Feasibility of brief distress screening for family caregivers of adults diagnosed with schizophrenia in Changsha, Hunan, China

Abstract

What is known on the subject? Distress screening amongst FGs is emphasized in worldwide studies, but existing general tools were found time‐consuming and sometimes inconvenient when using them amongst FGs of patients diagnosed with schizophrenia. The DT, a single‐item scale, was widely used to detect distress amongst FGs of cancer patients, showing good reliability, validity and discrimination power. The 21‐item Depression Anxiety and Stress Scale (DASS21) can identify distress in the general population and serve as a criterion to determine an optimal cut‐off score of the DT. What does the paper add to existing knowledge? The DT presented good reliability, validity and discriminatory power amongst FGs of adults diagnosed with schizophrenia. A cut‐off score of six maximized sensitivity (77%) and specificity (76%). Over half of the FGs of adults diagnosed with schizophrenia reached this cut‐off score and experienced significant distress. Distress was higher in FGs of male patients, when FGs were parents, and for FGs whose educational background was primary school or below. What are the implications for practice? The DT is an effective alternative to existing instruments in identifying distressed FGs of adults diagnosed with schizophrenia. It is important to provide FGs with distress screening programmes and interventions (e.g. skill‐building psychoeducation) to identify and relieve distress. In addition, future research could explore brief measures to simultaneously recognize potential negative and positive impacts of caregiving in FGs.

Severity of illness and distress in caregivers of patients with schizophrenia: Do internalized stigma and caregiving burden mediate the relationship?

“…The DT is an 11‐point visual analogue scale to detect distress ranging from 0 (no distress) ‐10 (extreme distress), where participants are asked to check the number that best corresponds with their level of distress in the past seven days (Donovan et al., 2014). The Chinese version of DT has acceptable overall accuracy and reliability and a reported test–retest is 0.95 among family caregivers of persons living with schizophrenia (Guan et al 2020b).…”

“…Participants were also informed that they could withdraw from the study before data analysis and their relatives’ appointments with psychiatrists and treatment were not affected by their decision to participate or not participate at any stage of their involvement in the study. Family caregivers who were identified with high distress (the rating of Distress Thermometer was equal to and more than six) (Guan et al 2020b) were invited to have a further consultation with the psychiatrist in the research team after completing the questionnaire. They would be provided with suggestions in the consultation, concerning potential assessments and referrals in relevant departments.…”

“…The Chinese version of CBI also presented good reliability with a Cronbach alpha of 0.95 (Chou et al., 2002). The Chinese version of DT has acceptable overall accuracy and reliability and a reported test‐retest is 0.95 among family caregivers of persons living with schizophrenia (Guan et al 2020b).…”