The Perceived Burden Among Caregivers of Deinstitutionalized Patients with Severe Mental Illness in Malaysia’s Capital City: An Interviewer Administered Survey

Abstract

Abstract Background: Patients with severe mental illness often linked to a severe decline in social abilities due to disorganized behaviours depend entirely on primary caregivers. Nonetheless, without formal payment and visible reward, this force inclined into a caregiving position interfered with caregivers’ daily functions and psychological condition. Thus, our study aims to determine the prevalence of caregiver’s burden, psychological implications and associated predictors among the caregivers of severely mentally ill patients in Malaysia's capital city, Kuala Lumpur. Methods: An interviewer-administered, cross-sectional study was conducted within six months-period involving 149 primary caregivers from outpatient psychiatric units of tertiary hospitals in Kuala Lumpur, who were selected using the single-level cluster sampling technique. The caregiver burden and psychological implication were evaluated using the validated local version of the Zarit-load-Interview Score and the DASS-21. At the same time, the association with its predictors were analyzed with a logistic model. Results: The mean ZBI score was 31.69 ± 18.52, with 34.6% of participants experiencing caregiver burden; the majority (16.8%) suffered from a moderate burden. Anxiety is the participants' most prevalent psychological implication, accounting for 29.3%, depression at 22.1% and stress at 11.7%. Multivariate analysis indicated that the odds of experiencing burden were 29 times higher among those who concurrently have symptoms of depression, four times higher among male caregivers, and three times higher among those caring for schizophrenia patients. Being a spouse, nonetheless, reduced the risk of experiencing a burden by 84%. Conclusion: Results indicated a significant prevalence of burden among the caregiver of severely mental-ill patients in Kuala Lumpur, Malaysia. Among those who are male, concurrently have symptoms of depression, and provide care for schizophrenia patients are substantially associated with caregiving burden. Rigorous screening activity and support-need assessment focusing on high-risk groups are crucial. A national holistic support module and additional respite centre must be formed immediately. Without appropriate intervention, they will continue at risk of exposure to the complication of caregiver burden.