Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry
Abstract
:1. Introduction
Objective
2. Study Methods
2.1. Study Design
2.2. Study Population and Sample
2.3. Study Setting
2.4. Sampling and Sample Size
2.5. Inclusion Criteria
2.6. Exclusion Criteria
2.7. Recruitment of Study Participants
2.8. Data Collection
2.9. Data Analysis
2.10. Ethical Considerations
3. Findings
3.1. Characteristics of the Participants and Their Relatives
3.2. Findings of the Qualitative Data
3.3. Obligation to Care for a Mentally Ill Relative
“When my mother passed away, …there was no one to look after him. My sister and I therefore decided to share the custodianship of him” (a 45-year old female, caring for her brother), and “I have to suffer, he is my son. Who else can take someone’s burden?” (a 50-year old female, caring for her son).
3.4. Violent and Aggressive Behaviour
“If I have to open up to you, my son does assault me physically. He once slapped me on the face when I told him about his father’s absence in my life”. (50-year old female who cares for her son) and “One day during evening time he took a baby girl of his fellow church member and ran with her to the nearest river where he tried to drown her.” (a 50-year old female caring for her husband).
“I don’t think that it is always good to beat them, but the way we are stressed up leads to that situation”.
3.5. Concerns about the Safety of the Patient
“If he feels that he was not treated fairly, he goes out on the yard and looks for some place to hide. My yard is very big and full of scrap and many dangerous objects. He exposes himself to high risk of injury. Snakes, falling objects and sharp objects are a real risk” (25-year old male, caring for his brother).
“Sometimes she becomes so sad that she threatens to kill herself. She has already taken overdose of her psychiatric treatment and spent few days in a general hospital. She sometimes threatens to hang herself, citing that life is useless and thus what is the point of living.” (A 61-year old female, caring for her daughter) and “The first time she took an overdose of tablets. She was helped in Eugene Mare hospital. Counselling and everything were done. I thought it was over, she repeated the overdose of medication. I took her to the very same hospital and they helped her. They then referred me to Weskoppies” (49-year-old male, caring for his daughter).
3.6. Financial Difficulties Experienced by the Family
3.7. Emotional and Psychological Impact
3.8. Societal Stigma Directed to the Patient and the Family
“I even addressed the community ward meetings about his mental state so as to make every one aware and to help support us in our quest to get him well” (66-year old male, caring for his son).
3.9. The Expressed Need for Continuation of Institutional Care for the Mentally Ill
4. Discussion
5. Conclusions
- i.
- That community-based outreach teams, which are based in primary health clinics and offer basic extended services to patients in communities, assist family members who provide homecare for discharged patients to provide some support and referrals according to their needs.
- ii.
- Carefully planned follow-up schedules should be developed to enable the continuous assessment of discharged patients, which will allow for timely appropriate decision making to support the wellbeing of such patients and their families.
Author Contributions
Funding
Conflicts of Interest
References
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Mental Health Care User | Participants/Caregivers | |||
---|---|---|---|---|
Race | Frequency | Percentage | Frequency | Percentage |
African | 16 | 80 | 16 | 80 |
Indian | 1 | 5 | 1 | 5 |
Coloured | 1 | 5 | 1 | 5 |
White | 2 | 10 | 2 | 10 |
Marital status | Frequency | Percentage | Frequency | Percentage |
Single | 18 | 90 | 4 | 20 |
Married | 1 | 5 | 11 | 55 |
Divorced | 0 | 0 | 4 | 20 |
Widowed | 1 | 5 | 1 | 5 |
Gender | Frequency | Percentage | Frequency | percentage |
Males | 12 | 60 | 8 | 40 |
Females | 8 | 40 | 12 | 60 |
Age group | Frequency | Percentage | Frequency | percentage |
18–19 | 2 | 10 | 1 | 5 |
20–39 | 12 | 60 | 3 | 15 |
40–59 | 4 | 20 | 13 | 65 |
60–79 | 2 | 10 | 3 | 15 |
Employment status | Frequency | Percentage | Frequency | percentage |
Employed | 1 | 5 | 8 | 40 |
Unemployed | 19 | 95 | 12 | 60 |
Religion | Frequency | Percentage | Frequency | percentage |
Christianity | 15 | 75 | 15 | 75 |
Islam | 1 | 5 | 1 | 5 |
No religion | 1 | 5 | 1 | 5 |
African | 3 | 15 | 3 | 15 |
Level of education | Frequency | Percentage | Frequency | percentage |
No formal education | 4 | 20 | 0 | 0 |
Primary education | 8 | 40 | 9 | 45 |
Secondary education | 3 | 15 | 10 | 50 |
Tertiary education | 5 | 25 | 1 | 5 |
Period of mental illness in years | Frequency | Percentage | ||
0–10 | 10 | 50 | ||
11–20 | 4 | 20 | ||
21–30 | 2 | 10 | ||
31–40 | 3 | 15 | ||
>40 | 1 | 5 | ||
Relationship of the participant to the patient | Frequency | Percentage | ||
Parent | 7 | 35 | ||
Siblings | 9 | 45 | ||
Spouse | 1 | 5 | ||
Others | 3 | 15 |
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Mokwena, K.E.; Ngoveni, A. Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry. Int. J. Environ. Res. Public Health 2020, 17, 8440. https://doi.org/10.3390/ijerph17228440
Mokwena KE, Ngoveni A. Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry. International Journal of Environmental Research and Public Health. 2020; 17(22):8440. https://doi.org/10.3390/ijerph17228440
Chicago/Turabian StyleMokwena, Kebogile Elizabeth, and Amukelane Ngoveni. 2020. "Challenges of Providing Home Care for a Family Member with Serious Chronic Mental Illness: A Qualitative Enquiry" International Journal of Environmental Research and Public Health 17, no. 22: 8440. https://doi.org/10.3390/ijerph17228440