Sobrecarga de familiares de pacientes psiquiátricos: fatores associados

Abstract

Since the implementation of community psychiatric treatment, the number of patients' family caregivers is growing quickly and their involvement and responsability in this process increased, resulting in family burden. However, there is a lack of systematic empiric studies using validated scales in Brazil to investigate the impact of this reality in relatives' life. In order to fulfill this gap, the present research evaluated the relatives' degree of objective and subjetive burden, the domains in which burden were more accentuated and the factors significantly related to family burden. The present work is a correlacional study with a random sample of 150 family caregives of patients having received the diagnostics of schizophrenia, schizo-affective disease or acute psychotic disorder of schizphrenic type and being treated by public services of mental health in the city of Belo Horizonte, Brazil. The relatives were submitted to structures interviews, where three scales and a questionnaire were applied by trained interviewers. In order to evalute the objective and subjective family burden, in different domains, the interviewers applied Family Burden Interview Schedule (FBIS-BR). The factors associated to family burden were investigated by univariate analysis and linear regression analysis using the data obtained de FBIS-BR, the Positive Feelings Scale, the Contributions of the Patients Scale and the Questionnaire of Factors Related to the Burden an of Clinical Variables. The resultats show the relatives had a moderate degree of objetive burden and a degree of subjective burden between moderate and high. The assistance given by the relative to the patients in daily activites was the most significant domain of objective family borden. The subjective family burden was more accentuated in the domains of worries about the present and future of the patients and the difficulties of dealing with their problematic behaviors. The factors significantly associated to family burden, in the regression analysis, were the severity of the patients' clinical conditions, the social and demographic characteristics of patients and relatives, the difficulties in family life conditions, the financial impact, the relative's types of activities and coping, a low quality of relative's relationship with the patient and relationship with mental health services. The results concerning the degree of family burden observed in this sample, the domains in which burden was significantly higher and the identification of the main factors associated to family burden confirmed previous data report in the literature and extended these results to a target populations of patients not yet studied in a systematic way, in Brazil. This study points to the need for new researches on family burden and to the importance of developing support and orientation programs for family caregives of psychiatric patients.