Mediating effects of care burden and sense of coherence between patients' disabilities and siblings' emotions in psychotic disorders

Abstract

Aim: Care burden and sense of coherence (SOC) can facilitate an understanding of how family members interpret their caregiving experiences regarding a relative with psychosis. In informal caregiving, understanding siblings' experiences in this regard is necessary to mitigate negative emotions and strengthen positive ones. This study investigated whether care burden and SOC mediate the relationship between the disabilities of patients with psychosis and their siblings' emotions. Methods: A nationwide online survey was used to screen and recruit adult siblings of patients with psychotic disorders. The patients' disabilities in their work lives, socializing, and family communication, the siblings' care burden and SOC, and the siblings' positive and negative emotions were assessed. Structural equation modeling (SEM) was employed to test the path model that illustrated the mediating effects of care burden and SOC on patients' disabilities and siblings' emotions. Results: The sample included 237 siblings aged 42.3 years (mean) with a male-to-female ratio of 0.88 and 237 patients with schizophrenia (80.2%) or schizoaffective disorder (19.8%). In the SEM analyses, care burden connected each of the three disabilities with the two types of emotions through the pathways in which care burden positively predicted both negative and positive emotions. Additionally, SOC functioned as a mediator between disability in family communication and both types of emotions. Conclusion: Siblings' negative emotions should be alleviated through interventions aimed at suppressing the care burden and enhancing SOC to address disabilities in patients' socializing and family communication. Nevertheless, care burden might contribute to their positive emotions.