Caregiving appraisal in schizophrenia: a study from India

This study evaluated caregiving experience in the caregivers of patients with schizophrenia within the framework of the stress-appraisal-coping model. By purposive random sampling, 100 Indian patients with schizophrenia and their primary caregivers were assessed. The patients were assessed on Positive and Negative Symptom Scale (PANSS). Caregivers completed the Scale for Positive Aspects of Caregiving Experience (SPACE), Involvement Evaluation Questionnaire (IEQ), Family Burden Interview (FBI) Schedule, Coping Checklist, Social Support Questionnaire, and General Health Questionnaire (GHQ-12). Path analysis showed that psychological morbidity is mainly determined by subjective experience of burden, which in turn is significantly influenced by severity of psychopathology, time spent per day (in hours) in caregiving and the coping strategies used. Although coping strategies and PANSS do influence objective burden, objective burden itself has no influence on the level of psychological morbidity. Total PANSS score has no direct influence on subjective burden, but acts indirectly through total time spent in caregiving and coping. Caregiver's gain in positive experiences on SPACE scale positively influences subjective burden. The present findings suggest that better control of patients' symptoms would lead to less demand on the caregivers in the form of time and strain on coping abilities and would thus reduce subjective burden and psychological morbidity in the caregivers.