A Study On The Status Of Psychological Resilience Of Family Caregivers Of Patients With Schizophrenia In A District Community Of Urumqi City And The Factors Influencing It

Objective:The study aimed to investigate in depth the psychological resilience of family caregivers of schizophrenia patients in the community and the various factors affecting their psychological resilience,in order to provide a reference basis for improving the current mental health status of this group,enhancing their psychological resilience and adopting effective interventions.Methods:A mixed sex study was used.The quantitative study used a stratified randomized whole-group sampling method to select 264community-based family caregivers of patients with schizophrenia managed by eight community health service centers in a district of Urumqi from December 2021 to December 2022 as the study population,and applied the Conner-Davidson Resilience Scale(CD-RISC),the Social Support Rating Scale(SSRS),the Brief Coping Style Scale(SCSQ)and the General Self-Efficacy Scale(GSES)to conduct a cross-sectional survey,and the data were analyzed using SPSS 26.0 and structural equation modeling using AMOS 24.0.The qualitative study implemented semi-structured interviews with 16 community-based family caregivers of patients with schizophrenia by purposive sampling method,and used the Colaizzi seven-step data analysis method,the interview data were integrated and analyzed in depth with the aim of extracting valuable themes.Results:1.Quantitative findings:(1)The total psychological resilience score of family caregivers of patients with community schizophrenia was(58.76±13.69),of which the resilience dimension score was(30.11±7.55),the strength dimension score was(19.15±4.99)and the optimism dimension score was(9.50±2.05);(2)Total score of family The total score of social support for caregivers of patients with community schizophrenia was(36.30±8.67),of which the subjective support score was(20.97±6.48),objective support score was(9.19±2.64),and support utilization score was(6.14±1.31);(3)The score of positive coping style for family caregivers of patients with community schizophrenia was(2.29±0.75),and the score of negative coping;(4)The general self-efficacy score of family caregivers of community schizophrenia patients was(2.53±0.72);(5)Univariate analysis showed statistically significant differences(P<0.05)in the effects of patients’gender,ethnicity,education level,medical payment method,presence of violent behavior and family caregivers’gender,age,education level,work status,per capita monthly household income,and knowledge of the disease on the psychological resilience of family caregivers of patients with community schizophrenia;(6)Correlation analysis showed that the psychological resilience of family caregivers of community schizophrenia patients was positively correlated with social support,positive coping and self-efficacy(P<0.05)and negatively correlated with negative coping style of family caregivers(P<0.05);(7)Multiple stepwise regression results showed that the presence or absence of violent behavior and the age,education level,and monthly per capita household income of family caregivers of community schizophrenia patients were correlates of the psychological resilience of family caregiving for community schizophrenia patients,where the coefficient of determination R~2=0.537,F=26.518,P<0.001;Social support,coping styles and self-efficacy of family caregivers are relevant factors influencing the psychological resilience of family caregivers of patients with schizophrenia,where the coefficient of determination R~2=0.889,F=341.878,P<0.001;(8)The results of path analysis showed that subjective support,objective support,positive coping,negative coping and self-efficacy and total psychological resilience scores were included in the model.Fit tests were conducted on the model withχ~2/df=0.047<3;RMSEA=0.000<0.10,SRMR=0.007<0.1,GFI=1.006,CFI=1.006,NFI=1.000,NNFI=1.014,AGFI=0.999,and IFI=1.006,all of which were greater than 0.900,suggesting the model fit was good.Family caregivers’subjective support and self-efficacy of community schizophrenia patients had both direct and indirect effects on psychological resilience,and family caregivers’coping style and objective support had direct effects on psychological resilience.2.Qualitative findings:A total of 5 themes and 12 sub-themes of negative emotional experience,burden,coping style,social support,and needs were extracted through analysis and summarization.Among them,negative emotional experiences included illness stigma,depression,and anxiety;burdens included caregiving and financial burdens;coping styles included positive coping styles and negative coping styles;social support included family support,government support,and good interpersonal relationships;and needs included the need for disease-related health education and medical care.Conclusion:The psychological resilience of family caregivers of patients with schizophrenia in the community was at an intermediate level,and the presence or absence of violent behavior of patients and the education level of family caregivers,monthly per capita household income,knowledge of the disease,social support,coping style,and self-efficacy were relevant factors affecting psychological resilience.The physical and psychological health of family caregivers of patients with schizophrenia should be emphasized in community management,and it is recommended to strengthen community health education and take effective interventions to improve their psychological resilience.