward the necessary universalizing of a disability policy. Milbank Q 1989;67(Suppl 2):401-28.
  • [7] Bevans M, Sternberg EM. Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. JAMA 2012;307:398-403.
  • [8] Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA 1999;282:2215-9.
  • [9] Chadda RK, Singh TB, Ganguly KK. Caregiver burden and coping. Soc Psychiatry Psychiatr Epidemiol 2007;42:923-30.
  • [10] Van Humbeeck G, Van Audenhove C, Pieters G, De Hert M, Storms G, Vertommen H, et al. Expressed emotion in the client-professional caregiver dyad: are symptoms, coping strategies and personality related? Soc Psychiatry Psychiatr Epidemiol 2002;37:364-71.
  • [11] Epstein BN, Ryan CE, Bishop DS, Miller IW, Keitner GI. The McMaster model: A view of healthy family functioning. In: Walsh F, editor. Normal family process. 3rd ed. New York: Guilford Press; 2003. pp. 581-607.
  • [12] Tremont G, Davis JD, Bishop DS. Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dement Geriatr Cogn Disord 2006;21:170-4.
  • [13] Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1987;1:6-18.
  • [14] Zarit SH, Todd PA, Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260-6.
  • [15] Ozlu A, Yildiz M, Aker T. [A reliability and validity study on the Zarit caregiver burden scale]. Arch Neuropsychiatry 2009;46:38-42. [Article in Turkish]
  • [16] Inci FH, Erdem M. [Validity and reliability of the burden interview and its adaptation to Turkish]. Ataturk Universitesi Hemsirelik Yuksekokulu Dergisi 2008;11:85-95. [Article in Turkish]
  • [17] Epstein BN, Baldwin L, Bishop DS. The McMaster family assessment device. J Marit Fam Ther 1983;9:171-80.
  • [18] Bulut I. [Family Functioning Scale Handbook]. Ankara; 1990. [Book in Turkish]
  • [19] Berksun O. Sizofrenide aile faktoru: expressed emotion olcek gelistirme ve uyarlama denemesi (Thesis). Ankara University; 1992.
  • [20] Dag I. Turkiye'de kullanilan psikolojik olcekler 1: Disa vurulan duygulanim duzeyi olcegi. Psikiyatri Psikoloji Psikofarmakoloji Dergisi, 1993; 1(Supp 2):29-30.
  • [21] Spitzer RL, Williams JBW, Gibbon M, First M. Structured Clinical Interview for DSM-IV (SCID). Washington DC: American Psychiatric Association; 1996.
  • [22] Lin I-F, Fee HR, Wu H-S. Negative and positive caregiving experiences: a closer look at the ıntersection of gender and relationship. Fam Relats 2012;61:343-58.
  • [23] Nomura H, Inoue S, Kamimura N, Shimodera S, Mino Y, Gregg L, et al. A cross-cultural study on expressed emotion in carers of people with dementia and schizophrenia: Japan and England. Soc Psychiatry Psychiatr Epidemiol 2005;40:564-70.
  • [24] Christine B, Hooley JM. Attributions and expressed emotion: a review. Clin Psychol Rev 2003;23:849-80.
  • [25] Christine B, Ward J, Wearden A, Gregg L. Expressed emotion and attributions in relatives of schizophrenia patients with and without substance misuse. Soc Psychiatry Psychiatr Epidemiol 2005;40:884-91.
  • [26] Greenley JR. Social control and expressed emotion. J Nerv Ment Dis 1986;174:24-30.
  • [27] Hooley JM. The nature and origins of expressed emotion. In: Hahlweg K, Goldstein MJ, editors. Understanding major mental disorder: The contribution of family interaction research. New York: Family Process Press, 1987. pp. 176-94.
  • [28] Barrowclough C, Tarrier N, Johnston M. Attributions, expressed emotion and patient relapse: An attributional model of relatives’ response to schizophrenic illness. Behav Ther 1994;25:67-88.
  • [29] Pitschel-Waltz G, Leucht S, Bauml J, Kissling W, Engel RR. The effect of family interventions on relapse and rehospitalisation in schizophrenia--a meta-analysis. Schizophr Bull 2001;27:73-92.
  • [30] Wearden AJ, Nicholas T, Christine B, Zastowny TR, Rahill AA. A review of expressed emotion research in health care. Clin Psychol Rev. 2000;20:633-66.
  • [31] Denno MS, Gillard PJ, Graham GD, DiBonaventura MD, Goren A, Varon SF, et al. Anxiety and depression associated with caregiver burden in caregivers of stroke survivors with spasticity. Arch Phys Med Rehabil 2013;94:1731-6.
  • [32] Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med 2012;40:618-24.
  • [33] Norup DA, Elklit A. Post-traumatic stress disorder in partners of people with epilepsy. Epilepsy Behav 2013;27:225-32.
  • [34] Elklit A, Reinholt N, Nielsen LH, Blum A, Lasgaard M. Posttraumatic stress disorder among bereaved relatives of cancer patients. J Psychosoc Oncol 2010;28:399-412.
  • [35] Martín-Carrasco M, Dominguez-Panchon AI, Gonzalez-Fraile E, Munoz-Hermoso P, Ballesteros J, The EDUCA Group. Effectiveness of a psychoeducational intervention group program in the reduction of the burden experienced by caregivers of patients with dementia: The EDUCA-II Randomized Trial. Alzheimer Dis Assoc Disord 2014;28:79-87.
There are 35 citations in total.

Details

Subjects Health Care Administration
Journal Section Original Articles
Authors

Mehmet Alper Cinar This is me

Umit Guzelkucuk This is me

Yasin Demir This is me

Taner Dandinoglu This is me

Publication Date March 4, 2017
Submission Date May 30, 2016
Acceptance Date November 14, 2016
Published in Issue Year 2017 Volume: 3 Issue: 1

Cite

AMA Cinar MA, Guzelkucuk U, Demir Y, Dandinoglu T. The impact of family functioning and expressed emotion on caregiver burden. Eur Res J. March 2017;3(1):55-61. doi:10.18621/eurj.2017.5000190725

e-ISSN: 2149-3189 


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