Perceived Burden and Family Functioning among Informal Caregivers of Individuals Living with Schizophrenia in Tanzania: A Cross-Sectional Study

Abstract

Background: Deinstitutionalization of persons with schizophrenia has led to families providing the majority of care and carrying the bulk of burden. There is a need to identify factors that influence caregiver burden in order to properly address the needs of caregivers. This is particularly important in low-resource settings, where psychiatric services are scarce and interventions for schizophrenia could be most effective if targeted to the affected individual and their caregiver. This study seeks to examine the association between family functioning and perceived burden in informal caregivers of individuals with schizophrenia in Tanzania and identify socio-demographic and illness-related factors that may be associated with caregiver burden in the study population.Methods: This study analyzed cross-sectional data from 65 dyads of individuals with schizophrenia and their informal caregivers in Dar es Salaam and Mbeya, Tanzania. Caregiver burden was measured using the Burden Assessment Scale (BAS). Univariable and multivariable regression analyses were performed to determine the relationship between perceived caregiver burden and family functioning and explore correlates of burden among caregivers. Results: Sixty-three percent of caregivers in our study reported experiencing high burden as a result of caring for a relative with schizophrenia. Multivariable regression analyses revealed that poor family functioning was a significant correlate of high caregiver burden (OR = 4.79; 95% CI = 1.19, 19.32). Additionally, caregiver having worked in the past 3 months was associated with high caregiver burden (OR = 4.80; 95% CI = 1.14, 20.23), while higher levels of hope in the caregiver were associated with low caregiver burden (OR = 0.82; 95% CI = 0.70, 0.95). Although not included in the multivariable regression model, another factor that was linked to high caregiver burden was caring for a woman with schizophrenia (OR = 3.91; 95% CI = 1.13, 13.50). Conclusions: We found that poor family functioning, caregiver having worked in the past 3 months, lower levels of hope in the caregiver, and caring for a woman with schizophrenia were correlates of high caregiver burden. Future interventions aiming to reduce caregiver burden may benefit from improving family functioning and nurturing hope among caregivers of individuals living with schizophrenia. We must pay special attention to the needs of caregivers that work in addition to providing care for a relative with schizophrenia in order to better support them.