Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.

Background: Stuttering as a communication disorder can lead to serious problems in interpersonal communication and affect the quality of life of the affected person. Objectives: The aim of this study was to investigate the effectiveness of telehealth in improving its treatment and its effect on maintenance phase of stuttering children. Methods: In this study, all 6 - 12 year-old stuttering children referred to the Speech Therapy Center of Shahid Beheshti Hospital in 2018 were selected by purposeful sampling method and divided into two groups of experiment and control. Children were healthy and without any disorder. All 12 children received a three-month course of treatment with a speech and language pathologist (SLP) weekly one session. Maintenance phase included 8 sessions of 30 minutes over a period of six months. Results: Six children in the experimental group received maintenance phase training exercises by the SLP in the form of audio and video files through the WhatsApp software. Average total satisfaction rating (4.22) the lowest satisfaction score (3.16) highest score (5). According to the total score of the questionnaire,17% of the parents were satisfied at a low rate, 33% of parents were satisfied with the average and 50% of parents were very satisfied. Conclusions: In this study, the efficacy of telehealth on the maintenance phase of stuttering children has been evaluated. Results showed that telemedicine, with its ability to completely remove distance and travel as barriers for both patients and health care professionals is one option. Telemedicine can be a viable alternative to traditional in-person physician-based care for stuttering.

Background: Severe mental illnesses, such as schizophrenia and affective disorders, have considerable effects on the life of not only patients, but also their caregivers. Objective: The aim of this study was to develop a self-administered quality of life (QoL) questionnaire for the assessment of QoL in caregivers of patients with schizophrenia and affective disorders. Methods: Based on a mixed method approach and purposive sampling method, a sample consisting of 196 caregivers was recruited from 2 psychiatric hospitals in Tehran and Kerman, Iran, as well as a charity center in Kerman during 2015 -16. A 67-item questionnaire was developed in the qualitative phase of the study, consisting of semi-structured interviews with 45 caregivers, comments of an expert panel, and some items from other relevant questionnaires. The item reduction in the quantitative phase was based on item distribution, missing data per item, inter-item correlation, and factor analysis. The reliability coefficient (Cronbach's alpha) was calculated for all the dimensions. Convergent validity was assessed by Pearson's correlation coefficient test, and discriminant validity was analyzed, using student's t test and analysis of variance (ANOVA). Results: The final version of the questionnaire included 21 items and 7 dimensions: emotional burden (5 items); dealing with patient symptoms (3 items); relationship with the therapeutic team (3 items); relationship with family (2 items); financial burden (3 items); relationship with the extended family and friends (2 items); and latent worry (3 items). The 7 dimensions could explain 78.45% of the total variance. Item internal consistency was satisfactory for all the dimensions, ranging from 0.77 to 0.96 for each item. Cronbach's alpha coefficient ranged from 0.74 to 0.89 in the whole sample. The SAC-QoL index was significantly correlated with all the dimensions of the world health organization QoL-BREF (WHOQoL-BREF) scale (r, 0.32 -0.65). Also, the predefined hypotheses confirmed the discriminant validity (P < 0.01). Conclusions:The SAC-QoL questionnaire revealed acceptable psychometric properties. Therefore, it can be considered as a valid and reliable measure of QoL in caregivers of patients with schizophrenia and affective disorders. Moreover, it would be useful for clinicians and authorities to focus on caregivers who are primary providers of healthcare services.

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