Stigma mediates role, involvement of caregivers with those hospitalized for mental illness

For informal caregivers of those hospitalized for mental illness, affiliated stigma was a full mediator between their role as caregiver and their involvement with patients, according to a study published in BMC Psychiatry.

“There is a positive association between affiliated stigma and the burden of caregiving, [which] has been documented in previous research,” Scholastic Ashaba, PhD, MMed, senior lecturer in the department of psychiatry at Mbarara University of Science and Technology in Uganda, and colleagues wrote. “In addition, there is an association between affiliated stigma and caregivers’ burden while at the same time, a higher caregiving burden is related to more severe affiliated stigma.”

Ashaba and colleagues sought to examine the mediating role of stigma within the relationship between informal caregivers and the associated burdens of providing care for hospital-admitted patients with mental illness in Uganda.

Their cross-sectional study was conducted among 428 adult caregivers (62.1% female; mean age 39.6 years) of individuals diagnosed with mental illness and admitted to the Mbarara Regional Referral Hospital’s psychiatry unit between July 2020 and November 2020. Caregiver information was collected through a questionnaire assessing basic sociodemographic data, caregiver involvement was assessed via the 33-item Involvement Evaluation Questionnaire, caregiver burden was measured with the 22-item Zarit Burden Instrument, and self-stigma was evaluated with the 22-item Affiliate Stigma Scale.

A total of 65.6% of participants resided in rural areas, 55.5% of participants were married, and 15.4% claimed no formal education. The most common psychiatric illnesses among patients who required caregiving were mood disorders (45%) and substance use disorders/addiction (27.2%).

Researchers additionally found that affiliated stigma served as a full mediator between the caregiver’s roles and involvement ( = 15.97), while being a woman increased the caregivers’ burden of care ( = -0.23).

“For effective interventions to reduce affiliated stigma, further studies are recommended to develop culturally acceptable methods incorporating strategies that target key variables associated with caregiving,” Ashaba and colleagues wrote.