The Relationship Of Psychological Distress, Self-esteem And Stigma Among Primary Caregivers Of Patients With Schizophrenia

Objective:To investigate the psychological distress in primary caregivers of patients with schizophrenia and its relationship with self-esteem and stigma. It will be of great benefit for exploring a new way to improve caregivers’mental health and caregiving quality.Methods:125 primary caregivers of patients with schizophrenia who come from a certain mental health center in Shandong province were included in this study. Caregivers’general demographic information, psychological distress, stigma and self-esteem were assessed by General Demographic Information Questionnaire, K10 Scale, Link Stigma Scale and Self-Esteem Scale.150 questionnaires have been issued and 125 were analyzed, so the return ratio was 83.3%. In data analysis, some statistical methods such as t-test. one-way analysis of variance (ANOVA), Pearson correlation analysis and hierarchical regression analysis were used. All analyses were conducted with SPSS 20.0.Results:1. Demographic characteristics of participants125 primary caregivers participated in this study. The age of most primary caregivers ranged from 31 to 50.84.0% of them were married and 63.2% of them had a moderate income level. In addition, a majority of primary caregivers were patients’ parents or spouses, and their occupation was peasant and working staff. Most caregivers have taken care of the patients for more than one year.2. Differences of psychological distress in demographic characteristic of participantsThe average score of K10 was (19.54±6.34), and caregivers whose score were equal or over 16 account for 70.4%. The analysis of ANOVA and t-test showed that the psychological distress of primary caregivers differed in terms of their age, economic status, the duration of caregiving and patients’illness duration (P< 0.05). Specifically, scores of psychological distress of caregivers whose age ranged from 31 to 50 was the lowest, caregivers who got a higher level of economic status get a higher score in psychological distress. Besides, the score of psychological distress were higher among caregivers who have taken care of the patients for more than one year.3. Correlations of stigma, self-esteem and psychological distressThe average score of stigma was (2.34±0.44), and 58.4% of caregivers’ scores were lower than 2.5. The average score of self-esteem was (30.23±3.99). The Pearson correlation analysis found that caregivers’stigma was positively correlated with psychological distress(r=0.360, P<0.01), and self-esteem was negatively related to psychological distress(r=-0.41, P<0.01).4. Hierarchical regression analyses of psychological distressA hierarchical regression analyses was performed with the psychological distress of primary caregivers as dependent variable, stigma and self-esteem as independent variables and the results indicated that stigma directly predicted caregivers’ psychological distress (β=0.325, P<0.001), and accounted for 9.9% of the variance in it. Self-esteem negatively predicted caregivers’psychological distress (β=-0.307, P<0.001), and accounted for 7.9% of the variance in it. In addition, the relationship between stigma and psychological distress was weakened after self-esteem was entered in the regression model (β=0.272, P=0.001), this means self-esteem as a protective factor could buffer the negative influence of stigma on psychological distress.Conclusions1. The occurrence rate of psychological distress in primary caregivers of patients with schizophrenia is relatively higher. It means that caregivers of patients with schizophrenia need concerned.2. The psychological distress of primary caregivers is influenced by a series of factors. Stigma as a risk factor contributed to a high psychological distress, and self-esteem as a protective factor could alleviate caregivers’ psychological distress.3. This study suggests that health care workers should pay more attention to caregivers with lower self-esteem and higher stigma level to adopt appropriate inventions to help them reduce their stigma and to increase self-esteem. All of these could reduce caregivers’psychological distress and improve their caring quality.