Burden on caregivers of schizophrenia outpatients in Brazil: Relationship to symptomatology and functioning

2021 ◽  
pp. 002076402110392
Author(s):  
Elaine Di Sarno ◽  
Isabel Napolitano ◽  
Mario Rodrigues Louzã

Background: To investigate the objective and subjective burden on caregivers of schizophrenia outpatients and their associations with sociodemographic factors, symptomatology, and functioning. Methods: This study included 60 schizophrenic outpatients aged 18 to 65 years who were clinically stable for at least 6 months, and 60 caregivers aged 18 to 80 years who were in contact with the patient for ⩾30 hours/week. The patients were assessed using a sociodemographic questionnaire, the Clinical Global Impression Scale for Schizophrenia (CGI-SCH), and the Personal and Social Performance scale (PSP). The caregivers were assessed using a sociodemographic questionnaire and the Family Burden Interview Schedule, Brazilian version (FBIS-BR). Results: The objective burden was positively correlated with CGI-SCH cognitive symptom scores ( p = .032) and number of hours spent weekly with the patient ( p = .028), and negatively correlated with PSP score ( r = −.346, p = .007). The subjective burden showed a negative correlation with age of disease onset ( r = −.338, p = .08). The independent variables included in the regression model were family income ( p = .005), PSP score ( p = .009), patient marital status ( p = .012), patient gender ( p = .046), and reception of financial benefit ( p = .027) for objective burden; and disease duration ( p = .045) and father/mother or sibling relationship ( p = .001) for subjective burden. The coefficient of determination ( R2) of the linear regression model for objective burden was 39.4%; subjective burden, 21.6%. Conclusion: Caring for female, single patients with longer disease duration, more severe cognitive symptoms, impaired functioning, and more caregiving time required per week were associated with higher caregiver burden levels.

2016 ◽  
Vol 38 (2) ◽  
pp. 96-99 ◽  
Author(s):  
Lucas M. Mantovani ◽  
Rodrigo Ferretjans ◽  
Iara M. Marçal ◽  
Amanda M. Oliveira ◽  
Fernanda C. Guimarães ◽  
...  

Abstract Objectives: To investigate the determinants of family burden in a sample of patients with schizophrenia and their caregivers. Methods: Thirty-one stable patients with schizophrenia and their main caregivers were recruited. Sociodemographic variables were assessed in a semi-structured interview, and positive and negative symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Cognitive performance was assessed with the Schizophrenia Cognition Rating Scale (SCoRS). Levels of burden on caregivers were assessed with the Family Burden Interview Schedule (FBIS). Interactions among variables were analyzed using Pearson correlations and linear regression analysis. Results: Objective and subjective FBIS scores were 1.9 (standard deviation [SD] = 0.5) and 2.4 (SD = 0.6) respectively. Objective burden correlated positively with positive and negative symptoms, and cognitive impairment. Subjective burden correlated positively with positive symptoms and negatively with mean age of disease onset. Positive, negative and cognitive symptoms accounted for 47.6% of the variance of objective burden, with negative symptoms accounting independently for 30.3%. Age of onset, parents as caregivers and positive symptoms accounted for 28% of the variance of subjective burden, with age of onset independently explaining 20.3%. Conclusion: Patients' clinical and sociodemographic variables are important determinants of family burden in schizophrenia. Objective burden is predicted by symptoms, particularly negative ones. Subjective burden is predicted by symptoms and sociodemographic variables, particularly age of disease onset.


2014 ◽  
Vol 1030-1032 ◽  
pp. 2738-2741
Author(s):  
Guang Jun Zhan

This paper applies Poisson regression model to examine university students' travel frequencies and relevant influence factors, using the data collected from four universities in Beijing by a web-based online travel survey. It finds that student grade, family income and school attended have significant effects on students' travel frequency. The study results reveal students travel frequency characteristics at a disaggregate level and provide information to well understand student travel frequency patterns.


Water ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1330
Author(s):  
Almalik Mohd Saupi ◽  
Nashiren Mailah ◽  
Mohd Mohd Radzi ◽  
Kamarul Mohamad ◽  
Saiful Ahmad ◽  
...  

Electrification coverage in Sarawak is the lowest at 78.74%, compared to Peninsular Malaysia at 99.62% and Sabah at 82.51%. Kapit, Sarawak, with 88.4% of its population located in rural areas and mostly situated along the main riverbanks, has great potential to generate electrical energy with a hydrokinetic system. Yearly water velocity data is the most significant parameter with which to perform a hydrokinetic analysis study. Nevertheless, the data retrieved from local river databases are inadequate for river energy analysis, thus hindering its progression. Instead, flow rates and rainfall data had been utilized to estimate the water velocity data. Till present, there is still no publication has been found on estimating of water velocity data in unregulated river using water level. Therefore, a novel technique of estimating the daily average water velocity data in unregulated rivers is proposed. The modelling of regression equation for water velocity estimation was performed and two regression model equations were generated to estimate both water level and water velocity on-site and proven to be valid as the coefficient of determination values had been R2 = 87.4% and R2 = 87.9%, respectively. The combination of both regression model equations can be used to estimate long-term time series water velocity data for type-C unregulated river in remote areas.


2012 ◽  
Vol 18 (11) ◽  
pp. 1570-1576 ◽  
Author(s):  
Michael Amann ◽  
Lutz Achtnichts ◽  
Jochen G Hirsch ◽  
Yvonne Naegelin ◽  
Johannes Gregori ◽  
...  

Background: We hypothesized that in multiple sclerosis (MS) patients, reduced cortical perfusion is associated with chronic white matter injury. Objective: To investigate the influence of different clinical and magnetic resonance imaging characteristics on cortical perfusion. Methods: Cerebral blood flow (CBF) was assessed by applying a pulsed arterial spin labelling (ASL) technique combined with single-shot 3D-GRASE (gradient-spin echo) in a cohort of 165 MS patients with a relapsing–remitting ( n=123) or secondary progressive disease course ( n=42). Mean age was 45.4 years (20–68 years), mean disease duration was 14.2 years (1–48 years). Results: Mean cortical CBF was 45.6 ml/100g per min (SD: 7.8 ml/100g per min). Stepwise multiple linear regression models were calculated to investigate the relationship between different factor sets and mean CBF. The model with the highest adjusted coefficient of determination included T2 lesion load, age, gender and disease duration as significant factors. Post-hoc Spearman rank correlation revealed significant correlation of adjusted CBF with T2 lesion load (t=−0.35, p=1*10–6), with age (t =−0.34, p=4*10–6), and with disease duration (t=0.16, p=0.03), while Expanded Disability Status Scale (EDSS) did not reach significance in either model. Conclusion: This study suggests that the amount of white matter lesions indicates a reduced metabolic demand and reduced perfusion at a cortical level.


Author(s):  
Leslie Wayne Ferguson ◽  
Ali H. Rajput ◽  
Alexander Rajput

AbstractBackground:Several studies have compared early-onset Parkinson disease (EOPD) and late-onset Parkinson disease (LOPD) but most are not based on autopsy confirmed cases.Methods:We compared clinical and pharmacological profiles, time to reach irreversible Hoehn and Yahr (H&Y) Stage 3 and levodopa motor complications in autopsy confirmed EOPD and LOPD cases.Results:At first clinic visit EOPD cases were younger but had longer disease duration and they died at a younger age (all p<0.0001). Anti-Parkinsonian drug use, including levodopa, was significantly delayed in EOPD. Lifetime use of amantadine (p<0.05) and dopamine agonists (p<0.01) were higher in EOPD. While lifetime use of levodopa was similar in the two groups, levodopa was used for a significantly longer period by EOPD (p< 0.0001). EOPD had a higher cumulative incidence of dyskinesias (p<0.01), wearing-off (p<0.01), and on-off (p<0.01). However, the time to dyskinesia onset was similar in the two groups. The threshold to wearing-off was much longer in EOPD (p<0.01). H&Y stage profile at first visit was similar in the two groups. The duration from disease onset to reach irreversible H&Y stage 3 was significantly longer in EOPD.Conclusions:Our observations indicate that progression of PD is slower in EOPD and suggest that the pre-clinical interval in this group is longer. These findings can be used for case selection for drug trials and studies of the pathogenesis of PD.


2015 ◽  
Vol 9 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Maria L.E Andersson ◽  
Kristina Forslind ◽  
Ingiäld Hafström

The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively. Methods : All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6. Results : At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point. Conclusion : Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.


2021 ◽  
Vol 36 (4) ◽  
pp. 595-692
Author(s):  
Sherif M Gamal ◽  
Sally S. Mohamed ◽  
Marwa Tantawy ◽  
Ibrahem Siam ◽  
Ahmed Soliman ◽  
...  

Objectives: This study aims to examine the frequency and clinical association of lupus-related vasculitis in patients with systemic lupus erythematosus (SLE). Patients and methods: We retrospectively analyzed medical records of a total of 565 SLE patients (42 males, 523 females; mean age: 32.7±9.5 years; range, 13 to 63 years) between January 2017 and February 2020. Demographic, clinical data, and laboratory data and treatment modalities applied were recorded. Lupus-related vasculitis and its different types were documented, and the patients with vasculitis were compared with those without vasculitis. Results: The mean disease duration was 8.9±6.3 years. Vasculitis associated with lupus was found in 191 (33.45%) patients. Cutaneous vasculitis was found in 59.2%, visceral vasculitis in 34.0%, and both in 6.8% of total vasculitis patients. The patients with vasculitis had a longer disease duration (p=0.01), were more likely to have juvenile onset (p=0.002), livedo reticularis (p<0.001), Raynaud's phenomenon (RP) (p<0.001), digital gangrene (p<0.001), thrombosis (p=0.003), and cranial neuropathy (p=0.004). The patients with vasculitis showed a higher prevalence of hypercholesterolemia (p=0.045), diabetes mellitus (p=0.026), higher Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) at disease onset (p<0.001), and Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (p=0.003) scores. They had more prevalent hematological manifestations (p<0.001), hypocomplementemia (p=0.007), received a higher cumulative dose of intravenous methylprednisolone (p<0.001), and had also more frequent cyclophosphamide (p=0.016) and azathioprine intake (p<0.001). In the logistic regression analysis, SLE vasculitis was independently associated with juvenile disease onset, livedo reticularis, RP, hematological manifestations, and higher scores of SLEDAI at disease onset (p<0.05). Conclusion: Juvenile disease onset, livedo reticularis, RP, hematological manifestations, and higher SLEDAI scores at disease onset may be associated with the development of vasculitis in SLE patients.


2018 ◽  
Vol 2 (1) ◽  
pp. 85
Author(s):  
I Ketut Alit Adianta ◽  
Gusti Ayu Wardianti

ABSTRACTDiabetes mellitus (DM) is chronic disease characterized by blood glucose level high than normal. When one of family member suffers from illness, it will affect family condition in managing treatment and caring.This study aimed to identify family burden of patients with Type II DM in Puskesmas III of North Denpasar including objective, subjective, and iatrogenic burden. This study employed descriptive design with cross sectional approach. The study involved 102 respondents with consecutive sampling. Data were collected by questionnaire. Findings indicated that objective burden of family with mild, moderate, and heavy burden were 24.5%, 8.8% and  66.7%; respectively). Subjective burden indicating mild, moderate, and heavy burden were 6.9%, 70.6% and 22.5% respectively. Iatrogenic burden indicating mild, moderate, and heavy burden were 8.8%,  1% and 90.2% respectively. All families experienced heavy burden in caring for patients with DM because of difficulty in treatment.  Keywords: Objective Burden, Subjective Burden, Iatrogenic Burden, Diabetes Mellitus


2020 ◽  
Vol 27 (02) ◽  
pp. 237-241
Author(s):  
Asim Khurshid ◽  
Shahid Ishaq ◽  
Mushtaq Ahmad

Objectives: Recurrent abdominal pain (RAP) impacts quality of life of the children. RAP also hampers education and physical activity of the children. Current study was aimed to find out the frequency of Helicobacter pylori in children with RAP in our tertiary care hospital. Study Design: Descriptive, cross-sectional study. Setting:  Department of Pediatric Medicine, Nishtar Hospital, Multan, Period: From 27-12-2017 to 26-06-2018. Material & Methods: A total of 185 patients suffering from RAP, aged 2-12 years, with a disease duration > 3 months, were enrolled. Age of the children, gender, duration of illness, number of episodes of pain, maternal literacy, family income, residential status, source of drinking water and h.pylori infection were calculated in these children. Post stratification chi-square test was applied to see its effect on H. Pylori infection. Results: Of these 185 study cases, 101 (54.6 %) were male patients while 84 (45.4%) were female. Mean age of our study cases was 7.57 ± 1.93 years. Of A total of 95 (51.4%) children belonged to rural areas and 90 (48.6 %) to urban areas. Helicobacter pylori infection was noted in 103 (55.7%) of our study cases. When helicobacter pylori  was stratified with regards to study variables, male gender, age < 8 years, monthly family income <Rs. 35000, source of drinking water as Hand Pump and disease duration < 6 months turned out to be statistically significant (P value < 0.05). Conclusion: Frequency of H.pylori was high in children with RAP. Helicobacter pylori was significantly associated with male gender, younger age, poor socioeconomic status, source of drinking water and disease duration.


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