Caregiver Burden and the Related Factors Among Family Caregivers of Older Persons With Schizophrenia: A Mixed Methods Study

Background

Schizophrenia is a chronic health condition that poses unique challenges for patients and their family caregivers. This study assessed the association between caregiver burden, sociodemographic characteristics and psychological factors among family caregivers of older persons with schizophrenia.

Methods

A mixed methods design was employed in this study. Three hundred and forty respondents were purposively selected to participate in the quantitative aspect of the survey, whereas 20 caregivers were purposively selected to participate in the qualitative phase. The Zarit Burden Interview Scale and Hospital Anxiety and Depression Scale were used to collect quantitative data from family caregivers, and qualitative data were collected through face-to-face, in-depth interviews using a semi-structured interview question guide. The qualitative responses were audio-recorded and transcribed, and the cleaned transcribed data were transferred to Atlas.ti Scientific version 24 for coding the themes and subthemes. SPSS version 29 was used to analyse the cleaned, sorted and coded quantitative data at a statistically significant level of p ≤ 0.05.

Results

The results showed that most family caregivers (60%) were female, aged between 17 and 64 years. Over half (52.6%) of the caregivers experienced severe caregiver burden. An ordinal logistic regression analysis to predict caregiver burden found that several factors were linked to lower caregiver burden, including older age (OR = 0.75, p = 0.042), certain living arrangements (OR = 0.51, p = 0.037) and longer caregiving duration (OR = 0.65, p < 0.001). In contrast, higher burden was strongly associated with depression (OR = 10.39, p < 0.001), anxiety (OR = 2.99, p < 0.001) and being married (OR = 1.65, p = 0.028). Qualitative findings revealed that caregivers experienced profound emotional distress, including anxiety and depression, and significant financial strain due to medication costs and transportation expenses. Qualitative interviews have highlighted emotional distress, financial strain and social isolation as core challenges.

Conclusion

There is a need to provide psychological and social support for family caregivers of older persons with schizophrenia. The government should consider subsidising medication and care costs, similar to existing models for TB and HIV treatments in Nigeria.

Implications for Practice

Family caregivers, especially women and those aged 53–64 years, experience a severe burden. Providing psychological support services, such as counselling and stress management, can help mitigate emotional distress.