A Descriptive Study to Assess the Psychosocial Problems of Significant Family Members of Mentally ill Person at SDM Hospital Dharwad

 

Mr. Nagesh V A¹, Prof. David A Kola²

¹Lecturer, Shri Dharmasthala Manjunatheshwara Institute of Nursing Sciences, Dharwad.

²Principal, Shri Dharmasthala Manjunatheshwara Institute of Nursing Sciences, Dharwad

 

ABSTRACT:

Background:Mental illness is a stressful condition not only for patient but also for family members. Numerous studies have demonstrated that family care givers of persons with a severe mental illness suffer from significant stress experience and high levels of burden.

Aims and objectives: To determine the psychosocial problems of significant family members of mentally ill Person. and To associate the psychosocial problems of significant family members of mentally ill person with the selected demographic variable.

Method: A descriptive approach was used for this study. The samples consist of 60 significant family members of the mentally ill persons in SDM Hospital Dharwad. Purposive sampling technique was adopted, and the data was collected with the help of following tools; Likert scale structured questionnaires.

Results: The result showed that moderate psychosocial problems (55%) affected the significant family members of mentally ill person. The study also says that there is a significant relationship between the psychosocial problems with socio demographic variables that is education (x²= 9.60), occupation (x² =25.3), relationship with the patient (x² =37.3) however association between psychosocial problems and other demographic variables were not significant 0.05 levels.

Conclusion: Research need to focus on the level of psychosocial problems in the significant family members of mentally ill person.

 

 

 

INTRODUCTION:

“Smile at each other; make time for each other in your family”                                      -Mother Theresa

A great saying is there “If you lose everything in your life, it’s not at all a problem, if you have a good family”.

 

A Family is a unit which builds up a person’s personality. Family life is also important in the sense that it gives you your basic strength as a person. The people who have a smooth and well settled family life are generally less scared of life. Those who are a part of a broken family are generally less confident. These people always expect the worst in life. This is a general state of mind resulting in building up of a negative personality¹. In the same way having a family member with a mental illness can be very stressful. Whether the ill person is a son, daughter, husband, wife, brother or sister, you also will be affected by the illness. A person with a psychiatric disorder often needs much love, help and support. At the same time, the problems, fears and behavior of your ill relative may strain your patience and your ability to cope³.

 

While it takes courage to tell your friends and family about your relative’s illness, it is not good to isolate yourself. Try to find ways to explain the illness and treatment to others, and to talk about the discomfort you and other people feel as a result of your relatives’ behavior².

 

It is estimated that approximately 450 million people worldwide have a mental health problem. W.H.O stated that family members are often the primary caregivers of people with mental disorders⁴. They provide emotional and physical support, and often have to bear the financial expenses associated with mental health treatment and care. It is estimated that one in four families has at least one member currently suffering from a mental or behavioral disorder⁶.

 

A study stated that as much as 50 percent of the mentally ill population also has a substance abuse problem.⁵ Hence, by doing proper assessment of problems faced by family members of mentally ill in the beginning stage itself we can well prevent the deterioration of the family health and well being⁷

 

STATEMENT OF THE PROBLEM:

“A descriptive study to assess the psychosocial problems of significant family members of mentally ill person at SDM hospital Dharwad”.

 

OBJECTIVES OF THE STUDY:

The Objectives of the study are:

1. To determine the psychosocial problems of significant family members of mentally ill

Person.

2. To associate the psychosocial problems of significant family members of mentally ill person with the selected demographic variables.

 

OPERATIONAL DEFINITIONS:

·        Assess: It refers to a method of evaluating the psychosocial problems of significant family members of mentally ill person with the help of rating scale.

·        Psychological problems: It refers to disequilibrium of higher mental functions of significant family members due to mentally ill person; usually interfere with the emotional or physical health, communication among the family members, work productivity and life adjustment, etc

·        Sociological problems: It refers to the impact made by of a mentally ill person on the significant family members such as financial burden on the family, interaction with the society, relationship within the family, contribution to society and family organization.

·        Psychosocial problems: It refers to the combination of psychological and social behavior of significant family members due to mentally ill person.

·        Significant family members: In this study it refers to the caregivers of a mental ill person either blood relationship (parents, brothers, sisters or children.) or other relationship (spouse or in laws).

·        Mental illness: Description of the behaviors labeled as symptomatic of mental disorders like schizophrenia, mania, depression etc.

 

ASSUMPTIONS:

·        Significant family members of mentally ill person may have some psychosocial problems.

·        Significant family members may struggle with accepting the realities of mental illness that is treatable, but not curable.

·        The impact of mental illness on significant family members may differ depending on the demographic variables.

 

DELIMITATIONS:

The study is delimited to

·        A period of two weeks.

·        Significant family members in selected settings at SDM Hospital, Dharwad.

 

MATERIALS AND METHODS:

SOURCE OF THE DATA:

Data will be collected form significant family members of mentally ill person admitted in SDM hospital, Dharwad.

 

RESEARCH DESIGN AND APPROACH:

Design: Non experimental descriptive design

Approach: Quantitative Research Method.

Setting: The study was conducted in SDM Hospital Dharwad

Population: The population selected for the study will be the significant family members of mentally ill persons.

 

VARIABLES:

·        Study variables: Psychosocial problems of significant family members of mentally ill person.

·        Attribute variables: age, sex, education, residence, family type, etc

 

METHOD OF DATA COLLECTION:

·        Technique: Purposive sampling technique will be used by the researcher in the study.

·        Sample size: 60 significant family members of mentally ill persons.

INCLUSION CRITERIA FOR SAMPLING: Significant family members who are:

·        Relatives of the mentally ill person such as, father, mother, husband, wife, brother, sister, son, daughter.

·        Available at the time of study.

·        The relatives who are willing to participate in the study.

 

EXCLUSION CRITERIA FOR SAMPLING: Significant family members who are

·        Other than the close relatives

·        Not willing to participate

 

CONTENT VALIDITY OF THE TOOL:

In order to obtain the content validity of the tool, prepared items along with the problem statement, objectives, operational definition and scoring pattern [questionnaire], were submitted to experts from the field of psychiatric and nursing department. The suggestions made by the experts were accepted and suitable modifications were made in the tool.

 

RELIABILITY OF THE TOOL:

The reliability was established through Split Half Technique by administering it to 6 significant family members of mentally ill person at SDM Hospital Dharwad. The Karl Pearson’s Co- efficient of Correlation was computed for significant family members psychosocial problem questionnaire were 0.99 respectively. This indicated that all the tools were reliable.

 

DESCRIPTION OF TOOL:

The final tool designed for study was to determine the psychosocial problems of significant family members of mentally ill person.

 

It consists of 3 parts.

·        Part 1: Demographic Variables such as Age, Sex, Education, Occupation, Relationship With patient, Duration of illness of patient about psychosocial problems of significant family members of mentally ill person at SDM Hospital Dharwad.

·        Part 2: Structured Interview Schedule comprising of 18 questions. Feelings and Behaviors of significant family members of mentally ill persons

·      Part 3:Psychosocial scale consisting 5 point Likert Scale(never, rarely, sometimes, frequently, always) and 18 questions.

 

DEVELOPMENT AND DESCRIPTION OF TOOL:

The instrument selected in the research must be a vehicle that can obtain the best data for drawing conclusion to the study. Structured questionnaire was developed on the basis of the objectives of the study.

The tool was developed based on the following steps;

·        After reviewing the related literature.

·        With guidance and consultation with the Subject Experts.

·        Based on the level of understanding of the family relatives.

·        Following consultation with the Statistician regarding analysis.

 

A structured knowledge questionnaire was used to collect the data. Blue print was prepared which showed the distribution of items according to the content areas such as psychosocial problems, feelings and behaviors of significant family members of mentally ill person.

 

PILOT STUDY:

Pilot study is the small version of trial run of major study. Its function is to obtain information of behaving the project or for assessing feasibility.

 

After obtaining formal app from SDM College of Medical Sciences and Hospital at psychiatric ward Dharwad, pilot study was conducted on 6 samples.

·        Data was collected from 6 significant family members of mentally ill persons at SDM Hospital Dharwad, who fulfilled the criteria set for selection of sample.

·        The purpose of the study was explained and consent was taken from respondent prior to

 

Study to get co-operation and prompt answers.

·        Study was conducted on 9-5-2016 by administering the tool. The average time taken for study was 25 minutes.

 

DATA COLLECTION:

Data was collected by the investigators on structured interview with the respondent who fitted the criteria of the study. Appropriate orientation was given to significant family members about the aim of the study, nature of the study, and the purpose of the questionnaire. Adequate care was taken to protect the subject from potential risk including maintaining confidentiality, secrecy and identity.

 

A formal written permission was obtained from the Medical Superintendent of SDM hospital Dharwad to conduct the study. Self introduction was given by the investigator to the sample and purpose of the study was explained. The students assured them anonymity and confidentiality. The numbers of samples selected were 60 from significant family members of the ill person and it took about 15-20mints for each sample.

 

 

 

PLAN FOR DATA ANALYSIS:

Data obtained was planned to be coded and edited to reduce the large data into a master sheet. Both descriptive and inferential statistics were planned to be used in this study to achieve the objectives of this study.

 

Descriptive and Inferential Statistics were used to analyze the data:

·        Frequency and Percentage for selected personal variables

·        Mean, Median, Standard Deviation for Psychosocial Problems of significant family members of mentally ill person.

·        Chi-square to assess the association between psychosocial problems of significant family members and their selected personal variables like age, sex, education, occupation, relationship and duration of illness of the patient.

 

RESULTS:

Objectives of the study and the statistics used:

·        To determine the psychosocial problems of significant family members of mentally ill person.

·        To associate the psychosocial problems of significant family members of mentally ill person with the selected demographic variables.

 

Presentation of Data:

The data obtained were organized in the master sheet for tabulation, statistically analyzed and interpreted by using descriptive inferential statistics. The data is presented under the following headings:-

 

SECTION 1: Deals with the analysis of demographic variables of the respondents:

Frequency and percentage distribution of significant family members of mentally ill person according to their selected personal variables.

A.      

SECTION2: Deals with the Description of Psychosocial problems of significant family

Members of mentally ill person:

A.     The mean, median, standard deviation levels of psychosocial problem scores as perceived by significant family members of mentally ill person.

B.     Perceived level of psychosocial problems of significant family members of mentally ill person.

 

SECTION 3: Deals with the Association of psychosocial problems of significant family Members of mentally ill person with the selected demographic variables.

A.               Chi-square values among significant family Members regarding of psychosocial problems according to their selected demographic variables.

 

The collected data was grouped and analyzed by using descriptive analytical Methods.Tables and Graphs were used to explain the socio-demographical variables of male adults included in this study.

 

SECTION 1: DEALS WITH THE ANALYSIS OF DEMOGRAPHIC VARIABLES OF THE RESPONDENTS.

Frequency and percentage distribution of significant family members of mentally ill person according to their selected personal variables.

A total of 60 significant family members were selected. The data thus obtained was presented in frequencies and percentages. The socio demographic variables are age, sex, education, occupation, relationship with the patient and duration of illness with the patie

 

Table 1: FREQUENCY AND PERCENT OF SAMPLE CHARACTERISTICS.                                                       N=60

 

SECTION 2: DEALS WITH THE PSYCHOSOCIAL PROBLEM LEVELSCORES OF SIGNIFICANT FAMILY MEMBERS.

A. the Mean, Median, Standard Deviation, Range and levels of psychosocial problem scores as perceived by significant family members of mentally ill person.

The psychosocial problem scores obtained by the subjects were tabulated a master sheet and the total score obtained for each sample in interview technique were tabulated. Mean, Median, Standard Deviation and range of psychosocial problems scores were computed. The findings_{are presented in the:}

 

TABLE 2 _N=60

	Mean	Median	S.D	Range
Perceived psychosocial problems	26.4	28	1.47	55

 

 

 

B. Perceived level of psychosocial problems of significant family members of mentally ill person.

 

This section deals with the description of data about perceived level of psychosocial problems of significant family members of mentally ill persons in selected area of SDM Hospital Dharwad.

 

TABLE 3 N=60

SL.NO	Level of psychosocial problems	Number	Percentage
1	Mild (0-24)	26	43.3%
2	Moderate (25-48)	33	55%
3	Severe(49-72)	1	1.7%
4	Total	60	100

 

 

 

SECTION 3: DEALT WITH THE ASSOCIATION OF PSYCHOSOCIAL PROBLEMS OF SIGNIFICANT FAMILY MEMBERS OF THE MENTALLY ILL PERSON WITH THE SELECTED DEMOGRAPHIC VARIABLES.

Table- 4

Sl.No	Personal variables	CHI- SQUARE value	Df	P- VALUE	LEVEL OF SIGNIFICANCE
1	AGE a.20-30 years b.31-40 years c.41-5o years d.51-60 years	5.47	3	7.82	NS
2	GENDER a.Male b.Female	.600	1	3.84	NS
3	EDUCATION a.Literate b.Illiterate	9.60	1	3.84	S
4	OCCUPATION a.Private employee b.Govt.employee c.Agriculture d.Household e.Students	25.33	4	9.49	S
5	RELATIONSHIP WITH THE PATIENT a.Father	37.33	7	14.07	S
	b.Mother c.Husband d.Wife e.Brother f.sister g.Son h.Daughter
6	DURATION OF ILLNESS OF THE PATIENT a. <1 year b. 1-3 years c. >3 years	0.40	2	5.99	NS
7	PSYCHOSOCIAL SCORE a. 0-26 b. 27-54 c. 55-72	28.30	2	5.99	S

S=Significant  NS=Not significant

 

 

 

 

 

 

 

 

 

DISCUSSION:

The Findings Have Been Discussed Under The Following Headings

SECTION 1: DEMOGRAFIC CHARATERISTICS OF PSYCHOSOCIAL PROBLEMS OF SIGNIFICANT FAMILY MEMBERS OF MENTALLY ILL PERSON.

Frequency and percentage distribution according to their personal variables. The finding of the study indicates that of the selected 60 respondents:

·      21[35%] belong to the age group of 51-60 years, 19[31.7%] belonged to the age group of 31-40 years, 10[16.7%] were of the age group of 41-50 and 10[16.7%] were in the age group of 20-30

·      33[55%] were females and the rest of 27 [45%] were males.

·      42[70%] of the respondent were literate and remaining 18[30%] were illiterate.

·      26[43.3%] of the respondents were Agriculture and 18[30%] were house hold workers,10[16.7%] were private employers, 16[10%] were government employee and 4[6.7%]were students.

·      Most of the respondents 16[26.7%%] were fathers, 15[25%] mothers, 13[21.7%] waves, 7[11.7%] brothers, 5[8.3%] sisters, 2[3.3%] husbands, 1[1.7%] son and1[1.7%] daughters.

·      Duration of the caring of the ill person varied as 22[36.7%] >3 years, 19[31.7%] 1-3 years and 19[31.7%] <1 years.

 

SECTION 2: DEALS WITH THE DESCRIPTION OF PSYCHOSOCIAL PROBLEMS OF SIGNIFICANT FAMILY MEMBERS OF MENTALLY ILL PERSON:

Majority of significant family members 33(55%) were suffering mild psychosocial problems, 26(43.3%) ,moderately and 1(1.7%) had severe psychosocial problems.

 

SECTION 3: THE ASSOCIATION OF PSYCHOSOCIAL PROBLEMS OF SIGNIFICANT FAMILY MEMBERS OF MENTALLY ILL PERSON WITH THE SELECTED DEMOGRAPHIC VARIABLE.:

The chi-square test computed between level of psychosocial problems with respect to selected demographic variables showed that there is a significant relationship between the level of psychosocial problems and selected demographic variables that are Education (x2= 9.6 p value=3.84) Occupation (x2= 25.3 p value=9.49) Relationship of the client (x2= 37.3 p value=14.0) Other demographic variables showed that there is no significant relationship between the level of psychosocial problems with selected demographic variables.

 

CONCLUSION:

In the 21^st century, India shows clear signs of emerging as a developed country and enrolls its name in the list of super powers and self developing nations. Hence to achieve these goals development of human resources plays an important role, which meant not only in quantity but also in quality of human resources.

 

The impact of mental illness in significant family members causes psychosocial problems like, depression, fear and anxiety, social isolation etc. Majority of the family members experience psychosocial problems while taking care of mentally ill person. The findings of this study will help community health nurses and clinical psychiatric nurses to identify the various psychosocial problems and how to understand and prevent the problems in the daily life. This proposed study explored the level of psychosocial problems in the significant family members of mentally ill person at SDM Hospital, Dharwad.

 

Hence the study concludes that the psychosocial problems in significant family members (of mentally ill person) and the remedial action taken were not effectively. There was thus a need to provide information regarding psychosocial problem management and it is very important to note that a high degree of empathetic understanding is needed to help the significant family members of the mentally ill person.

 

REFRENCE:

1.     The importance of family life. www.grandmas crftguides.com/family corner.

2.     Canadian Mental Health Association. Mental Illness in the Family.May 1-7-2011. Available from :http://www.cmha.ca/bins/content_page.asp?cid=4-37-186.

3.     HannaMolander, Effects of Mental illness on the Family. First version: 22 Jul 2008. Latest revision: 19 Aug 2008. Available from:http://web4health.info/en/answers/life-family-mental-illness.htm

4.     Agnes B. Hatfield, Ph.D.Dual Diagnosis and Mental illness (Schizophrenia and Drug or Alcohol dependence).Copyright 1993 National Alliance for the Mentally ill. Available from :www.schizophrenia.com/family/dualdiag.html

5.     World Health Organization. Family burden cannot be ignored. Investing inmentalhealth2003.www.who.int/mental_health/en/investing_in_mnh_final.pdf

6.     Abraham Rudnik, Burden of Care givers of mentally ill individuals in Israeil.2004. Available from: psychosocial.com/IJPR_9/Burden_of_caregivers.htmlWorried, Tired and Alone A Report of Mental Health Carers’ Issues in WA, 2003. Available at http://www.carerswa.asn.au/uploadedfiles/MentalHealthResearchReportDec2003.pdf

7.     MijungPark Correspondence, immigrant families organize their world to care fora mentallyill person, Available at-http://www.biomedcentral.com/1472-6955/11/28

 

 

 

 

 

Received on 16.09.2017           Modified on 03.11.2017

Accepted on 20.12.2017         © A&V Publications all right reserved