Strategies for coping with family members of patients with mental disorders

to identify the coping strategies of family members of patients with mental disorders and relate them to family member sociodemographic variables and to the patient's clinical variables.

Method:

this was a descriptive study conducted at a psychiatric hospital in the interior of the state of São Paulo, with 40 family members of hospitalized patients over the age of 18, and who followed the patient before and during hospitalization. We used tools to characterize the subjects and the Folkman and Lazarus Inventory of Coping Strategies.

Results:

the coping strategies most often used by family members were social support and problem solving. Mothers and fathers used more functional strategies (self-control p=0.037, positive reappraisal p=0.037, and social support p=0,021). We found no significant differences between the strategies and other variables examined.

Conclusion:

despite the suffering resulting from the illness of a dear one, family members make more use of functional strategies, allowing them to cope with adversities in a more well-adjusted way.

Descriptors:
Adaptation, Psychological; Psychiatric Nursing; Mental Disorders; Family Health

Authorship

Daniele Alcalá Pompeo

PhD, Adjunct Professor, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.Faculdade de Medicina de São José do Rio PretoBrazilSão José do Rio Preto, SP, BrazilPhD, Adjunct Professor, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil.

Arélica de Carvalho

Undegraduate student in Nursing, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil. Scholarship holder of the Scientific Initiation Program at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.Faculdade de Medicina de São José do Rio PretoBrazilSão José do Rio Preto, SP, BrazilUndegraduate student in Nursing, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil. Scholarship holder of the Scientific Initiation Program at the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.

Aline Morgado Olive

RN, student of the Obstetric Nursing of the Residency Program, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.Universidade de São PauloBrazilSão Paulo, SP, BrazilRN, student of the Obstetric Nursing of the Residency Program, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.

Maria da Graça Girade Souza

Sueli Aparecida Frari Galera

PhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.Universidade de São PauloBrazilRibeirão Preto, SP, BrazilPhD, Associate Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Corresponding Author: Daniele Alcalá Pompeo Faculdade de Medicina de São José do Rio Preto Departamento de Enfermagem Especializada Av. Brigadeiro Faria Lima, 5416 Vila São Pedro CEP: 15090-000, São José do Rio Preto, SP, Brasil E-mail: dalcala@eerp.usp.br/ daniele.pompeo@famerp.br

SCIMAGO INSTITUTIONS RANKINGS

Tables

Tables (3)

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Table 1
Mean scores of the coping strategies reported by family members of patients with mental disorders. São José do Rio Preto, SP, Brazil, 2013

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Table 2
Mean values of coping strategies mentioned by the family members of patients with mental disorders by sociodemographic variable. São José do Rio Preto, SP, Brazil, 2013

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Table 3
Mean values for FLICS factors among the caregivers of patients with mental disorders according to the clinical variables of the patient. São José do Rio Preto, SP, Brazil, 2013

Table 1 Mean scores of the coping strategies reported by family members of patients with mental disorders. São José do Rio Preto, SP, Brazil, 2013

Coping strategy	Mean score	Standard deviation	Median	Cronbach's alpha
Confrontation	0.69	0.92	0.50	0.44
Distancing	0.83	1.03	0.35	0.62
Self-control	1.10	1.10	0.80	0.47
Social support	1.66	1.09	1.66	0.66
Acceptance of responsibilities	1.09	1.02	0.85	0.70
Escape-avoidance	1.25	1.13	1.0	0.78
Problem solving	1.57	1.06	1.75	0.57
Positive reappraisal	1.42	1.14	1.44	0.79

Table 2 Mean values of coping strategies mentioned by the family members of patients with mental disorders by sociodemographic variable. São José do Rio Preto, SP, Brazil, 2013

Family member sociodemographic variables		Mean value of the factors in the Folkman and Lazarus Inventory of Coping Strategies
Family member sociodemographic variables		Confron-tation	Distancing	Self-control	Social support	Acceptance of responsibilities	Escape-avoi-dance	Problem solving	Positive reappraisal
Gender
	Male	0.72	0.75	1.01	1.53	1.00	0.95	1.37	1.48
	Female	0.77	0.93	1.19	1.78	1.16	1.55	1.81	1.33
	p-value*	0.903	0.310	0.391	0.349	0.355	0.093	0.093	0.532
Age group
	18 - 30	0.70	0.74	0.93	1.56	0.91	1.18	1.51	1.35
	31 - 59	0.67	0.84	1.19	1.66	1.17	1.17	1.67	1.42
	60 or over	1.29	1.24	1.30	1.99	1.35	1.87	1.50	1.55
	p-value^†	0.143	0.283	0.512	0.452	0.294	0.376	0.797	0.782
Years of schooling
	0 to 4	0.80	1.18	1.20	1.60	0.97	1.16	1.41	1.03
	5 to 9	0.68	0.65	0.90	1.66	0.99	1.40	1.57	1.34
	10 or more	0.76	0.83	1.15	1.66	1.15	1.20	1.64	1.53
	p-value^†	0.865	0.238	0.380	0.917	0.790	0.749	0.638	0.225
Income
	1 - 3	0.71	0.83	1.08	1.51	1.03	1.30	1.43	1.22
	4 - 7	0.83	0.93	1.05	2.02	1.24	1.21	1.96	1.86
	Does not know	0.79	0.76	1.28	1.93	1.13	1.00	1.95	1.81
	p-value^†	0.773	0.897	0.770	0.132	0.691	0.737	0.108	0.069
Has partner
	Yes	0.72	0.80	1.18	1.76	1.17	0.93	1.79	1.58
	No	0.77	0.88	1.00	1.52	0.98	1.64	1.34	1.19
	p-value*	0.611	0.622	0.502	0.539	0.234	0.056	0.055	0.134
Relationship with patient^‡
	Father or mother	1.02	1.05	1.71^§	2.21^§	1.32	0.93	1.96	1.91^§
	Son/Daughter	0.69	0.69	1.18^§\|\|	1.86^§\|\|	1.36	1.85	1.75	1.65^§\|\|
	Sibling	0.66	1.02	0.89^\|\|	1.27^\|\|	0.72	1.11	1.50	0.94^\|\|
	Other	0.70	0.72	0.87^§\|\|	1.47^§\|\|	0.99	1.07	1.35	1.28^§\|\|
	p-value^†	0.646	0.406	0.037	0.021	0.089	0.137	0.283	0.037

Mann-Whitney *p-value (<0.05); Kruskal-Wallis with Dunn Multiple Comparison test †p-value (P<0.05); ‡Different symbols in same column v differ significantly according to Dunn's Multiple Comparison Test (P<0.05) (§significant difference between || and §|| no significant difference between § and ||)

Table 3 Mean values for FLICS factors among the caregivers of patients with mental disorders according to the clinical variables of the patient. São José do Rio Preto, SP, Brazil, 2013

Patient clinical variables		Mean value of the factors in the Folkman and Lazarus Inventory of Coping Strategies
Patient clinical variables		Confron-tation	Distancing	Self-control	Social support	Acceptance of responsibilities	Escape-avoidance	Problem solving	Positive reappraisal
Patient disorder
	Schizophrenia	0.72	0.82	1.18	1.64	1.11	1.09	1.38	1.26
	ABD	0.81	0.92	1.12	1.72	1.13	1.43	1.68	1.58
	Depression	0.69	0.75	1.00	1.57	1.00	1.15	1.65	1.32
	p-value*	0.744	0.734	0.833	0.695	0.769	0.668	0.600	0.423
Disease duration
	30 days or less	0.66	0.35	0.80	1.33	0.67	1.00	1.31	1.36
	31 days - 3 years:	0.96	1.02	1.40	2.10	1.11	1.41	1.62	1.49
	4 to 10 years	0.58	0.85	1.45	1.78	1.49	0.75	1.75	1.57
	11 or more years	0.73	0.87	1.02	1.58	1.08	1.32	1.60	1.37
	p-value*	0.595	0.278	0.371	0.402	0.193	0.409	0.955	0.995
Psychotic symptoms
	Yes	0.77	0.89	1.14	1.56	1.01	1.50	1.37	1.38
	No	0.71	0.78	1.05	1.75	1.17	0.97	1.84	1.44
	p-value^†	0.631	0.594	0.733	0.480	0.513	0.095	0.052	0.828

*Value of P for the Kruskal-Wallis test with Dunn's Multiple Comparison Test (P<0.05); ^† Value of P for the Mann-Whitney Test (P<0.05).

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Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
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Strategies for coping with family members of patients with mental disorders

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[1] Corresponding Author: Daniele Alcalá Pompeo Faculdade de Medicina de São José do Rio Preto Departamento de Enfermagem Especializada Av. Brigadeiro Faria Lima, 5416 Vila São Pedro CEP: 15090-000, São José do Rio Preto, SP, Brasil E-mail: dalcala@eerp.usp.br/ daniele.pompeo@famerp.br