| Description |
Since the passage of the Community Mental Centers Act in 1963, a large percentage of chronically mentally ill adults are being cared for in the community and living with their families. For these individuals, families and not professional mental health workers have in many ways become the primary care takers. Despite this trend, there continues to be a paucity of systematic research on the problems encountered by relatives of the chronically mental ill in day-to-day living. Such information is needed both to guide nursing practice and to maintain the family as a support system for the chronically mentally ill. The objectives of the current study were to identify the perceived frequency of common problems as encountered by relatives of schizophrenics as well as the perceived amount of stress provoked by these problems. The present study also examined the types of effectiveness of coping strategies used by these subjects to manage the stresses. In order to collect information regarding stresses and coping strategies, it was necessary to develop a research tool and method that could eventually be used to gather valid and reliable data. Lazarus' (1980) model of stress appraisal provided the theoretical framework. Frequency distributions and Pearson product-moment correlations were computed in order to describe the data. A convenience sample was taken of 27 relatives who were taking primary responsibility for 20 schizophrenic clients who were living at home or elsewhere. The subjects were chosen from several of the units in Salt Lake County Division of Mental Health and from families associated with the Utah Alliance for the Mentally Ill. Fifty-five percent of the sample was mothers of the client, 26% were fathers, 15% were spouses, and 4% were siblings. Eighty-five percent of the subjects were members of the Utah Alliance for the Mentally Ill. Eighty-one percent were of the LDS religion. A card sort developed in a pilot study contained those problems and coping strategies most commonly reported by relatives of schizophrenics. The problem cards were organized around the adaptive tasks for coping with chronic physical illness. Information was elicited from the subjects through this card sort. The data revealed that the primary symptoms of the client's illness take priority over other problems encountered by relatives of schizophrenics (e.g., inactivity, aggressive behaviors, and disturbances of sleep patterns). These were conceptualized as primary problems that initiated a series of secondary problems, such as a sense of helplessness and depression that are reflection of the impact the symptoms of the illness have on relatives. In order to determine the types and effectiveness of coping strategies used by subjects, frequency distributions were computed on the subject's ratings. Those coping strategies that suggested going outside of the family for support, for example, seeking assistance from self-help groups for relatives of the mentally ill, rated high. This would be expected since a majority of subjects belonged to such a self-help group. Several coping strategies were rated low, for example, sleeping more in response to problems, or trying to go on as if nothing had happened, which suggested that either the coping strategies presented were not used and/or were not effective when used. Correlation coefficients were used to determine if problems and/or coping strategies occurred in clusters. Significant inter-correlations among problems, coping strategies occurred in clusters. Significant inter-correlations among problems, coping strategies indicated that problems and coping seemed to occur in clusters. Thus suggests that clinicians may be able to impact several problems alleviating one problem in the network. |
