IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v259y2020ics0277953620303324.html
   My bibliography  Save this article

Test of the stress process model of family caregivers of people living with schizophrenia in China

Author

Listed:
  • Yu, Yu
  • Liu, Zi-Wei
  • Li, Tong-Xin
  • Li, Yi-Lu
  • Xiao, Shui-Yuan
  • Tebes, Jacob Kraemer

Abstract

Across the world, people living with schizophrenia (PLS) are often cared for by family caregivers. This is especially true in China where community-based systems of care for PLS are underdeveloped. Thus, family caregivers of PLS may experience emotional distress and burden in the absence of community-based services. Pearlin (1990) proposed a highly influential model for understanding the stress process and its relationship to health and wellbeing. Although the model has been examined worldwide, it has yet to be studied in China for caregivers of PLS. In the present study, we use Pearlin's stress process model to examine the mediating effect of perceived caregiver burden, family functioning, and caregivers' positive feelings about caregiving on PLS global functioning and caregiver depressive symptoms. We also examine whether the model differs for parent and spouse caregivers. A total of 327 primary family caregivers of PLS in Hunan province, China, were assessed cross-sectionally using culturally-validated measures. Bootstrap methods with Hayes's PROCESS Macro were used to test multiple mediation models of global functioning scores of PLS and caregiver depressive symptoms. In this first study of the stress process model of family caregivers of PLS in China, the results generally support the model. Caregiver perceived burden, family functioning, and positive caregiver feelings about caregiving all mediate the relationship between PLS global functioning and caregiver depression, with perceived caregiver burden having the strongest indirect effect. Analyses also show that the stress process differs between parent and spouse caregivers, with perceived caregiver burden a mediator for both groups but family functioning only a mediator for parent depressive symptoms. We discuss implications of these findings for extending the stress process model cross-culturally; suggest hypotheses for future research to examine parent and spouse differences; and discuss fruitful directions for intervention.

Suggested Citation

  • Yu, Yu & Liu, Zi-Wei & Li, Tong-Xin & Li, Yi-Lu & Xiao, Shui-Yuan & Tebes, Jacob Kraemer, 2020. "Test of the stress process model of family caregivers of people living with schizophrenia in China," Social Science & Medicine, Elsevier, vol. 259(C).
    • Handle: RePEc:eee:socmed:v:259:y:2020:i:c:s0277953620303324
    DOI: 10.1016/j.socscimed.2020.113113
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620303324
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2020.113113?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Yu Yu & Zi-wei Liu & Bing-wei Tang & Mei Zhao & Xi-guang Liu & Shui-yuan Xiao, 2017. "Reported family burden of schizophrenia patients in rural China," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-18, June.
    2. Koschorke, Mirja & Padmavati, R. & Kumar, Shuba & Cohen, Alex & Weiss, Helen A. & Chatterjee, Sudipto & Pereira, Jesina & Naik, Smita & John, Sujit & Dabholkar, Hamid & Balaji, Madhumitha & Chavan, An, 2017. "Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India," Social Science & Medicine, Elsevier, vol. 178(C), pages 66-77.
    3. Song, Jieun & Mailick, Marsha R. & Greenberg, Jan S., 2018. "Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma," Social Science & Medicine, Elsevier, vol. 217(C), pages 152-158.
    4. Wolfe, Barbara & Song, Jieun & Greenberg, Jan S. & Mailick, Marsha R., 2014. "Ripple effects of developmental disabilities and mental illness on nondisabled adult siblings," Social Science & Medicine, Elsevier, vol. 108(C), pages 1-9.
    5. Ice, Gillian H. & Sadruddin, Aalyia F.A. & Vagedes, Amy & Yogo, Jaja & Juma, Elizabeth, 2012. "Stress associated with caregiving: An examination of the stress process model among Kenyan Luo elders," Social Science & Medicine, Elsevier, vol. 74(12), pages 2020-2027.
    6. Idstad, Mariann & Røysamb, Espen & Tambs, Kristian, 2011. "The effect of change in mental disorder status on change in spousal mental health: The HUNT study," Social Science & Medicine, Elsevier, vol. 73(9), pages 1408-1415.
    7. Chiu‐Yueh Hsiao & Yun‐Fang Tsai, 2015. "Factors of caregiver burden and family functioning among Taiwanese family caregivers living with schizophrenia," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(11-12), pages 1546-1556, June.
    8. Li, Ting & Yang, Yang Claire & Zhang, Yanlong, 2018. "Culture, economic development, social-network type, and mortality: Evidence from Chinese older adults," Social Science & Medicine, Elsevier, vol. 204(C), pages 23-30.
    9. Hoult, John & Rosen, Alan & Reynolds, Ingrid, 1984. "Community orientated treatment compared to psychiatric hospital orientated treatment," Social Science & Medicine, Elsevier, vol. 18(11), pages 1005-1010, January.
    10. Magliano, Lorenza & Fiorillo, Andrea & Malangone, Claudio & De Rosa, Corrado & Maj, Mario, 2006. "Social network in long-term diseases: A comparative study in relatives of persons with schizophrenia and physical illnesses versus a sample from the general population," Social Science & Medicine, Elsevier, vol. 62(6), pages 1392-1402, March.
    11. Cannuscio, Carolyn C. & Colditz, Graham A. & Rimm, Eric B. & Berkman, Lisa F. & Jones, Camara P. & Kawachi, Ichiro, 2004. "Employment status, social ties, and caregivers' mental health," Social Science & Medicine, Elsevier, vol. 58(7), pages 1247-1256, April.
    12. Kate, Natasha & Grover, Sandeep & Kulhara, Parmanand & Nehra, Ritu, 2013. "Caregiving appraisal in schizophrenia: A study from India," Social Science & Medicine, Elsevier, vol. 98(C), pages 135-140.
    13. Liu, Sizhe & Zhang, Wei & Wu, Li-hsueh & Wu, Bei, 2019. "Contributory behaviors and life satisfaction among Chinese older adults: Exploring variations by gender and living arrangements," Social Science & Medicine, Elsevier, vol. 229(C), pages 70-78.
    14. Krupchanka, D. & Chrtková, D. & Vítková, M. & Munzel, D. & Čihařová, M. & Růžičková, T. & Winkler, P. & Janoušková, M. & Albanese, E. & Sartorius, N., 2018. "Experience of stigma and discrimination in families of persons with schizophrenia in the Czech Republic," Social Science & Medicine, Elsevier, vol. 212(C), pages 129-135.
    15. Kaschowitz, Judith & Brandt, Martina, 2017. "Health effects of informal caregiving across Europe: A longitudinal approach," Social Science & Medicine, Elsevier, vol. 173(C), pages 72-80.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ruttana Phetsitong & Patama Vapattanawong, 2022. "Reducing the Physical Burden of Older Persons’ Household Caregivers: The Effect of Household Handrail Provision," IJERPH, MDPI, vol. 19(4), pages 1-17, February.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Song, Jieun & Mailick, Marsha R. & Greenberg, Jan S., 2018. "Health of parents of individuals with developmental disorders or mental health problems: Impacts of stigma," Social Science & Medicine, Elsevier, vol. 217(C), pages 152-158.
    2. Man-Man Peng & Jianli Xing & Xinfeng Tang & Qinglu Wu & Dannuo Wei & Mao-Sheng Ran, 2022. "Disease-Related Risk Factors for Caregiver Burden among Family Caregivers of Persons with Schizophrenia: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 19(3), pages 1-16, February.
    3. Erdinç Kalayci & İmran Uzunaslan & Şerif Uzunaslan, 2023. "Caregiver burden experiences of caregivers of patients with schizophrenia: A qualitative inquiry," International Journal of Social Psychiatry, , vol. 69(3), pages 543-550, May.
    4. Teerawichitchainan, Bussarawan & Low, Timothy Qing Ying, 2021. "The situation and well-being of custodial grandparents in Myanmar: Impacts of adult children's cross-border and internal migration," Social Science & Medicine, Elsevier, vol. 277(C).
    5. Jianliang Nie & Bohan Chen & Yini Liao & Yufeng Wu & Dan Li, 2023. "The Characteristics and the Influencing Factors of Rural Elders’ Social Networks: Evidence from China," Sustainability, MDPI, vol. 15(5), pages 1-13, February.
    6. Longobardo, Luz María Peña & Rodríguez-Sánchez, Beatriz & Oliva, Juan, 2023. "Does becoming an informal caregiver make your health worse? A longitudinal analysis across Europe," Economics & Human Biology, Elsevier, vol. 50(C).
    7. Ting Li & Wenting Fan & Jian Song, 2020. "The Household Structure Transition in China: 1982–2015," Demography, Springer;Population Association of America (PAA), vol. 57(4), pages 1369-1391, August.
    8. Bom, Judith & Stöckel, Jannis, 2021. "Is the grass greener on the other side? The health impact of providing informal care in the UK and the Netherlands," Social Science & Medicine, Elsevier, vol. 269(C).
    9. Andrew Shepherd & Caroline Sanders & Michael Doyle & Jenny Shaw, 2016. "Personal recovery in personality disorder: Systematic review and meta-synthesis of qualitative methods studies," International Journal of Social Psychiatry, , vol. 62(1), pages 41-50, February.
    10. José Manuel Pérez Mármol & María Luz Flores Antigüedad & Adelaida María Castro Sánchez & Rosa María Tapia Haro & María del Carmen García Ríos & María Encarnación Aguilar Ferrándiz, 2018. "Inpatient dependency in activities of daily living predicts informal caregiver strain: A cross‐sectional study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 177-185, January.
    11. Bram Hogendoorn & Juho Härkönen, 2023. "Single Motherhood and Multigenerational Coresidence in Europe," Population and Development Review, The Population Council, Inc., vol. 49(1), pages 105-133, March.
    12. repec:zbw:bofitp:2020_018 is not listed on IDEAS
    13. Meltzer, Ariella, 2021. "What is ‘sibling support’? Defining the social support sector serving siblings of people with disability," Social Science & Medicine, Elsevier, vol. 291(C).
    14. Cheng, Grand H.-L. & Sung, Pildoo & Chan, Angelique & Ma, Stefan & Malhotra, Rahul, 2022. "Transitions between social network profiles and their relation with all-cause mortality among older adults," Social Science & Medicine, Elsevier, vol. 292(C).
    15. Liam Delaney & Colm Harmon & Cecily Kelleher & Caroline Kenny, 2007. "The Determinants of Self-Rated Health in the Republic of Ireland Further Evidence and Future Directions," Working Papers 200741, Geary Institute, University College Dublin.
    16. Jingyi Ai & Jin Feng & Yangyang Yu, 2022. "Elderly Care Provision and the Impact on Caregiver Health in China," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 30(5), pages 206-226, September.
    17. Chi-Hsuan Fan & Shih-Chieh Hsu & Fei-Hsiu Hsiao & Chia-Ming Chang & Chia-Yih Liu & Yu-Ming Lai & Yu-Ting Chen, 2021. "The Association of Social Support and Symptomatic Remission among Community-Dwelling Schizophrenia Patients: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(8), pages 1-14, April.
    18. Tami Saito & Naoki Kondo & Koichiro Shiba & Chiyoe Murata & Katsunori Kondo, 2018. "Income-based inequalities in caregiving time and depressive symptoms among older family caregivers under the Japanese long-term care insurance system: A cross-sectional analysis," PLOS ONE, Public Library of Science, vol. 13(3), pages 1-13, March.
    19. Rapp, Thomas & Grand, Alain & Cantet, Christelle & Andrieu, Sandrine & Coley, Nicola & Portet, Florence & Vellas, Bruno, 2011. "Public financial support receipt and non-medical resource utilization in Alzheimer's disease results from the PLASA study," Social Science & Medicine, Elsevier, vol. 72(8), pages 1310-1316, April.
    20. Boyoung Park & So Young Kim & Ji-Yeon Shin & Robert W Sanson-Fisher & Dong Wook Shin & Juhee Cho & Jong Hyock Park, 2013. "Suicidal Ideation and Suicide Attempts in Anxious or Depressed Family Caregivers of Patients with Cancer: A Nationwide Survey in Korea," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-7, April.
    21. Man-Man Peng & Hong-Lin Chen & Tin Zhang & Yong-You Yao & Zi-Han Li & Lan Long & Qing-Qing Duan & Fu-Rong Lin & Ya Zen & Jia Chen & Siu-Man Ng & Cecilia Lai-Wan Chan & Mao-Sheng Ran, 2019. "Disease-related stressors of caregiving burden among different types of family caregivers of persons with schizophrenia in rural China," International Journal of Social Psychiatry, , vol. 65(7-8), pages 603-614, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:259:y:2020:i:c:s0277953620303324. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.