Economic Burden and Quality Of Life of Family Caregivers of Schizophrenic Patients Attending Out Patient Department of Psychiatric Hospitals in Ghana

Abstract

Background Caregiving plays an important role in the management of severe mental health disabilities like schizophrenia. In many low - income settings where formal (or paid) caregiving is not prevalent, the economic and psychological burden borne by family members who play these roles often go unnoticed. . In the case of Ghana, where the Mental Health Act (2012) provides for de-institutionalization of mental health care, it is important to highlight the (especially economic and psychological) burden borne by family members in caring for people with severe mental health disabilities. There is paucity of studies on the burden of family caregiving for severe disabilities, and the current research fills this gap. The objective of this current study, therefore, is to estimate the economic burden and assess the quality of life of schizophrenia on family caregivers in Ghana. Method A cost analytic approach (Cost of illness) was used in estimating the economic burden and WHOQOL-BREF was employed to determine the quality of life. The primary source of data for this study included caregivers of patients who were diagnosed with schizophrenia at least six months before the commencement of the study and who present to any of the three psychiatric hospitals in Ghana Economic burden was categorized direct costs (including medical and non-medical costs of seeking care), indirect costs (productivity losses to caregivers) and intangible costs (non-monetary costs such as stigma, pain, etc.). Direct costs were estimated using the direct economic costs of seeking care (e.g. medicines, consultations, travel, etc.). Indirect costs were estimated as the time (in hours) of productive time lost to caregiving multiplied by the daily wage. Intangible costs assessed using the Zarit Burden Interview. Quality of life was assessed using the WHO Quality of Life tool (WHOQOL), which has four (4) domains namely, physical health, Psychological? implications, Social relationships and Environment. Results The total cost of caregiving for schizophrenic patients to the caregiver was estimated to be GHS 299,674.20 (USD 76,839.50). The indirect cost accounted for a greater proportion (82.5%) of the total cost of caregiving while the direct cost constituted the remaining 17.5% as indicated in the folder. The estimated direct cost for a month was GHS 52,521.20 (USD 13,467.00) of which the medical cost contributed GHS 33,744.20 (USD 8652.36), while the non- medical cost contributed GHS 18,777.00 (USD 4814.6). It was deduced that, the average total cost to the caregiver in treating schizophrenia was estimated as GHS 1065.80 (USD 151.8) for a month. The total quality of life of caregivers of schizophrenia was found to be low in all QoL domains relation to sex and was also clear that female caregivers have a lower quality of life. It was also found out that educational level?? have effect on the quality of life, the higher the educational level, the higher your quality of life. Lastly, it was also evident in the study that among the burdens, the intangible burden has the greatest adverse effect of the quality of life of the caregiver. Conclusion The cost of family caregiving for schizophrenia is huge and for that matter cannot be overlooked and as a result, the quality of life experienced by the caregivers is affected. A negative association was found between the cost components and the quality of life and more significantly was the intangible cost. . This study was done within the three psychiatric hospitals in Ghana and hence can be generalized to the entire population.