Estratégias de enfrentamentos e sobrecarga dos familiares cuidadores de pacientes psiquiátricos: revisão de literatura
DOI:
https://doi.org/10.24879/20150090010026Resumo
A desinstitucionalização psiquiátrica resultou em maior responsabilidade dos familiares no cuidado informal dos pacientes, o que pode resultar em elevada sobrecarga para estes cuidadores. Essa sobrecarga pode ser diminuída com o uso de estratégias eficazes de enfrentamento, segundo o modelo teórico da sobrecarga. Foi realizada uma busca sistemática nos indexadores SciELO, LILACS, Pubmed, Web of Science e PsycINFO, sendo encontrados 36 estudos internacionais que avaliaram a relação entre coping e sobrecarga dos familiares cuidadores. Os resultados indicaram que os familiares utilizam uma diversidade de estratégias de enfrentamento, mas, em geral, elas não estão associadas a um menor grau de sobrecarga. As estratégias de evitação e de resignação estão claramente associadas a um maior grau de sobrecarga, devendo, portanto, ser evitadas.Downloads
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Referências
Antoniazzi, A. S., Dell’aglio, D. D., & Bandeira, D.
R. (1998). O conceito de coping: Uma revisão
teórica. Estudos de Psicologia, 3(2), 273-294.
Awad, A. G., & Voruganti, L. N. P. (2008). The
Burden of Schizophrenia on Caregivers. A
Review. Pharmacoeconomics, 26, 149-162. doi:
10.2165/00019053-200826020-00005
Bandeira, M. (1991). Desinstitucionalização ou
transinstitucionalização: Lições de alguns países.
Jornal Brasileiro de Psiquiatria, 40(7), 350-360.
Bandeira, M., & Barroso, S. M. (2005). Sobrecarga
das famílias de pacientes psiquiátricos. Jornal
Brasileiro de Psiquiatria, 54(1), 34-46.
Bandeira, M., Gelinas D., & Lesage A. (1998).
Desinstitucionalização: O programa de
acompanhamento intensivo na comunidade.
Jornal Brasileiro de Psiquiatria, 47(12), 627-640.
Barroso, S., Bandeira, M., & Nascimento, E. (2009).
Fatores preditores da sobrecarga subjetiva de
familiares de pacientes psiquiátricos atendidos na
rede pública de Belo Horizonte, Minas Gerais,
Brasil. Caderno de Saúde Pública, 25(9), 1957-1968.
Bauer, R., Koepke, F., Sterzinger, L., & Spiessl, H.
(2012). Burden, rewards, and coping – The
ups and downs of caregivers of people with
mental illness. Journal of Nervous and Mental
Disease, 200(11), 928-934. doi: 10.1097/
NMD.0b013e31827189b1.
Budd, R. J., Oles, G., & Hughes, I. C. (1998). The
relationship between coping style and burden in
the carers of relatives with schizophrenia. Acta
Psychiatrica Scandinavica, 98(4), 304-309.
Chadda, R. K., Singh T. B., & Ganguly, K. K. (2007).
Caregiver burden and coping: A prospective study
of relationship between burden and coping in
caregivers of patients with schizophrenia and
bipolar affective disorder. Social Psychiatry and
Psychiatric Epidemiology, 42(11), 923-930. doi:
10.1007/s00127-007-0242-8
Chakrabarti, S., & Gill, S. (2002). Coping and
its correlates among caregivers of patients with
bipolar disorder: a preliminary study. Bipolar
Disorders, 4, 50-60. doi: 10.1034/j.1399-
5618.2002.01167.xChandrasekaran, R., Sivaprakash B., & Jayestri, S.
R. (2002). Coping strategies of the relatives of
schizophrenic patients. Indian Journal of Psychiatry,
44(1), 9-13.
Creado, D. A., Parkar, S. R., & Kamath, R. M.
(2006). A comparison of the level of functioning
in chronic schizophrenia with coping and burden
in caregivers. Indian Journal of Psychiatry, 48(1),
27-33. doi: 10.4103/0019-5545.31615
Dyck, D. G., Short, R., & Vitaliano, P. P. (1999).
Predictors of Burden and Infectious Illness in
Schizophrenia Caregivers. Psychosomatic Medicine,
61, 411-419.
Gonçalves-Pereira, M., Xavier, X., Wijngaarden,
B. van, Papoila, A. L. Schene, A. H, & Caldasde-Almeida,
J. M. (2013). Impact of psychosis
on Portuguese caregivers: A cross-cultural
exploration of burden, distress, positive aspects
and clinical-functional correlates. Social Psychiatry
and Psychiatric Epidemiology, 48, 325-335. doi:
10.1007/s00127-012-0516-7
Goossens, P. J. J., Wijngaarden, B. van, KnoppertVan
der Klein, E. A. M., & Achterberg, T. Van
(2008). Family Caregiving in Bipolar Disorder:
Caregiver Consequences, Caregiver Coping.
International Journal of Social Psychiatry, 54, 303-
316. doi: 10.1177/0020764008090284
Grandón, P., Jenaro C., & Lemos, S. (2008). Primary
caregivers of schizophrenia outpatients: Burden
and predictor variables. Psychiatry Research, 158,
335-343. doi: 10.1016/j.psychres.2006.12.013
Hanzawa, S., Bae, J., Tanaka, H., Bae, Y., Tanaka,
G., Inadomi, H. , ... Ohta, Y. (2010). Caregiver
burden and coping strategies for patients with
schizophrenia: Comparison between Japan and
Korea. Psychiatry and Clinical Neurosciences,64, 377-
386. doi: 10.1111/j.1440-1819.2010.02104.x
Hanzawa, S., Tanaka, G., Inadomi, H., Urata, M., &
Ohta, Y. (2008). Burden and coping strategies in
mothers of patients with schizophrenia in Japan.
Psychiatry and Clinical Neurosciences, 62, 256-263.
doi: 10.1111/j.1440-1819.2008.01791.x
Hassan, W. A. N., Mohamed, I. I., Elnaser, A. E.
A., & Sayed, N. E. (2011). Burden and coping
strategies in caregivers of schizophrenic patients.
Journal of American Science, 7(5), 802-811.
Hinrichsen, G. A., & Lieberman, J. A. (1999).
Family attributions and coping in the prediction
of emotional adjustment in family members of
patients with firs t-episode schizophrenia. Acta
Psychiatrica Scandinavica, 100, 359-366. doi:
10.1111/j.1600-0447.1999.tb10879.x
Hobbs, T. R. (1997). Depression in the Caregiving
Mothers of Adult Schizophrenics: A Test of the
Resource Deterioration Model. Community
Mental Health Journal, 33, 387-99. doi:
10.1023/A:1025070402153
Jagannathan, A., Thirthalli, J., Hamza, A., Nagendra,
H. R., & Gangadhar, B. N. (2014). Predictors
of family caregiver burden in schizophrenia:
Study from an in-patient tertiary care hospital
in India. Asian Journal of Psychiatry, 8, 94-98.
doi: 10.1016/j.ajp.2013.12.018
Kate, H., Grover, S., Kulhara, P., & Nehra, R.
(2013). Relationship of caregiver burden with
coping strategies, social support, psychological
morbidity, and quality of life in the caregivers of
schizophrenia. Asian Journal of Psychiatry, 6, 380-
388. doi: 10.1016/j.ajp.2013.03.014
Kung, W. W. (2003). The illness, stigma, culture
or immigration? Burdens of Chinese American
caregivers of patients with schizophrenia. Families
in Society, 84(4), 547-557.
Lim, Y. M., & Ahn, Y. (2003). Burden of Family
Caregivers With Schizophrenic Patients in Korea.
Applied Nursing Research, 16, 110-117. doi:
10.1016/S0897-1897(03)00007-7
Loukissa, A. D. (1995). Family burden in chronic
mental illness: A review of research studies. Journal
of Advanced Nursin, 21, 248-255.
Magliano, L., Fadden, G., Economou, M., Held,
T., Xavier M., Guarneri, M., ... Maj, M.
(2000). Family burden and coping strategies
in schizophrenia: 1-year follow-up data from
the BIOMED I study. Social Psychiatry and
Psychiatric Epidemiology, 35, 109-115. doi:
10.1007/s001270050192
Magliano, L., Fadden, G., Madianos, M., Almeida, J.
M. C., Held, T., Guarneri M., ... Maj, M. (1998a).
Burden on the families of patients with schizophrenia:
results of the BIOMED I study. Social Psychiatry and
Psychiatric Epidemiology, 33, 405-12. doi: 10.1007/
s001270050073
Magliano, L., Fadden, G., Economou, M., Xavier,
M., Held, T., Guarneci, M., ... Maj, M. (1998b).
Social and clinical factors influencing the choice
of coping strategies in relatives of patients with
schizophrenia. Social Psychiatry and Psychiatric
Epidemiology, 33, 413-9. doi: 10.1007/
s001270050074Magliano, L., Guarneri, M., Marasco, C., Tosini,
P., Morosini, P. L., & Maj, M. (1996). A new
questionnaire assessing coping strategies in relatives
of patients with schizophrenia: development and
factor analysis. Acta Psychiatrica Scandinavica,
94, 224-228. doi: 10.1111/j.1600-0447.1996.
tb09853.x
Maurin, J. T., & Boyd, C. B. (1990). Burden of
mental illness on the family: A critical review.
Archives of Psychiatric Nursing, 4(2), 99-107.
Moller-Leimkuhler, A. M. (2005). Burden of relatives
and predictors of burden. Baseline results from
the Munich 5-year-follow-up study on relatives
of first hospitalized patients with schizophrenia
or depression. European Archives of Psychiatry
and Clinical Neurosciences, 255, 223-231. doi:
10.1007/s00406-004-0550-x
Moller-Leimkuhler, A. M. (2006). Multivariate
prediction of relatives’ stress outcome one year
after first hospitalization of schizophrenic and
depressed patients. European Archives of Psychiatry
and Clinical Neurosciences, 256, 122-130. doi:
10.1007/s00406-005-0619-1
Moller-Leimkuhler, A. M., & Obermeier, M. (2008).
Predicting caregiver burden in first admission
psychiatric patients. 2-year follow-up results.
European Archives of Psychiatry and Clinical
Neurosciences, 258, 406-413. doi: 10.1007/
s00406-008-0818-7
Moller-Leimkuhler, A. M., & Wiesheu, A. (2012).
Caregiver burden in chronic mental illness: the role
of patient and caregiver characteristics. European
Archives of Psychiatry and Clinical Neurosciences,
262, 157-166. doi: 10.1007/s00406-011-0215-5
Nehra, R., Chakrabarti, S., Kulhara, P., & Sharma, R.
(2005). Caregiver-coping in bipolar disorder and
schizophrenia: A re-examination. Social Psychiatry
and Psychiatric Epidemiology, 40, 329-336. doi:
10.1007/s00127-005-0884-3
Organização Mundial de Saúde – OMS. (2001).
Relatório Mundial da Saúde. Saúde mental: nova
concepção, nova esperança. Lisboa: Divisão de
Saúde Mental da OMS.
Ostman, M., & Hansson, L. (2001). The relationship
between coping strategies and family burden
among relatives of admitted psychiatric patients.
Scandinavian Journal of Caring Sciences, 15, 159-
164. doi: 0.1046/j.1471-6712.2001.00020.x
Pai, S., & Kapur, R. L. (1981). The burden on the
family of a psychiatric patient: development of an
assessment scale. British Journal of Psychiatry, 138,
332-335.
Panzini, R. G., & Bandeira, D. R. (2007). Coping
(enfrentamento) religioso/espiritual. Revista de
Psiquiatria Clínica, 34, 126-135. doi: 10.1590/
S0101-60832007000700016
Patrick, J. H., & Hayden, J. M. (1999). Neuroticism,
coping strategies, and negative well-being among
caregivers. Psychology and Aging, 4(2), 273-83. doi:
10.1037//0882-7974.14.2.273
Perlick, D. A., Rosenheck, R. A., Miklowitz, D. J.,
Kaczynski, R., Link, B., & Ketter, T. (2008).
Caregiver burden and health in bipolar disorder:
A cluster analytic approach. The Journal of Nervous
and Mental Disease, 196, 484-491. doi: 10.1097/
NMD.0b013e3181773927
Rammohan, A., Rao, K., & Subbakrishna, D. K.
(2002a). Burden and coping in caregivers of
persons with schizophrenia. Indian Journal of
Psychiatry, 44(3), 220-227.
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(2002b). Religious coping and psychological wellbeing
in carers of relatives with schizophrenia.
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10.1034/j.1600-0447.2002.1o149.x
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teórica. Estudos de Psicologia, 3(2), 273-294.
Awad, A. G., & Voruganti, L. N. P. (2008). The
Burden of Schizophrenia on Caregivers. A
Review. Pharmacoeconomics, 26, 149-162. doi:
10.2165/00019053-200826020-00005
Bandeira, M. (1991). Desinstitucionalização ou
transinstitucionalização: Lições de alguns países.
Jornal Brasileiro de Psiquiatria, 40(7), 350-360.
Bandeira, M., & Barroso, S. M. (2005). Sobrecarga
das famílias de pacientes psiquiátricos. Jornal
Brasileiro de Psiquiatria, 54(1), 34-46.
Bandeira, M., Gelinas D., & Lesage A. (1998).
Desinstitucionalização: O programa de
acompanhamento intensivo na comunidade.
Jornal Brasileiro de Psiquiatria, 47(12), 627-640.
Barroso, S., Bandeira, M., & Nascimento, E. (2009).
Fatores preditores da sobrecarga subjetiva de
familiares de pacientes psiquiátricos atendidos na
rede pública de Belo Horizonte, Minas Gerais,
Brasil. Caderno de Saúde Pública, 25(9), 1957-1968.
Bauer, R., Koepke, F., Sterzinger, L., & Spiessl, H.
(2012). Burden, rewards, and coping – The
ups and downs of caregivers of people with
mental illness. Journal of Nervous and Mental
Disease, 200(11), 928-934. doi: 10.1097/
NMD.0b013e31827189b1.
Budd, R. J., Oles, G., & Hughes, I. C. (1998). The
relationship between coping style and burden in
the carers of relatives with schizophrenia. Acta
Psychiatrica Scandinavica, 98(4), 304-309.
Chadda, R. K., Singh T. B., & Ganguly, K. K. (2007).
Caregiver burden and coping: A prospective study
of relationship between burden and coping in
caregivers of patients with schizophrenia and
bipolar affective disorder. Social Psychiatry and
Psychiatric Epidemiology, 42(11), 923-930. doi:
10.1007/s00127-007-0242-8
Chakrabarti, S., & Gill, S. (2002). Coping and
its correlates among caregivers of patients with
bipolar disorder: a preliminary study. Bipolar
Disorders, 4, 50-60. doi: 10.1034/j.1399-
5618.2002.01167.xChandrasekaran, R., Sivaprakash B., & Jayestri, S.
R. (2002). Coping strategies of the relatives of
schizophrenic patients. Indian Journal of Psychiatry,
44(1), 9-13.
Creado, D. A., Parkar, S. R., & Kamath, R. M.
(2006). A comparison of the level of functioning
in chronic schizophrenia with coping and burden
in caregivers. Indian Journal of Psychiatry, 48(1),
27-33. doi: 10.4103/0019-5545.31615
Dyck, D. G., Short, R., & Vitaliano, P. P. (1999).
Predictors of Burden and Infectious Illness in
Schizophrenia Caregivers. Psychosomatic Medicine,
61, 411-419.
Gonçalves-Pereira, M., Xavier, X., Wijngaarden,
B. van, Papoila, A. L. Schene, A. H, & Caldasde-Almeida,
J. M. (2013). Impact of psychosis
on Portuguese caregivers: A cross-cultural
exploration of burden, distress, positive aspects
and clinical-functional correlates. Social Psychiatry
and Psychiatric Epidemiology, 48, 325-335. doi:
10.1007/s00127-012-0516-7
Goossens, P. J. J., Wijngaarden, B. van, KnoppertVan
der Klein, E. A. M., & Achterberg, T. Van
(2008). Family Caregiving in Bipolar Disorder:
Caregiver Consequences, Caregiver Coping.
International Journal of Social Psychiatry, 54, 303-
316. doi: 10.1177/0020764008090284
Grandón, P., Jenaro C., & Lemos, S. (2008). Primary
caregivers of schizophrenia outpatients: Burden
and predictor variables. Psychiatry Research, 158,
335-343. doi: 10.1016/j.psychres.2006.12.013
Hanzawa, S., Bae, J., Tanaka, H., Bae, Y., Tanaka,
G., Inadomi, H. , ... Ohta, Y. (2010). Caregiver
burden and coping strategies for patients with
schizophrenia: Comparison between Japan and
Korea. Psychiatry and Clinical Neurosciences,64, 377-
386. doi: 10.1111/j.1440-1819.2010.02104.x
Hanzawa, S., Tanaka, G., Inadomi, H., Urata, M., &
Ohta, Y. (2008). Burden and coping strategies in
mothers of patients with schizophrenia in Japan.
Psychiatry and Clinical Neurosciences, 62, 256-263.
doi: 10.1111/j.1440-1819.2008.01791.x
Hassan, W. A. N., Mohamed, I. I., Elnaser, A. E.
A., & Sayed, N. E. (2011). Burden and coping
strategies in caregivers of schizophrenic patients.
Journal of American Science, 7(5), 802-811.
Hinrichsen, G. A., & Lieberman, J. A. (1999).
Family attributions and coping in the prediction
of emotional adjustment in family members of
patients with firs t-episode schizophrenia. Acta
Psychiatrica Scandinavica, 100, 359-366. doi:
10.1111/j.1600-0447.1999.tb10879.x
Hobbs, T. R. (1997). Depression in the Caregiving
Mothers of Adult Schizophrenics: A Test of the
Resource Deterioration Model. Community
Mental Health Journal, 33, 387-99. doi:
10.1023/A:1025070402153
Jagannathan, A., Thirthalli, J., Hamza, A., Nagendra,
H. R., & Gangadhar, B. N. (2014). Predictors
of family caregiver burden in schizophrenia:
Study from an in-patient tertiary care hospital
in India. Asian Journal of Psychiatry, 8, 94-98.
doi: 10.1016/j.ajp.2013.12.018
Kate, H., Grover, S., Kulhara, P., & Nehra, R.
(2013). Relationship of caregiver burden with
coping strategies, social support, psychological
morbidity, and quality of life in the caregivers of
schizophrenia. Asian Journal of Psychiatry, 6, 380-
388. doi: 10.1016/j.ajp.2013.03.014
Kung, W. W. (2003). The illness, stigma, culture
or immigration? Burdens of Chinese American
caregivers of patients with schizophrenia. Families
in Society, 84(4), 547-557.
Lim, Y. M., & Ahn, Y. (2003). Burden of Family
Caregivers With Schizophrenic Patients in Korea.
Applied Nursing Research, 16, 110-117. doi:
10.1016/S0897-1897(03)00007-7
Loukissa, A. D. (1995). Family burden in chronic
mental illness: A review of research studies. Journal
of Advanced Nursin, 21, 248-255.
Magliano, L., Fadden, G., Economou, M., Held,
T., Xavier M., Guarneri, M., ... Maj, M.
(2000). Family burden and coping strategies
in schizophrenia: 1-year follow-up data from
the BIOMED I study. Social Psychiatry and
Psychiatric Epidemiology, 35, 109-115. doi:
10.1007/s001270050192
Magliano, L., Fadden, G., Madianos, M., Almeida, J.
M. C., Held, T., Guarneri M., ... Maj, M. (1998a).
Burden on the families of patients with schizophrenia:
results of the BIOMED I study. Social Psychiatry and
Psychiatric Epidemiology, 33, 405-12. doi: 10.1007/
s001270050073
Magliano, L., Fadden, G., Economou, M., Xavier,
M., Held, T., Guarneci, M., ... Maj, M. (1998b).
Social and clinical factors influencing the choice
of coping strategies in relatives of patients with
schizophrenia. Social Psychiatry and Psychiatric
Epidemiology, 33, 413-9. doi: 10.1007/
s001270050074Magliano, L., Guarneri, M., Marasco, C., Tosini,
P., Morosini, P. L., & Maj, M. (1996). A new
questionnaire assessing coping strategies in relatives
of patients with schizophrenia: development and
factor analysis. Acta Psychiatrica Scandinavica,
94, 224-228. doi: 10.1111/j.1600-0447.1996.
tb09853.x
Maurin, J. T., & Boyd, C. B. (1990). Burden of
mental illness on the family: A critical review.
Archives of Psychiatric Nursing, 4(2), 99-107.
Moller-Leimkuhler, A. M. (2005). Burden of relatives
and predictors of burden. Baseline results from
the Munich 5-year-follow-up study on relatives
of first hospitalized patients with schizophrenia
or depression. European Archives of Psychiatry
and Clinical Neurosciences, 255, 223-231. doi:
10.1007/s00406-004-0550-x
Moller-Leimkuhler, A. M. (2006). Multivariate
prediction of relatives’ stress outcome one year
after first hospitalization of schizophrenic and
depressed patients. European Archives of Psychiatry
and Clinical Neurosciences, 256, 122-130. doi:
10.1007/s00406-005-0619-1
Moller-Leimkuhler, A. M., & Obermeier, M. (2008).
Predicting caregiver burden in first admission
psychiatric patients. 2-year follow-up results.
European Archives of Psychiatry and Clinical
Neurosciences, 258, 406-413. doi: 10.1007/
s00406-008-0818-7
Moller-Leimkuhler, A. M., & Wiesheu, A. (2012).
Caregiver burden in chronic mental illness: the role
of patient and caregiver characteristics. European
Archives of Psychiatry and Clinical Neurosciences,
262, 157-166. doi: 10.1007/s00406-011-0215-5
Nehra, R., Chakrabarti, S., Kulhara, P., & Sharma, R.
(2005). Caregiver-coping in bipolar disorder and
schizophrenia: A re-examination. Social Psychiatry
and Psychiatric Epidemiology, 40, 329-336. doi:
10.1007/s00127-005-0884-3
Organização Mundial de Saúde – OMS. (2001).
Relatório Mundial da Saúde. Saúde mental: nova
concepção, nova esperança. Lisboa: Divisão de
Saúde Mental da OMS.
Ostman, M., & Hansson, L. (2001). The relationship
between coping strategies and family burden
among relatives of admitted psychiatric patients.
Scandinavian Journal of Caring Sciences, 15, 159-
164. doi: 0.1046/j.1471-6712.2001.00020.x
Pai, S., & Kapur, R. L. (1981). The burden on the
family of a psychiatric patient: development of an
assessment scale. British Journal of Psychiatry, 138,
332-335.
Panzini, R. G., & Bandeira, D. R. (2007). Coping
(enfrentamento) religioso/espiritual. Revista de
Psiquiatria Clínica, 34, 126-135. doi: 10.1590/
S0101-60832007000700016
Patrick, J. H., & Hayden, J. M. (1999). Neuroticism,
coping strategies, and negative well-being among
caregivers. Psychology and Aging, 4(2), 273-83. doi:
10.1037//0882-7974.14.2.273
Perlick, D. A., Rosenheck, R. A., Miklowitz, D. J.,
Kaczynski, R., Link, B., & Ketter, T. (2008).
Caregiver burden and health in bipolar disorder:
A cluster analytic approach. The Journal of Nervous
and Mental Disease, 196, 484-491. doi: 10.1097/
NMD.0b013e3181773927
Rammohan, A., Rao, K., & Subbakrishna, D. K.
(2002a). Burden and coping in caregivers of
persons with schizophrenia. Indian Journal of
Psychiatry, 44(3), 220-227.
Rammohan, A., Rao, K., & Subbakrishna, D. K.
(2002b). Religious coping and psychological wellbeing
in carers of relatives with schizophrenia.
Acta Psychiatrica Scandinavica, 105, 356-362. doi:
10.1034/j.1600-0447.2002.1o149.x
Rose, L. E. (1996). Families of psychiatric patients:
a critical review and future research directions.
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