. 2016 Aug 31;22(1):922. doi: 10.4102/sajpsychiatry.v22i1.922

TABLE 2.

Factors influencing burden.

Burdens	Factors
Increased Burdens	Severely ill/disabled patient.^11,17,21,28 Unemployment/low level of patient psychosocial functioning of.^{11,12,15,17,21,23} Patient presenting with severe negative symptoms and poor self-care.^12,22,31 Acutely psychotic patient,¹⁶ severe positive symptoms and undue suspiciousness.^12,17,22 Patient with concomitant symptoms like obsessions and phobias.²² Patient hostility,²¹ aggression,^16,22 disruptive symptoms,³¹ violence,^11,22 property damage,²² childish/sexually inappropriate behaviour,^16,22 rapid mood changes and behavioural disturbance.²² Patient suicidal ideation/self-harm.^31,22 Patient sleep-wake cycle disturbance.²² Initial onset and early stages of patient illness.^{11,12,14,17,31} Patient symptom relapse/deterioration.¹⁶ Patient hospitalization.¹⁴ Frequent hospital visits.^17,31 Poor patient medication adherence.¹⁵ Young/old or male patient.^17,28,31 Low level of patient and caregiver education.^12,17,28 Female and/or unmarried caregiver.^16,17 Young/old caregiver age.^{4,12,17,26,28} Parents/close relatives as caregivers.^4,12 Passive caregiver coping skills (eg. avoid-ance/denial).^14,17,28,31 Poor caregiver quality of life.^12,17 Large number of hours spent caring for the patient (> 7hours daily – ‘role overload’).^{11,12,15,17,32} Limited friend/family care involvement.⁴ Non-nuclear family/negative family atmosphere with frequent arguments (decreased sense of coherence).⁴ Poor family resources,³¹ greater family demands and lower income/socio-economic background.^4,12,17 Family home far from hospital/in an urban setting.¹⁷ Experiencing illness-related stigma.²²
Decreases burden	Improved patient condition.¹⁶ Long periods of remission.^12,16 Good relationship with patient/mutuality.^4,33 Patient participation in a rehabilitation programme.^15,23 Family participation in a psycho-education programme, group therapy/in a self-help group.^23,25,29 Home visits by nurses as part of an individualized care plan.²³ High social support.^12,14,31 Professional network support.²¹ Caregiver optimism.³³ High active caregiver coping mechanisms.^14,31 Caregiver religious coping strategies.²⁸ Male caregiver.²⁸ Sibling/close relative/friend as caregiver.⁴ Caregiver problem-solving skills.²

Burdens

Factors

Increased Burdens

Severely ill/disabled patient.^11,17,21,28
Unemployment/low level of patient psychosocial functioning of.^{11,12,15,17,21,23}
Patient presenting with severe negative symptoms and poor self-care.^12,22,31
Acutely psychotic patient,¹⁶ severe positive symptoms and undue suspiciousness.^12,17,22
Patient with concomitant symptoms like obsessions and phobias.²²
Patient hostility,²¹ aggression,^16,22 disruptive symptoms,³¹ violence,^11,22 property damage,²² childish/sexually inappropriate behaviour,^16,22 rapid mood changes and behavioural disturbance.²²
Patient suicidal ideation/self-harm.^31,22
Patient sleep-wake cycle disturbance.²²
Initial onset and early stages of patient illness.^{11,12,14,17,31}
Patient symptom relapse/deterioration.¹⁶
Patient hospitalization.¹⁴
Frequent hospital visits.^17,31
Poor patient medication adherence.¹⁵
Young/old or male patient.^17,28,31
Low level of patient and caregiver education.^12,17,28
Female and/or unmarried caregiver.^16,17
Young/old caregiver age.^{4,12,17,26,28}
Parents/close relatives as caregivers.^4,12
Passive caregiver coping skills (eg. avoid-ance/denial).^14,17,28,31
Poor caregiver quality of life.^12,17
Large number of hours spent caring for the
patient (> 7hours daily – ‘role overload’).^{11,12,15,17,32}
Limited friend/family care involvement.⁴
Non-nuclear family/negative family atmosphere with frequent arguments (decreased sense of coherence).⁴
Poor family resources,³¹ greater family demands and lower income/socio-economic background.^4,12,17
Family home far from hospital/in an urban setting.¹⁷
Experiencing illness-related stigma.²²

Decreases burden

Improved patient condition.¹⁶
Long periods of remission.^12,16
Good relationship with patient/mutuality.^4,33
Patient participation in a rehabilitation programme.^15,23
Family participation in a psycho-education programme, group therapy/in a self-help group.^23,25,29
Home visits by nurses as part of an individualized care plan.²³
High social support.^12,14,31
Professional network support.²¹
Caregiver optimism.³³
High active caregiver coping mechanisms.^14,31
Caregiver religious coping strategies.²⁸
Male caregiver.²⁸
Sibling/close relative/friend as caregiver.⁴
Caregiver problem-solving skills.²