Abstract

Schizophrenia is a common mental illness that seriously affects the health of the person. Patients with speech, behavior and personality are different from normal people. In order to improve the effectiveness of treatment for schizophrenia, the National Project for Community Mental Health Care has been implemented since 1999. People with schizophrenia who are not well-managed and well-taken care of by family members increase the risk of relapse, lengthen treatment time, and cost economically and possibly security. This study assessed the status of family management and care for Schizophrenic patients and identified some related factors. The subjects of the study were family members of schizophrenic patients. The study used a descriptive study. In Nam Dinh Province, Vietnam, situation of management and care for Schizophrenia patients outpatient treatment were medium level. The situation of management and care about periodic re-examination, labor and social reintegration had not reached a very high rate. There were periodic follow-up examination (53.7%), poor labor and community reintegration (49.7%). There was also a correlation between the age band, educational level, average income of caregivers and the quality of care for patients. Thus, similar studies should be conducted along this line to verify the findings of the study.

1. Introduction

According to the World Health Organization (WHO) ^{1, 2}, mental illness schizophrenia accounts for 0.7-1% of the population and estimates around The World has about 26 million Schizophrenia Patients. In Vietnam, according to clinical epidemiological investigation, rate Schizophrenia Patients are 0.47%, ^{3, 4, 5}. In Vietnam, before 1998, people suffered from schizophrenia often focused on taking care of the hospital there large scale ⁶, ^{7, 8}. Since 1999, the "Target Program Community Mental Health Protection” of the State is deployed in the whole country ⁹ for Schizophrenia Patients’ early detection, early treatment and attention recovery community-based functional resuscitation. When people are sick Schizophrenia for outpatient treatment, family members have very important role ¹⁰. Managing and caring for Schizophrenia Patients for outpatient treatment is a very good trend. This is a good opportunity for Schizophrenia Patients to reintegrate into the community, increase treatment effectiveness. But, it also requires the health system and the patient's family to do well the management and care of the outpatient patients ¹¹. Schizophrenia Patients who are not well-managed outpatient treatment will relapse. Resulting in severe consequences such as: patients disrupt order, get serious disease, increase the number of hospitalizations, patients put up drugs to commit suicide, attack people around causing harm to their health ^{12, 13}. They will directly manage and care for Schizophrenia Patients such as adherence to treatment, nutrition, cleaning, periodic re-examination, labor and reconciliation social integration ^{14, 15}. Managing and caring for Schizophrenia Patients is the process of confirmation determine the need to support patients, build and implement plans to support patients Schizophrenia, coordinating activities to assist patients stabilize, reintegrate into the community in Nam Dinh Province, Vietnam, the program is implemented community mental health protection goals from there have been no studies in 1999 until now on the status of management and care for people with schizophrenia outpatient treatment.

Therefore, the study was conducted on the review of current situation of management and care for Schizophrenia Patients Outpatient treatment and identification of some interrelated factors.

2. Objectives of the Study

This study aimed to conduct a study on 352 family members of Schizophrenia. Specifically, the study re-examined the annual review of the standard of people who live directly and regularly take care of people schizophrenia particularly greater than or equal to 18 years old with ability to communicate and agree participate in research and people with time to participate in managing and caring for patients continuous schizophrenia for less than 1 month.

3. Materials and Methods

This study used a research toolkit. The research instrument included the questionnaires and interview guide which evaluated the reliability Cronbach Alpha at 0.70 and expert opinion on interview questionnaires. Data were collected, entered, processed and analyzed by software SPSS version 20. The evaluation criteria of the study were the management and care of the people care for people with Schizophrenia for outpatient treatment- assessed through the implementation of work and adherence to treatment and protection birth, nutrition, routine follow-up, labor and reconciliation social integration from there we divided the level of management and take care of Schizophrenia Patients of family members into 3 level: good, medium and poor.

4. Results and Discussion

Research results are analyzed in total 352 family members participated in management and care for Schizophrenia Patients on drug use, nutrition, hygiene, labor and social reintegration, regular follow-up visits, with results after:

The research team have the highest proportion are workers (28.1%). There are no students join the study. Cultural level of caregivers of patients Schizophrenia: the research group has a high school level (47.7%). The team has Primary education still accounts for a relatively large proportion (13.1%).

The results show average monthly income of patient schizophrenia's families are often low with levels less than 1 million (30.4%), from 1-3 million (39.8%), over 3 million (29.8%).

Schizophrenia Patients are managed and cared for in the community, including: adherence to treatment, nutrition, personal hygiene and social reintegration at different levels. Schizophrenia Patients are well managed and cared for in the community 40.1%. Schizophrenia Patients are medium managed and cared for in the community 54, 3%. Schizophrenia Patients are poor managed and cared for in the community 5, 7%.

There is a correlation between the age band, educational level, average income of caregivers and the quality of care for patients. There is no correlation between gender of caregivers, job of caregivers and the quality of care for patients.

General information about managers and caregivers for patients

The main occupation of managers and caregivers for patients are worker (28.1%) and free labor (20.5%). Worker have a long working time at the company due to overtime. Freelance workers have not job stable. These factors make time to work hard less care for patients’ schizophrenia. Retirement objects and counterparts statues of government officials have more time for the managers and caregivers for patients.

Educational level of manager and caregiver patients’ Schizophrenia is still quite low: primary (13.1%), junior high school (39.2%). This will be an obstacle great in accessing information and knowledge about caring for patients’ Schizophrenia.

Average monthly income of patients' families is very low: less than 1 million (30.4%). This will be an economic burden for families patients schizophrenia. The patients schizophrenia are often in the working age, when they become ill, their families lose one of their main labor. Moreover, people with schizophrenia do not take care of themselves, leading to a rapid decline in the family's economy. Economic difficulties for people with schizophrenia will affect the managers and caregivers for patients.

Situation of Management and Care for Schizophrenia Patients Outpatient Treatment

Caregivers often focus on compliance treatment and hygiene for patients’ Schizophrenia. The rate of patients with good treatment compliance reached 97.7%, caregivers who performed well in hygiene care reached 81.5%. But the proportion of managers and caregivers for patients for regular follow-up visits, nutrition and especially social reintegration for patients is not good. The rate of patients’ regular re-examination is 53.7%, poor labor and community reintegration is 49.7%. Managers and caregivers for patients are not aware of the importance of having to re-examine regularly and guide the patients to work, reintegrate into the community. Failure to achieve these two problems will be difficult to improve the condition of people with schizophrenia

Relevance Between The Elements With The Degree Manage And Care For Patients

Analyzing the relationship between occupations caregivers with good or not good performance levels the management and care of patients by T test in SPSS 20. Seeing the difference is statistically significant with p <0.05. Caregivers have many jobs time will be able to take care of the sick be better. Use T-test in SPSS single analysis Factors affecting the status of care People with schizophrenia, our research has shown education level factor, average income level of caregivers affect the state of care patients: People with incomes below 1 million VND / month often are worse care level than people with income of over 1 million / month (p <0.05). So, economic conditions caregivers are better, patient’s care are better and better. However a present reality we can get found that most people with schizophrenia often sick at the age of 18-40, this is the age of tuberculosis motivated to make a living but they have to depend on people take care of. So most caregivers have a refund difficult scene. Therefore to create more favorable conditions in caring for patients, we need to improve knowledge with caregivers so that they are aware of encouraging patients. Work is also a way to increase income, reduce difficulties for them. follow them I need to improve my knowledge with caregivers so that they are aware of encouraging patients Work is also a way to increase income, reduce less difficult for them. Using T-test in SPSS 20, we see an association between the level of education and the level of management and good care of people with schizophrenia. Caregivers have under education levels from primary school are worse than caregivers have over levels of high school (p <0.05).

5. Conclusion and Recommendation

Educational level of managers and caregivers for patients are low level. Situation of Management and Care for Schizophrenia Patients Outpatient Treatment are Medium level. The situation of management and care about periodic re-examination, labor and social reintegration has not reached a very high rate: periodic follow-up examination (53.7%), poor labor and community reintegration (49.7%). There is a correlation between the age band, educational level, average income of caregivers and the quality of care for patients. Caregivers have a higher level of education, average income higher month care for patients better. The difference is statistically significant with p <0.05.

Health education activities need to be organized to improve knowledge for caregivers while education needs to focus on the caregivers with low educational levels and difficult economic circumstances. Educational content should pay special attention to the drug regimen and periodic re-examination of Schizophrenia. The community health care program needs to strengthen the team of collaborators (village health workers, Red Cross ...) to the homes of Schizophrenic Patients to monitor and consult on demand. Develop a process of health education counseling and health education organization for patients and caregivers before leaving hospital. Establishing a community mental health club for patients and caregivers to live, share experiences, help patients to reintegrate into society.

References