Download - INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH … 1021.pdf · Vasanth Kumar Kasturi, IJPRBS, 2015; Volume 4(2): 263-271 IJPRBS Available Online at 264 INTRODUCTION Mental illness

Research Article CODEN: IJPRNK ISSN: 2277-8713 Vasanth Kumar Kasturi, IJPRBS, 2015; Volume 4(2): 263-271 IJPRBS

Available Online at www.ijprbs.com 263

A STUDY TO ASSESS THE STRESS AND COPING AMONG CAREGIVERS OF

MENTALLY ILL PATIENTS IN SVRRGGH, TIRUPATI.

VASANTH KUMAR KASTURI, BHAGYALAKSHMI M, HEMALATHA S

Department of Psychiatric (Mental Health) Nursing, College of Nursing, SVIMS, Tirupati, Andhra Pradesh

Accepted Date: 09/04/2015; Published Date: 27/04/2015

Abstract: Introduction: Care of mentally ill patients is an enduring stress and leads to considerable

amount of stress among caregivers. Little is known about the ways in which caregivers cope while

caring for a relative with mental illness in developing countries. Aim: The aim of the present study was

to assess the stress and coping among caregivers of mentally ill patients in SVRRGGH, Tirupati. Method:

the stress was measured my Cohen perceived stress scale and coping was measured by brief cope scale.

Results: A total number of 100 samples was taken for study, among 24 % had mild stress levels,

majority 52% had moderate stress levels and 24% had severe stress levels , for coping levels among 100

caregivers, 24% had inadequate, 52% had adequate, 24% had adequate respectively. There was a

statistical significant relationship between stress with caregivers variables like Education, Residence,

and Relationship to patient at p<0.01, Occupation and Income at p<0.05 Level. There was a statistical

significant relationship between coping with caregivers variables like Marital status, Education,

Occupation, Residence, Monthly and Income at p<0.01, Age in years and Relationship to patient at

p<0.05 Level. Moreover there was a high negative correlation between stress and coping i.e. -0.82 and

correlation was significant at the p<0.01 level. It is concluded that: Caregivers experienced 24% of High

stress levels and 24% were inadequate coping levels. Recommendation: Psycho educational program is

needed to assist caregivers cope successfully with stress resulting from the care of mentally ill patients.

Keywords: Stress, Coping, Mentally ill.

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Vasanth Kumar Kasturi, IJPRBS, 2015; Volume 4(2): 263-271



INTRODUCTION

Mental illness can be defined as a clinical, significant, behavioral or psychological syndrome

that occurs in a person and this is normally associated with impairment in one or more

important areas in functioning, or an important loss of freedom.1 The society views the mental

illness as something to be ashamed of and usually the members of the society initially recognize

most of the mentally ill patients behavior deviated from the social norms.2

In such a stage the families play an important role in caring of these mentally ill patients even

though the family members of the mentally ill patients are less likely to label the individuals

behavior as mental illness. The core concept of the care giving consists of accepting the patient,

encouraging and supporting the patient and assist in the daily activities of the patient.3

Caregiver is an individual who has the responsibility of meeting the physical and psychological

needs of the dependent patient. Psychiatric patients need assistance or supervision in their

daily activities and this often places a major burden on their caregivers, thereby placing the

caregiver at a great risk of mental and physical health problems. The diagnosis of a person with

a mental illness makes the care givers initially denial, which is sometimes expressed by anger

and they are looking for a lot of coping methods to cope and adjust with these situations.

Coping with stress is one of the biggest health concerns and its effect can be different from one

person to another. Stress is primarily a process of motivation since it requires some sort of

adaptation (coping) to the demand or set of demands. The effect of stress is directly linked to

coping.4

Stress is an organism’s total response to environmental demands or pressure. The cause of

stress can include any event or occurrence that a person considers a threat to his or her coping

strategies or resources and coping is a complex process. It is variously described as a situational

and as a trait-like response to stress and as a disposition to respond to change.5

A study was conducted in religious practices by chronic mentally ill patient and their care givers

they are living in south India. Persons with mental illness and their care givers were interviewed

at religious sites using a guided questionnaire. The result of the study shows that-seeking

religious help for mental illness is often a first and common step in which most of the care

givers are adopting to cope with the burden.6

A study was conducted in USA to find out the associated stages with adaptive use of coping

methods by Primary Care Givers total of 225 Primary care givers of mentally ill patients were

participated in the study. The result of the study highlighted that more extensive adaptive

coping was associated with increased social support (as measured by the density of the social

network) and with a greater sense of self efficiency in dealing with the illness of the patient.7



OBJECTIVES

To assess the level of stress and Coping among caregivers of mentally ill patients

To assess the level of Coping among caregivers of mentally ill patients

To associate the level of stress and coping among caregivers of mentally ill patients with

selected demographic variables.

To correlate the relationship between level of stress and coping among caregivers of

mentally ill patients.

Materials and methods:

Research approach: Quantitative research approach was adopted for the present study.

Research design: cross sectional descriptive research design was adopted for the study.

Variables of the study:

Independent variable: Mentally ill Patients

Dependent variables: Stress and Coping of caregivers

Extraneous Variables: Age, Gender, Occupation, Education, Income, etc.

Setting: The study was conducted at psychiatry ward, SVRRGGH, Tirupati. The reason for

selected this hospital for the study because, this is the only one Government district hospital

though out this Rayalaseema area. Moreover, daily 50 to 60 outpatients come for checkup

daily. The setting was chosen on the basis of investigator feasibility in terms of availability of

required sample and cooperation extended by the management and health personnel.

Population: The population includes caregivers of mentally ill patients

Sample: Caregivers of mentally ill patients

Sample Size: consists of 100 caregivers who fall under inclusion criteria.

Sampling technique: As the selection of samples depends on availability of the sample, a

convenient sampling technique was adopted based on inclusion criteria. Description of the

research tool

Development and description of the tool:



The tool was developed with the help of related literature from various text books, journals,

web sites, discussion and guidance from the experts in the field of nursing and psychiatric

nursing.

The tool consists of 3 sections.

Section-I: consists of questions to collect demographic data.

Section II: Cohen Perceived Stress

Section-III: Brief Coping

Plan for data analysis:

Analysis of data was done by using descriptive and inferential statistics.

Descriptive statistics were used to find out:

Frequency, Percentage, Mean, Standard Deviation

Inferential statistics were used to find out:

Chi-square, Correlation

Results:

Level of Stress among Caregivers of mentally ill patients

The above Fig-1 illustrate that among 100 Caregivers 24% had mild stress, 52% had moderate

stress and 24% had severe stress levels

[VALUE]%

[VALUE]%

[VALUE]%

0 10 20 30 40 50 60

Inadequate Stress

Moderate Stress

Adequate Stress

Stress Levels



Level of Coping among Caregivers of mentally ill patients

The above Fig-2 Depicts that among 100 Caregivers 24% had mild coping, 52% had moderate

coping and 24% had severe stress coping

Table 1. Frequency and percentage distribution of association between the caregiver’s

demographic variables and stress levels of caregivers of mentally ill patients

Areas of Stress (Demographic Variables)

n

Mean

SD

df

X2

p

Education Illiterate Primary Education Secondary Education Intermediate Graduate Post Graduate

35 17 23 09 15 1

58.43 43.24 41.30 36.39 22.83 25.00

25.140 18.849 25.438 27.218 19.818 26.188

10

28.000

0.002**

Occupation Home Maker Unemployee Coolie Private Employee Government Employee Retired Others

10 3 33 14 5 1 34

43.50 20.83 56.29 29.11 29.50 75.00 42.35

26.066 5.774 25.040 26.010 31.245 22.796 26.188

12

24.879

0.015*

Residence Rural Urban

67 33

52.35 27.80

25.428 19.282

2

14.414

0.001**

24%

52%

24%

0

20

40

60

Coping Levels

Inadequate Coping Moderate Coping Adequate Coping



Monthly Income <3000 3001-6000 6001-10000 >10000

22 28 41 9

37.27 57.41 41.40 33.33

22.677 23.079 26.328 30.949

6

15.071

0.020*

Relationship to Patient Spouse Parent Children Sister Brother Others

39 30 10 8 6 7

39.94 54.17 57.25 25.94 24.58 45.00

21.077 25.859 33.280 16.143 27.451 30.788

10

29.566

0.001**

Table 1. Depicts that there was a statistical significant association between some of the

demographic variables and Stress Levels like Education, Residence, and Relationship to patient

at p<0.01, Occupation and Income at p<0.05 Level

Table 2. Shows the association between the demographic variables and coping levels of

caregivers of mentally ill patients

S. No Demographic Variables Chi-Square Test (χ2) df p

1 Age in Years 14.658 6 0.023

2 Marital Status 27.079 4 0.000

3 Education 47.638 10 0.000

4 Occupation 39.499 12 0.000

5 Residence 21.604 2 0.000

6 Monthly Income 19.824 6 0.003

7 Relationship to Patient 21.085 10 0.021

Table 2. Illustrate that there was a statistical significant association between some of the

demographic variables and coping Levels like Marital status, Education, Occupation, Residence,

Monthly and Income at p<0.01, Age in years and Relationship to patient at p<0.05 Level

Table-3: Mean standard deviation and correlation between stress and coping among

caregivers of mentally ill patients

S. No Scale Mean Standard Deviation Correlation p

1 Stress 44.25 26.188 -0.823

0.000 2 Coping 56.30 20.400



Table 3 depicts Stress Mean and Standard Deviation values was, 44.25 and 26.188. Coping

Mean and Standard Deviation values was, 56.30 and 20.400 respectively. There was statistically

High Significant Negative Correlation (r= -0.823), (p<0.01) exists between stress and coping

among caregivers of mentally ill patients.

Graph 1: Shows the correlation between the Stress and Coping of caregivers of mentally ill

patients

From above Graph 1, there is Statistically High Negative Correlation between Stress & Coping

DISCUSSION

The first objective of the study was to assess the Stress and Coping among the caregivers of

mentally ill patients, out of 100 Caregivers 24% had mild stress, 52% had moderate stress and

24% had severe stress levels. The present study finding were supported by the study conducted

by Nabanita Barman, Pushpita Chakravortty, Majority of the family members (56%) had

moderate level of stress while 22% family members had severe stress and the remaining 22%

family members had mild stress, (8)

The second objective of the study was to assess the Coping levels among the caregivers of

mentally ill patients. Out of 100 Caregivers 24% had mild coping, 52% had moderate coping and

24% had severe stress coping. The present study finding were supported by the study

conducted by Binil V (2008) conducted a correlative study to assess burden and coping

strategies among the caregivers of patients with affective disorders in Kasturba Hospital and

A.V Baliga Hospital, Karnataka which contradicts the findings of the present study. Out of 100

caregivers, 32 % of caregivers were found to be using medium coping and 68 % were using high

coping. Mean percentage score was highest ie 86% in the area of planning. Lowest mean

percentage score i.e. 34% was in humor, substance use and behavioral disengagement. (9)

0

20

40

60

80

100

120

0 20 40 60 80 100 120

Stre

ss

Coping



The third objective of the study was to associate the level of stress and coping among

caregivers of mentally ill patients with selected demographic variables. Related to stress, there

was a statistical significant association between some of the demographic variables and Stress

Levels like Education, Residence, and Relationship to patient at p<0.01, Occupation and Income

at p<0.05 Level. For coping, there was a statistical significant association between some of the

demographic variables and coping Levels like Marital status, Education, Occupation, Residence,

Monthly and Income at p<0.01, Age in years and Relationship to patient at p<0.05 Level. The

present study finding were supported by the study conducted by Clare. C. Pratt, et al (1985)

Two hundred forty subjects were surveyed. Differences in burden scores were not significantly

affected by caregivers' age, sex, income, education, or patient residence (i.e., community

dwellings, institutions). However, burden scores were significantly related to caregivers' health

status. Also burden scores were not significantly related to presence of confidant or support

group membership. Three internal coping strategies (confidence in problem-solving, reframing

the problem, and passivity) and two external coping strategies (spiritual support and extended

family) were found to be significantly related to caregiver burden scores. (10)

The fourth objective of the study was to correlate the relationship between level of stress and

coping among caregivers of mentally ill patients. Stress Mean and Standard Deviation values

was, 44.25 and 26.188. Coping Mean and Standard Deviation values was, 56.30 and 20.400

respectively. There was statistically High Significant Negative Correlation (r= -0.823), (p<0.01)

exists between stress and coping among caregivers of mentally ill patients. The present study

was supported by Rammohan A, Rao K, Subbakrishna DK (2002), Mean total burden

experienced by the spouses (70) is more than the parents (65.4). Spouses reported greater

emotional burden (17.88). Parents used more of denial as a coping strategy, while spouses

more of negative distraction strategies. Patient’s age, educational level, caregiver’s use of

denial as a coping strategy emerged as significant predictors of caregiver burden. The study

highlights the fact that family intervention programs need to address the specific concerns of

caregivers. (11)

CONCLUSION

In the present study, it has been observed that all the family members of mentally ill clients had

certain level of stress. It shows that among 100 caregivers 24% were having sever stress and

24% were having inadequate coping skills, even more present study demonstrated that there is

a significant relationship between the caregivers stress and coping levels with caregivers

demographic variable like Education, Residence, Relationship to patient, Occupation and

Income. Moreover the study revealed that there is a high negative correlation between stress

and coping of caregivers of mentally ill patients. Awareness programme on mental health and

mental illness and education package on different techniques of stress management & coping



strategies for caregivers of mentally ill patients, other professionals are recommended to

reduce stress level and a better coping strategies for the caregivers and community at large

REFERENCE

1. Denise.F. Polit and Cheryl Tatano Beck, (2004 ) “Nursing Research” Lippincott Willians and

Wilkins, Philadelphia, 7th edition, P .No.587,661

2. Jugbauer.J (2006) “Stress of family care givers of psychiatric patients” Abstract retrieved

from pub med database on 17.12,10 PMID: 11407252.

3. Kaplan HI and Sedock BJ, (2000), “Comprehensive text book of Psychiatry”, Lippincott

Williams and Wilkins, Philadelphia, 7th edition, P .No.2587-2613.

4. Stress and coping, by Fumi O. Naughton (spring 1997), California State University,

Northridge.

5. Larry E. Beutler, Rudolf H. Moos (2003), ‘Coping and coping styles in personality and

treatment planning: Introduction to the special series’. Journal of Clinical Psychology, 59 (10):

1045-1047.

6. Lefley HP (2007) “Aging parents as caregivers of mentally ill adult children: an emerging

social problem”. Abstract retrieved from pub med database on 17.12,10, PMID: 3666695.

7. www.amazon.com

8. http://dysphrenia.hpage.co.in/a_descriptive_study_to_assess_the_level_of_stress_among_

family_members_of_selected_mentally_ill_clients_attending_psychiatry_opd_of_a_tertiary_ca

re_teaching_hospital_99184934.html

9. Binil V .A correlative study of burden and coping strategies among the caregivers of patients

with affective disorders in selected hospitals of Udupi district, Karnataka. [M.Sc. thesis].August

2008.Manipal: Maniple University

10. Clare. C. Pratt, et al. Burden and coping strategies of caregivers of Alzheimer’s patients, Vol.

34, No. 1, Jan., 1985

11. Rammohan A, Rao K, Subbakrishna DK. Burden and coping in caregivers of person with

schizophrenia. Indian Journal of Psychiatry 2002; 44:220 -27.

http://www.ncbi.nlm.nih.gov/pubmed?term=%22Lefley%20HP%22%5BAuthor%5D

http://www.amazon.com/

http://dysphrenia.hpage.co.in/a_descriptive_study_to_assess_the_level_of_stress_among_family_members_of_selected_mentally_ill_clients_attending_psychiatry_opd_of_a_tertiary_care_teaching_hospital_99184934.html



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http://www.jstor.org/stable/10.2307/i224685