Factors associated with family functioning among people with a diagnosis of schizophrenia and primary family caregivers
Authors: Hsiao Chiu‐Yueh , Lu Huei‐Lan , Tsai Yun‐Fang 
Published: January 2020

Accessible summaryWhat is known on the subject?

Families act not only as the primary support for people with a diagnosis of schizophrenia but also as partners in the healthcare system.

Families who have members with mental disorders, particularly schizophrenia, experience challenges in family functioning.

Research on families in relation to schizophrenia primarily focuses on the determinants that affect family functioning from primary family caregivers' perspectives.

What does the paper add to existing knowledge?

This report provides evidence that there is a concordance between family functioning and inpatient psychiatric rehabilitation facilities for the patient–caregiver dyad; both care‐receivers and primary family caregivers considered family functioning as poor.

Care‐receivers with lower education levels, increased number of previous hospitalizations and poor quality of family‐centred care experienced unhealthy family functioning.

Primary family caregivers and care‐receivers with higher education levels, lower suicidality and greater quality of family‐centred care experienced healthier family functioning.

What are the implications for practice?

Understanding the degree of family functioning, particularly its concordance and correlates as perceived by patients and primary family caregivers, may serve as a platform for inculcating assessment of family functioning to achieve holistic patient care.

Open dialogue in family‐focused care planning is essential to facilitate collaborative partnerships and improve family functioning among people with a diagnosis of schizophrenia and their primary family caregivers.

Further research on culturally relevant, evidence‐based family interventions to enhance the functioning of affected families is warranted, especially for families with members in inpatient psychiatric rehabilitation facilities.

AbstractIntroductionFamilies provide frontline caregiving support for people with a diagnosis of schizophrenia. However, research primarily addresses correlates of family functioning from primary family caregivers' perspectives.AimTo examine perceived family functioning, particularly its concordance within patient–caregiver dyads and associated factors in families of people living with schizophrenia.MethodsA cross‐sectional, descriptive correlational design was used. A total of 133 dyads of patients and primary family caregivers from inpatient psychiatric rehabilitation services participated. Descriptive statistics, independent‐sample t test, one‐way ANOVA, Pearson's correlation coefficients, intraclass correlation coefficient and stepwise multiple linear regression analyses were applied.ResultsFamily functioning was perceived as impaired by patient–caregiver dyads, and there existed a concordance in this regard. Patients' and family caregivers' education levels, patients' suicidality, number of previous hospitalizations and quality of family‐centred care correlated with patients' and primary family caregivers' family functioning.DiscussionFindings highlight the importance of patient‐ and family‐reported family functioning with implications to address individual and collective concerns.Implications for PracticeEvidence‐based family interventions are crucial for assisting vulnerable families in promoting family functioning. Mental health nurses should facilitate collaboration and open dialogue concerning perspectives of patients and families to improve delivery of comprehensive mental health care.