Study Participant And Study Participants
Among other relatives, parents of patients with schizophrenia werequestioned regarding their present living situation and illness-relatedburdens. To be able to document temporal developments and processes ofchange, a prospective study design was chosen. Three detailedinterviews were conducted with the parents at intervals of months.The interviews were conducted by qualified psychologists trained inusing the technique of narrative interviews.Thestudy participants were recruited from inpatient, day care, andoutpatient psychiatric facilities in Leipzig. On the condition that thepatients agreed to their parents interviews, the latter were contactedby telephone or mail. Fifty-one of the parents who had beencontacted agreed to participate in the study; at the time of the firstinterview t, mothers and fathers of patients with schizophreniawere interviewed. The average age of study participants was years;the age span ranged from to years. The patientsâ?? average age was years, and most of them had been under psychiatric treatment for years at the outset of the study. Forty-one percent of the patientsstill lived with their parents, whereas % lived independently. Torecord the functional impairment of the patients, the psychiatrist inattendance was asked to make a quantitative assessment according toAxis V of DSM-IV Global Assessment of Functioning [GAF]. An averageGAF value of showed a moderately severe impairment.Theinterviews were largely conducted in the form of home visits. First,the study participants were asked to report about their changedsituation regarding the mental illness What has changed for you sinceyour sons/daughters illness. In the follow-up interviews, theopening question was: What has happened since our last interview Incompliance with the nondirective method of narrative interviews, theinterviewer intervened and directed as little as possible during thesubsequent reports and descriptions. As soon as a topic was completedor longer gaps in the conversation occurred, the study participantswere prompted with questions to continue their narration, such as Whatoccupies you the most at the moment and Was there anything latelywhich represented an extreme burden for you?In addition, theinterviewer had the possibility to generate concrete narrating anddescription of situations by means of narrative-deepening questions,especially in cases in which the study participant had a strongtendency toward argumentative or abstracting description. On average,the interviews lasted minutes; after all interview contacts,detailed contact protocols were produced.During the course ofthe study, there were only a few dropouts. Thus, a total of interview sets were available for qualitative development analysis.Forty of these sets included parents who participated in all threeinterviews; moreover, there are another seven interview sets for whicha temporal development could be analyzed using two interviews. Fourstudy participants were either not willing or not able to continuetheir participation after the first interview had been conducted.Theanalysis of the parents interviews was carried out following themethod of Typological Process Structure Analysis as suggested by.The material was analyzed in several stages allowing the creation ofdescriptive developmental types representing the main trend of changesand developments reported by the study participants. The methodicalprocedure included several steps. First, the tape-recorded interviewswere transcribed verbatim. Based on the interview transcripts and thecontact protocols, the members of the research team generateddevelopment-related individual case descriptions for every studyparticipant. In these individual case descriptions, the mainemphases of the interviews with regard to content and the developmentoutlined by the study participants were documented. In aconsensus-building discussion compare,the individual case descriptions were then categorized following theprinciple of maximum and minimum contrasting, ie, first, those caseswere selected for which different developments were reported during thecourse of the study maximum contrasting. These individual casesserved as the starting point for the creation of preliminary categoriesinto which parents with similar developments of burden were combined.In the course of a discursive evaluation process, these categories weredifferentiated, combined, and revised several times, with unclearclassifications and thematic overlaps being discussed by the researchteam. According to this principle, a set of six developmental types wasgradually constructed, which allowed the assignment of all individualcase descriptions. In the further course, variations within adevelopmental type were described minimum contrasting and thevalidity of the developmental types in similar cases was checked. In afinal step, ideal-typical individual cases were selected for eachdevelopmental type. Furthermore, significant interview passages werefiltered out which illustrate the respective development regarding thesubjective burden of the parents as concisely as possible. Finally, thedescriptions of the different developmental types were retested on thebasis of the interview material and the research question to determinetheir suitability for generalization with the intended criteria.ResultsAnalysisof the present case developments led to the creation of the followingsix different developmental types that represent the changes orinvariance of subjective burden in parents over a period of months: constantly high level of burden; increased burden; reducedburden; shifting burden; preeminence of other burdens; and constantly low level of burden compare.We explain the different developmental types and exemplary individualcases and quotations from the follow-up interviews are used forillustration.Table. Developments of Burden Over Months in Parents of Patients With Schizophrenia
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