Family caregivers' role in dignity of people with schizophrenia: A qualitative study

Background: When patients with schizophrenia feel a lack of dignity, their sense of worth is weakened and they are more likely to feel like a burden to their family. In this regard, families play a vital role in supporting the patient, who can effectively contribute to preserving their dignity. The concept of understanding the role of families in the patients' dignity is influenced by various factors. Still, there is limited knowledge in this domain in the sociocultural context of Iran.Aim: This study was to elucidate the role of family caregivers in the patients' dignity with schizophrenia, based on the perspectives of patients, family caregivers, and healthcare personnel.Design: This qualitative study was conducted utilizing conventional content analysis. The data were accordingly collected through field notes, and semi-structured, in-depth face-to-face interviews with 16 patients with schizophrenia, 4 family caregivers, 2 nurses, and 3 psychologists. The data were analyzed according to Graneheim and Lundman (2004).Ethical Considerations: The study protocol was approved by the ethics committee and followed ethical principles closely.Findings: The analysis of the data led to the emergence of two subcategories as follows: "Under the umbrella of family support" and "Being ignored by the family." The category of "Under the umbrella of family support" was characterized by subcategories including "Being the center of attention," "Understanding the patient's condition," "Financial support," and "Emotional support." Besides, the category of "Being ignored by the family" was characterized by subcategories including "Rejection from the family," "Not accepting the patient's condition," and "Tangential life with patients."Conclusion: This study found that some family caregivers were trying to reach the stage of acceptance. Following the understanding of the patient's condition, the family caregivers were responsible for the patient and were considered a strong support for the patient, and in such a situation, the patients' dignity was respected. On the other hand, some family caregivers did not accept the patient's condition and were indifferent to the patients' needs, which in such a situation created grounds for violating the dignity of the patients. A deep understanding of the factors threatening the patients' dignity with schizophrenia from their families can help health policymakers take positive steps toward preserving the dignity of these patients by designing and implementing programs aimed at raising awareness and empowering families.