Professional Documents
Culture Documents
2017 December;3(6):656-661
Accepted: 14 December 2017
http://belitungraya.org/BRP/index.php/bnj/
Department of Community and Psychiatric Nursing, Faculty of Nursing, University of Sumatera Utara, Medan, Indonesia
*Correspondence:
Jenny Marlindawani Purba, S.Kp, MNS, Ph.D
Department of Community and Psychiatric Nursing, Faculty of Nursing
University of Sumatera Utara, Medan, Indonesia
E-mail: Jhuan_702@hotmail.com
Abstract
Background: A caregiver is a primary nurse and has a major role in providing care for people with schizophrenia. Caring
for those with schizophrenia for a long period of time is a challenge for families, especially caregivers. Various needs ought
to be studied by nurses to assist caregivers in providing optimal care for family members who experience schizophrenia.
Objective: This qualitative study aims to explore the needs of caregivers in treating schizophrenia at home.
Methods: The method used in this study is the method of purposive sampling with the number of participants as many as 10
people with criteria: 1) have family members diagnosed with schizophrenia, 2) directly involved in home care patients, 3)
caring for schizophrenia for more than one year, 4) willing to be a participant by signing informed consent, 4) being able to
identify what is needed in treating schizophrenia. Colaizzi is used to analyze interview data.
Results: The results of the study found four themes of caregiver needs in caring for schizophrenia patients at home, namely:
1) seeking information about schizophrenia, 2) sought schizophrenic relatives’ recovery, 3) looking for appropriate
rehabilitation for relatives with schizophrenias, and 4) utilizing mental health facilities.
Conclusions: It is expected that nurses have the knowledge and skills in identifying and helping families, especially
caregivers, to meet unmet needs so they can optimize home care.
INTRODUCTION
Schizophrenia is a persistent and serious Therefore it takes an active role of the family,
neurobiological disorder of the brain, a especially caregiver to treat schizophrenia at
clinical syndrome that can result in damage to home. Caring for a family member with
life both individually, family and community disabilities such as schizophrenia is a major
(Stuart, 2014). Schizophrenia is also a chronic role for women in Asian countries such as
disease disorder that is quite high in Japan, Taiwan, Malaysia, Philippines and
prevalence. The prevalence of schizophrenia Indonesia (Talwar & Matheiken, 2010).
in the world from the median of schizophrenia
is 4.6 / 1,000 for the prevalence of points, 4.0 A caregiver or other family member is
/ 1,000 for lifetime prevalence and 7.2 / 1,000 important in the healing process for
for morality risk. schizophrenic patients. In the course of
treating patients, due to this disorder being
As a chronic illness of mental illness, the chronic or relapse, a caregiver must have
treatment of schizophrenia takes a long time. sufficient knowledge in treating patients with
patients, , 3) the need for group support, 4) "... already been hospitalized three times ...
looking for appropriate rehabilitation for healed ... his girlfriend relapsed again ... it
confused us ... my child is still taking
relatives with schizophrenia patients, and 5) medication ..." (Participant 2)
the need for easy mental health facilities that The patient's healing is the participants' main
are affordable. desire, so caregiver seeks to bring patients
Theme 1. Seeking for information about regularly treated every month.
schizophrenia "... hope to recover ... the medicine is taken
Information about the disease is needed by regularly ... there’s only two left ... came to
caregivers in caring for schizophrenic patients the poly to continue treatment ..."
(Participant 1)
at home. The information they get from health
Caregiver assured himself that by taking
workers and other sources helps them to take
medication on a regular basis the patient's
care of their sick family.
".... I asked the doctor about my son's illness can heal.
illness, he said his mentality was disturbed, "... when my sibling was severely sick-the
I asked another doctor, he said it was medication was not taken regularly ...always
chronic, probably Schizophrenia... " restless... difficult to sleep ... disturbing
(Participant 1). others ... currently calm ... sometimes help
clean the house, that's it, taking medicine
Participant's need for information on the cause regularly ..." (Participant 5)
of schizophrenia. Group support is needed by participants in
"... suddenly came home from work angry ...
yelled ... held the phone ... talked to people caring for family members who have
... but no ... strange behavior ... silence ... schizophrenia. Caregiver is very happy to
showered at night ... played music loudly." accompany family members to the outpatient
(Participant 7). medical treatment because they can meet
"... the Doctor explained there was a
disturbance in my sibling’s brain ... had to
other families.
"... it feels good to meet with others ... we
take medicine for my sibling to calm down,
vent ... if there is a problem in taking care of
that's it, I'm curious, sometimes I googled to
the child ... we exchange opinions ...
find out the cause of my sibling’s pain."
persuade to take medicine ...." (Participant
(Participant 3)
3)
Drug compliance is needed to prevent the
Participants expressed their opinion that they
recurrence of the disease, although the drugs
needed a meeting with members of the family
consumed by patients sometimes cause side
who suffered the same illness as their family
effects that makes patients uncomfortable.
members. They usually discuss with other
This condition makes caregiversworried,
families while waiting for nurse calls in the
because they do not know the side effects of
outpatient poly.
the treatment of Schizophrenia. This is "... we like to exchange ideas, share
expressed by the participants as follows: experiences with others ... waiting to be
"... my son's eyes glared upwards, he called ... so we share stories with others."
complained his neck was tense, I was (Participant 7)
confused, I stopped the medication, took "... the good thing is this, there's a place
him for medication again, the doctor where we gather, help each other, we both
changed the medicine without explanation have family members who suffer from
..." (Participant 6) schizophrenia” (Participant 9)
"... my mother complained her feelings were
all over the place, hair is pulled after taking
the medicine, the next day we went for Theme 3. Looking for appropriate
check up again and the doctor changed the rehabilitation for Schizophrenia patients
medicine, he said it didn’t fit ..." (Participant Caregiver is in dire need of rehabilitation for
4) family members with schizophrenia, because
"... a few moments ago, the medication was
replaced by the doctor, it wasn’t suitable,
with rehabilitation the patient has the skills so
my child was restless, and the medication that the patient can adjust to the environment.
was changed again, then it fit him ... "... there should be a place for my child to
(Participant 8) learn skills, so they can work, sew, cook,
whatever it is, as long as my child is kept
busy ..." (Participant 8)
Theme 2. Sought the healing of "... if there is any kind of workshop for my
schizophrenic patients sick sibling, I’d be happy, I’d be willing to
Participants expressed their curiosity about pay , let him have work, not kept at home,
the mental state of sick family members.
658 BELITUNG NURSING JOURNAL, VOLUME 3, ISSUE 6, NOVEMBER – DECEMBER 2017
Purba, J. M. (2017)
eat and sleep, let him have friends because schizophrenia resulted in delays in realizing
there are others together ..." (Participant 5) the mental state of a family member
experiencing schizophrenia (Cahyono &
Theme 4. Utilizing mental health facilities Asrap, 2017).
Problems in accessible mental health services
were felt by participants who accompanied Group support received by caregivers in this
family members who went to an outpatient study was obtained from families with
clinic. Mental health services that are located schizophrenia. A caregiver requires group
far from the family members’ home becomes support as a forum to share experiences in
a big problem for them. caring for family members with
"... my home is far... we change
transportation three times ... not to mention
Schizophrenia. The support of this group can
taking my child ... the fare is expensive, I help caregivers develop adaptive coping and
also have to work and sell..." (Participant be able to reduce their tension. In addition,
10) nurses can also provide support to caregivers
"... traffic on the way ... far away, my and patients. The nurse can provide health
husband is not healthy, the child still have to
go to the hospital, why is there no medicine education about the actions the family can
for my child, not to mention queuing, take to control the signs and symptoms of
because there are many others wanting Schizophrenia. Nurses can also give family
treatment, every month I come with my child therapy (Attendance, 2010). A systematic
..." ( Participant 8)
review showed that caregivers need to receive
caregiving support from others including
professional health care providers, other
DISCUSSION family members, friends as well as self-help
The results of this study indicate that groups to help them to live with and care for
participants need information about their family member diagnosed with
schizophrenia, causes and treatment. This schizophrenia effectively, thus those group
information is important for them to assist in resources need to be made available at the
caring for family members who are community level (Tungpunkom, Napa,
schizophrenic. This information will facilitate Chaniang, & Srikhachin, 2013). Magliano
the caregiver in recognizing signs and adds that adequate supportive support
symptoms of Schizophrenia, drug types, received by families can improve the family's
benefits and actions to be taken to overcome ability to deal with any challenges in care so
the side effects of taking medication. In this that they can overcome the difficulties
study, participants received information from encountered while treating schizophrenic
health workers such as doctors and nurses. In patients at home (Magliano, 2008).
addition, one participant looked for
information about schizophrenia from the Rehabilitation of patients with schizophrenia
internet. The results of this study are in line is another requirement of caregivers that have
with previous research suggested that not been achieved optimally. Participants
caregivers get information about mental revealed that rehabilitation can improve a
illness experienced by family members from patient's ability to adapt to his environment.
doctors, nurses and the Internet They have confidence that patients will get
(Sabanciogullari & Tel, 2015). In addition, better quality of life by following the
caregivers also need information related to the rehabilitation program. Research conducted
actions to be taken when facing the by Purba showed that schizophrenia patients
aggressiveness of the patient, overcoming who were given rehabilitation intervention
medication non-compliance, coping with drug had better social skills than schizophrenia
side effects, communicating with patients, patients who were not given rehabilitation
information on illness, symptoms, how and intervention (Purba, 2013). The provision of
where to seek help in the event of a crisis, this rehabilitation program can improve and
recognize the signs and symptoms of maintain its health and social skills and can
recurrence, and who can help them when they also prevent recurrence. Rehabilitation
need help. The family's lack of understanding, programs in the form of occupational
especially caregivers about the symptoms of therapies, vocational training and social skills
Tungpunkom, P., Napa, W., Chaniang, S., & Srikhachin, Yang, C. I., Hsieh, M. Y., Lee, L. H., & Chen, S. L.
P. (2013). Caregiving experiences of families (2017). Experiences of caring for a sibling
living with persons with schizophrenia: a with schizophrenia in a Chinese context: A
systematic review. JBI Database of Systematic neglected issue. International journal of
Reviews and Implementation Reports, 11(8), mental health nursing, 26(4), 409-417.
415-564.
Cite this article as: Purba, J. M. (2017). Caregivers’ needs in caring for relatives with schizophrenia
in Medan Indonesia: A phenomenological study. Belitung Nursing Journal, 3(6), 656-661