Impact of Patients’ Psychiatric Hospitalization on Caregivers: A Systematic Review
Abstract
Objective:
Methods:
Results:
Conclusions:
Methods
Results
Study and country | Caregiver type | Caregiver race | Patient race and age group | Previously hospitalized | Patient diagnosis |
---|---|---|---|---|---|
Bauer et al., 2011 (37); Germany | 18 spouses, 7 parents, 3 children, 3 siblings, 1 friend | nr | nr | nr | 32 bipolar disorder |
Clarke and Winsor, 2010 (20); Canada | 9 mothers, 1 father | nr | nr; adults | nr | nr |
Dore and Romans, 2001 (21); New Zealand | 15 parents, 13 partners, 9 other relatives, 3 friends, 1 sibling | nr | nr; adults | nr | Bipolar disorder |
Gerson et al., 2009 (22); U.S. | 9 mothers, 3 fathers, 1 brother, 1 aunt | nr | 5 white, 4 Hispanic, 3 black, 1 East Asian; youths and adults | nr | 6 schizophrenia, 6 psychotic disorder NOS, 1 schizoaffective disorder |
Hanson, 1995 (10); U.S. | 20 mothers, 9 fathers, 2 wives, 2 sisters, 1 in-law | nr | nr; adults | Average of 5.6 | nr |
Heru et al., 2004 (31); U.S. | 24 spouses, 8 parents, 4 children, 2 others, 1 sibling | nr | nr; adults | nr | 22 major depressive disorder, 17 bipolar disorder |
Heru and Ryan, 2004 (32); U.S. | 11 spouses, 4 parents, 2 children, 2 others | nr | nr; adults | nr | 10 major depressive disorder, 9 bipolar disorder |
Hinrichsen and Lieberman, 1999 (17); U.S. | 33 mothers or stepmothers, 11 fathers, 7 siblings, 6 spouses, 4 other family | nr | 27 white, 24 black, 12 Hispanic, Asian, or other; adults | First | 45 schizophrenia, 13 schizoaffective disorder and depression, 5 schizoaffective disorder and manic |
King et al., 1993 (13); U.S. | 53 both parents, 26 single biological parents, 13 biological and stepparents, 7 neither parent | nr | 91 white, 6 other, 5 black; youths | nr | 51 major depressive disorder and suicidal behaviors, 23 behavior disorder and suicidal behaviors, 18 dysthymia, 16 anxiety disorder, 14 eating disorder, 9 bipolar disorder, 2 psychotic disorder |
King et al., 1997 (12); U.S. | 74 parents | nr | 57 white, 6 black, 3 other; youths | nr | 48 major depressive disorder, 16 conduct disorder, 15 dysthymia, 12 alcohol use disorder, 10 other substance use disorder, 10 social phobia, 9 ADHD, 8 generalized anxiety disorder, 7 oppositional defiant disorder, 7 eating disorder, 6 separation anxiety disorder,6 PTSD, 4 bipolar disorder, 1 depressive disorder NOS |
Kjellin and Ostman, 2005 (25); Sweden | 45 spouses, 42 parents, 18 children, 42 siblings or other relatives, 8 close friends | nr | nr; adults | nr | 48 schizophrenia, delusional disorders, schizoaffective disorder, schizophreniform disorder, or atypical psychosis; 67 affective mood disorder, 40 other |
Knox and Singh, 2007 (38); U.S. | 51 mothers, 4 grandmothers, 3 fathers, 1 foster mother | nr | 48 white, 5 black, 4 Hispanic, 4 biracial or other; youths | nr | nr |
Lauber et al., 2003 (28); Switzerland | 64 caregivers | nr | nr | nr | Schizophrenia |
Möller-Leimkühler, 2005 (33); Germany | 65 spouses, 17 parents, 1 brother | nr | nr | nr | Schizophrenia, major depressive disorder |
Möller-Leimkühler, 2006 (34); Germany | 52 spouses, 16 parents, 1 brother | nr | nr | nr | Schizophrenia, major depressive disorder |
Möller-Leimkühler and Obermeier, 2008 (36); Germany | 51 spouses, 11 parents, | nr | nr | nr | Schizophrenia, major depressive disorder |
Möller-Leimkühler and Mädger, 2011 (35); Germany | 52 spouses, 11 parents | nr | nr | nr | Schizophrenia, major depressive disorder |
Ostman et al., 2000 (27); Sweden | 35 parents, 26 spouses, 11 children, 7 other relatives, 3 nonrelatives | nr | nr; adults | nr | 54 psychosis; 34 major depressive disorder, bipolar disorder, or anxiety disorder; 12 other |
Owens and Qualls, 1997 (18); U.S. | 22 children, 5 spouses, 4 parents, 1 sibling | nr | 23 white; adults | nr | nr |
Phelan et al., 1998 (19); U.S. | 29 spouses, 94 parents who live with patient, 45 parents who do not live with patient, 27 others | 154 white, 247 black, 14 Hispanic | nr; youths and adults | First | nr |
Puotiniemi et al., 2001 (29); Finland | 55 mothers, 23 fathers, 1 stepmother, | nr | nr; youths | 79% first hospitalization | nr |
Puotiniemi et al., 2002 (30); Finland | 55 mothers, 23 fathers, 1 stepmother | nr | nr; youths | 79% first hospitalization | Emotional and conduct disorders, major depressive disorder, ADHD, eating disorders |
Ronan et al., 2008 (14); U.S. | 60 parents | nr | nr; youths | nr | 25 major depressive disorder, 13 dysthymia, 7 ADHD, 7 adjustment disorder, 5 conduct disorders, 2 anxiety disorders, 1 schizophrenia |
Schmid et al., 2009 (11); Germany | 37 siblings | nr | nr; adults | nr | 37 schizophrenia |
Snell et al., 2010 (15); U.S. | 35 mothers, 2 fathers, 1 nonparental figure | nr | nr; youths | 32% previously hospitalized | Major depressive disorder, bipolar II disorder, adjustment disorder with depressed mood, and depressive disorder secondary to a general medical condition |
Solomon et al., 1988 (23); U.S. | 13 parents | nr | 16 white; adults | Average of 9 | Schizophrenia |
Stueve et al., 1997 (24); U.S. | 180 caregivers | 93 white, 43 black, 43 Hispanic | nr; adults | nr | Schizophrenia, major depressive disorder |
Thompson and Doll, 1982 (26); U.S. | 53 parents, 44 spouses, 30 siblings, children, or relatives | 73 white | nr; adults | nr | nr |
Wagner et al., 2000 (16); U.S. | 19 biological mothers, 6 biological fathers, 5 stepfathers, 1 stepmother, 1 adoptive mother, 1 adoptive father, 1 grandmother | 20 white, 3 black, 1 Hispanic | 18 white, 3 black, 2 Hispanic; youths | nr | Serious suicide attempt |
Study and country | Data sourceb | Time of assessment | Primary outcome |
---|---|---|---|
Bauer et al., 2011 (37); Germany | Problem-focused semistructured interviews | nr | Degree of patients’ illness, degree of support |
Clarke and Winsor, 2010 (20); Canada | Qualitative interviews | nr | Personal well-being, stigma |
Dore and Romans, 2001 (21); New Zealand | Semistructured interviews using the General Health Questionnaire | 2 years posthospitalization | Personal well-being, stigma, daily life, economic strain, relationship changes, positive impact |
Gerson et al., 2009 (22); U.S. | Qualitative interviews | During hospitalization | Personal well-being, stigma |
Hanson, 1995 (10); U.S. | Qualitative interviews | nr | Personal well-being |
Heru et al., 2004 (31); U.S. | Caregiver Strain Scale, visual analog scales | nr | Personal well-being, general medical health, positive impact |
Heru and Ryan, 2004 (32); U.S. | Family Assessment Device, MOS-36, Caregiver Strain Scale, Instrumental Activities of Daily Living | 1 year posthospitalization | Positive impact |
Hinrichsen and Lieberman, 1999 (17); U.S. | Health and Daily Living Form, Dementia Management Strategies Scale, Patient Rejection Scale, Burden Interview, SCL-90 | Shortly after admission | Personal well-being, coping, caregiver attributes |
King et al., 1993 (13); U.S. | SCL-90-Revised, SAS-SR, McMaster Family Assessment Device | During hospitalization | Personal well-being |
King et al., 1997 (12); U.S. | SCL-90-Revised, SAS-SR | During hospitalization and 6 to 8 months posthospitalization | Personal well-being, relationship |
Kjellin and Ostman, 2005 (25); Sweden | Semistructured questionnaire | 1 month after admission | Personal well-being, daily life |
Knox and Singh, 2007 (38); U.S. | Parenting Stress Index | During hospitalization | Personal well-being |
Lauber et al., 2003 (28); Switzerland | Semistructured interviews | 4 years and 3 months after admission | Personal well-being, daily life, relationship changes |
Möller-Leimkühler, 2005 (33); Germany | 5-minute speech sample, Family Questionnaire, semistructured biographical interviews, family burden questionnaire, subjective beliefs of competence and control (German questionnaire), NEO Five-Factor Inventory, perceived social support (German questionnaire), Lancashire Quality of Life Profile | Baseline, with unspecified details | Personal well-being, coping |
Möller-Leimkühler, 2006 (34); Germany | Qualitative interview, generalized stress response, Ways of Coping Checklist (German version), subjective beliefs of competence and control, NEO Five-Factor Inventory, perceived social support, subjective well-being, SCL-90-Revised, Lancashire Quality of Life Profile | 1 year posthospitalization | Personal well-being, stress, diagnoses |
Möller-Leimkühler and Obermeier, 2008 (36); Germany | Qualitative interview, generalized stress response, Ways of Coping Checklist (German version), subjective beliefs of competence and control, NEO Five-Factor Inventory, perceived social support, subjective well-being, SCL-90-R, Lancashire Quality of Life Profile | 2 years posthospitalization | Personal well-being, burden |
Möller-Leimkühler and Mädger, 2011 (35); Germany | NEO Five-Factor Inventory, family burden questionnaire, SCL-90 | 2 years posthospitalization | Personal well-being, gender differences |
Ostman et al., 2000 (27); Sweden | Semistructured questionnaire | During hospitalization | Personal well-being, care, support |
Owens and Qualls, 1997 (18); U.S. | Life Experiences Survey, Burden Interview, Brief Symptom Inventory, responsible family member evaluation form | During hospitalization | Personal well-being |
Phelan et al., 1998 (19); U.S. | Open-ended questions from SAS | Baseline, with unspecified details and 6 months postbaseline assessment | Stigma |
Puotiniemi et al., 2001 (29); Finland | Questionnaires with 93 items (5-point Likert scales) on 5 topics: coping, coping demands, coping strategies, coping resources, and social support | During hospitalization, with measures provided, unspecified when returned | Personal well-being, economic strain, Relationship changes |
Puotiniemi et al., 2002 (30); Finland | Questionnaires, open-ended questions about social support | During hospitalization, with measures provided, unspecified when returned | Economic strain, relationship changes |
Ronan et al., 2008 (14); U.S. | SCL-90-R, Life Experiences Survey, problem solving inventory, 3 subscales from the McMaster Family Assessment Device | 3 days after admission | Personal well-being |
Schmid et al., 2009 (11); Germany | Narrative interviews | nr | Personal well-being, relationship changes, positive impact |
Snell et al., 2010 (15); U.S. | Semistructured interviews, global assessment of each caregiver's emotional state, caregiver interviews | During hospitalization and 2 to 6 weeks after first assessment | Personal well-being |
Solomon et al., 1988 (23); U.S. | Qualitative interviews, survey item | During hospitalization | Stigma, economic strain, relationship changes |
Stueve et al., 1997 (24); U.S. | Perceived burden scale, Brief psychiatric symptom scale, caregiver help scale, network help scale, network quality scale | Baseline, with unspecified details, and 6 to 12 months postbaseline | Personal well-being, stigma |
Thompson and Doll, 1982 (26); U.S. | Index of family member embarrassment, incomplete-sentence blank test | Recruitment began six months postdischarge, other details unspecified | Personal well-being, economic strain, burden |
Wagner et al., 2000 (16); U.S. | Reaction to suicide attempt scale (modification of statement rating scale), family history interview | During hospitalization | Personal well-being |
Effects of Psychiatric Hospitalization on Caregivers
Psychological well-being.
Stigma.
Daily life.
Economic strain.
General medical health.
Relationships.
Positive impact.
Changes Over Time
Factors Influencing the Impact on Caregivers
Discussion
Practice Implications
Research Implications
Conclusions
References
Information & Authors
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Cover: By the Pond, by Mary Cassatt, circa 1898. Color print with dry point and aquatint, fourth and final state (classmark: MEZAP+). Print collection, Miriam and Ira D. Wallach Division of Art, Prints and Photographs, New York Public Library. Photo credit: The New York Public Library/Art Resource, New York City.
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