Schizophrenia in Minority Communities

Summary Statement

The increased number of incidences of mental health issues such as Schizophrenia among the minority community has led to raise the concern regarding quality of care provided by the family members to the patients after discharge from the hospital. The literature review is developed to inform about the role of the family members and the impact of their care intervention along with healthcare providers in delivering support to the schizophrenia patients who are discharged from hospital. The proposal is developed to inform about the reasons behind the importance of encouraging the family as well as relatives in delivering care intervention for the schizophrenia patients who belong from the minority community. The review is going to focus on what has been done so far within the minority community and the things that needs to be updated to ensure effective support to the patients. The experience of families and health care providers in promoting better health through various means including therapies and how they perceive these procedures have been documented. For this reason, it is needed to review how health care providers work alongside families to provide these services and perceptions in the areas where improvements in mental health care can be achieved. Therefore this review aims to improve care quality and advance patients outcomes amongst minority group, drawing parallels with similar approaches found in healthcare dissertation help resources.

Background and Description of the condition

Schizophrenia is referred to the chronic and intense mental disorder which affects the way a person think, feel as well as behaves. The people suffering from schizophrenia are often seen to have lost their touch with the reality. The disease through may not be as common as other mental disorder but the symptoms are perceived to be disabling (Phoroah et al. 2010).Schizophrenia is seen to vary among individuals and it can be serve as well as disabling with symptoms which involve psychotic symptoms like delusions, hallucination, lack of proper expression and others (Hettige et al. 2017). As per Olfson et al. (2015), schizophrenia develops in early adulthood or late adolescent stage. The two chemicals which are dopamine and glutamate are seen to be responsible for carrying messages to the brain which helps the person to control perception, thinking and motivation. In schizophrenia, the dopamine is reported to cause hallucinations because the brain area which operates with the help of dopamine in the case of schizophrenic patients becomes overactive in nature (Grace, 2016). The study of Hollis & Rappoport (2008) informs that schizophrenia is usually diagnosed in the late teen extending to the late thirties. They are seen to occur earlier in men compared to women and are involved with creating most subtle changes in social and cognitive relationship which may increase the actual diagnosis of the disease by years. At the present, it is reported that identification of the prevalence of schizophrenia is difficult to obtain and thus they are often estimated with other studies. Schizophrenia is seen to create a significant impact on the family members of the patients. In case of minority community such as the black Caribbean in the UK, it is seen that they are nine times more prone to get affected by schizophrenia in comparison to others (Pinto, Ashworth & Jones, 2008). Thus, effective family intervention is essential for them after recovery from schizophrenia to be able to live a healthy life. This is because proper family intervention for the patients on recovering from schizophrenia helps to create individual economic and social changes which are often known as caring effects

Research rationale

The schizophrenia is seen to be most prevalent among the minority community in the UK compared to white individuals. It has made the minority communities such as the black Caribbean others at increased risk of experiencing the disease. This is evident as 3-5 times increased the risk of schizophrenia is identified among the black Caribbean community in the UK compared to other ethnic groups (www.mentalhealth.org.uk, 2018). It is seen that people of the black origin in the UK enters the mental care services through police and courts rather than from the primary care Moreover, the rate of recovery of the black Caribbean community in the UK in respect to schizophrenia is seen to be low (www.mentalhealth.org.uk, 2018). This informs that in most cases the family of the black people are less involved in providing care to the individuals to ensure their effective recovery. However, in case of the Asian community, which is another minority group in the UK it is seen that the recovery rate from schizophrenia is more as they have effective support from the family (www.mentalhealth.org.uk, 2018). Thus, it has become an issue for the black minority community in the UK to face a lack of family intervention to gain proper recovery from schizophrenia. The lack of family intervention for lower recovery of minority community in the UK from schizophrenia has become an issue because without family proper health monitoring and care services required to ensure effective solution of the disease cannot be given to them. Moreover, lack of family intervention is seen to create more expenditure of the minority community in the UK to spend recovering from schizophrenia (Edge et al. 2016). In the study of Maura & Weisman (2018), it is mentioned that involving family members during recovery of minority community patients from schizophrenia helps to include collectivist principles as well as spiritual coping methods for faster recovery of the patients. Thus, the lack of proper family intervention among the minority group patients who are recovering from schizophrenia has presently become an issue as it has led to create hindrance in offering better-coping methods to the patients to ensure their faster recovery. Therefore, this study is framed to shed light on the importance of family intervention on patients recovering from schizophrenia who belong to the minority community. Further, it shed light on the concept of family intervention and the challenges faced by family while intervening to care for minority patients who are recovering from schizophrenia.

Aims and objectives

To identify the concept of family intervention on assisting patients recovering from schizophrenia within minority community

To evaluate the impact of family intervention for assisting patients recovering from schizophrenia within minority community

To analyse the challenges faced during family intervention for assisting patients recovering from schizophrenia within minority community

To suggest strategies to resolve issues faced during family intervention for assisting patients recovering from schizophrenia within minority community

Research Questions

What is the concept of family intervention on assisting patients recovering from schizophrenia within minority community?

What is the impact of family intervention for assisting patients recovering from schizophrenia within minority community?

What are the challenges faced during family intervention for assisting patients recovering from schizophrenia within minority community?

What are the strategies to resolve issues faced during family intervention for assisting patients recovering from schizophrenia within minority community?

Literature Review

At the present, there are still no unique approaches mentioned for creating family intervention for the schizophrenia patients to ensure their good health. However, evidence-based family therapies such as psycho education, emotional processing, stress reduction, structured problem solving and cognitive reappraisal are seen to be usually used by families to intervene to care for the schizophrenic patients. In the study of Dykxhoorn et al. (2018), it is reported that intervention consisting of psychotherapeutic strategies while working with the family members of the people who are suffering from schizophrenia helps to develop a close relation between the carers and family member that eventually leads to help in making the patients progress in a faster way.

The study of McFarlane (2016) mentioned that family therapy to the schizophrenic patients led to create a positive impact on recovery of the patients by significantly reducing readmission and relapses as well as creating improvement of the patient to function socially. In the study of Sin & Norman (2013), it is informed that psycho education is require to be regularly offered to the family members of the schizophrenic patients so that the members remains in direct contact with the carers. This allows the family to increase their knowledge regarding the way they are to support the patients after recover so that they are able to live a normal life. Moreover, it is also mentioned that psychoeducation is able to reduce adherence of the patient towards medication and reduces chances of recurrence of schizophrenia among the patients who have recovered. The study of Okpokoro, Adams & Sampson (2014) informed that family intervention in case of schizophrenia patients are to reduce expressed emotional turmoil of the family as well as benefited in improving the quality of life of the relatives and the patients. As a result of this, the family therapy programs are seen to be focused not only on delivering information regarding the schizophrenia and its management but also is related with promotion of positive attitudes like affection, empathy and executing verbal communication between the members of the family to make them efficient in caring for the patients (Girón et al. 2015). In the study of Kuipers, Onwumere & Bebbington (2010), a cognitive model related to care giving is developed in which the key nature of care giving relationship in schizophrenia and proposed way of providing family intervention related to the disease is mentioned. The model developed is seen to be based on the affective reaction and care giving appraisals in schizophrenia that led to mention certain care giving behaviour to be adopted by service providers in delivering services to the service users.

The family intervention thought proved to be effective way of delivering care to the patients recovering from schizophrenia but still many challenges are linked with them. During family intervention, the family member responsible in offering care to the schizophrenic patient may face difficulty of lack of proper practical knowledge related to therapeutic intervention to efficiently support the patient even after accessing the psychoeducation. Another difficulty related to family intervention is that during family function, the family member caring for the schizophrenic patient may be stigmatized which may lead the individual to quit. Moreover, the burden of care of the schizophrenic patient may often make the family members top avoid supporting the patient after recover opposing difficulty to effectively implement family intervention (Loughland et al. 2009).

Proposed methodology

Search Strategy

The analytical research strategy is referred to the process in which the researcher studies as well as analyses the data available for retrieving proper information to explain and resolve complex problems raised in the study. Moreover, this strategy is effective to provide critical details as well as new information for adding ideas in the development information to resolve the raised research problem in a better way (Knowles et al. 2015). Thus, this strategy will be used in the study as it would offer enriched information required to resolve the raised problem. The analytical research strategy includes use of current along with available information and facts to derive data required for the study (Schäfer et al. 2017). Therefore, this research strategy will be used as the researcher is executing presentation of a literature review by analysing the currently available information in primary and secondary articles related to the study topic.

Database

The literature search will be executed online by using different search engines and databases as the electronic search helps the researcher to identify potential and updated evidence which are related to the research topic. The process will be adopted for the study as it is less time consuming, easier and simpler than searching for information in books and study materials present in the library (McGowan et al. 2016). The online platforms that will be used for identifying the sources for the literature review are:

British journals on psychiatric

National Institute for Health Care Excellence (NICE) Evidence search

PsycINFO

PubMed

MEDLINE,

CINAHL (Cumulative Index of Nursing and Allied Health Literature)

Cochrane Library, Summon

The selected databases will be chosen to search for the research articles which are relevant to the study as they offers full access to various medicine as well as nursing journals that compile vast information that is fundamental to the study field (Greene et al. 2018).

Search Terms and Boolean Operators

The search terms are referred to the keywords that are entered in the search engine for specifying particular information to be researched required for a study (Gray et al. 2018). The use of proper search terms will help the researcher to be able to retrieve various relevant journals and peer-reviewed articles ensuring to develop a comprehensive study. The search terms that will be used for this study are: “family intervention”, “patients recovering from schizophrenia”, “minority population”, “family intervention for mental health recovery” and others. In this study, the researcher will use Boolean operators such as “AND” and “OR” to combine the search words to identify the journals and articles on online databases by increasing specificity as well as the sensitivity of the researches.

Inclusion and Exclusion criteria

The exclusion criteria are referred to the attributes that are disqualified within the subjects to ensure relevance for the study. However, the inclusion criteria are the attributes which are required to be involved in executing the study (Swerdlow et al. 2018). In this study, the inclusion criteria will be fully accessed journals that are written in English. This is because lack of full access to the journals results the researchers to be unable to derive vital information and facts required in presenting and resolving the raised problem in the study. Moreover, journals that are written in English will be chosen as they are easier to understand by the researcher who has their first language as English during the course. The inclusion criteria will also involve the journals and articles that are academic in nature and are published within 10 years (2008 to 2018) from the present. This is because the journals within 10 years from present would offer most current and updated information required for executing the study (Swerdlow et al. 2018). The exclusion criteria will include journals that are published before 2008, not written in English, have access to only abstract and not related to individuals who are suffering from schizophrenia. (Refer to Appendix 1)

Ethical Consideration

The ethical consideration is important to promote authenticity of the study. Thus, the researcher will be using ethically approved articles so that the review will be able to avoid misrepresentation of the information and be able to promote truth. The author while using articles to ensure ethical consideration will be properly referencing them so that proper credit to the owner of the information is given while presenting the review. The author in this research will involve cooperation and coordination among many different people in different disciplines and institutions to be able to achieve reasonable outcome confidentiality will be maintained, informed consent and periods of debriefing (Gheondea-Eladi, 2017). This idea will promote the value that is essential in a literature review which includes trust, accountability, mutual respect and fairness. The data usage policies will also be respected as most researchers want to receive recognition for their contributions and do not want their ideas stolen or disclosed prematurely thus all references will be made to authors of chosen articles. The researcher will be taking prior permission from the ethics committee before executing this study to ensure it is ethically performed.

Data Collection and Analysis

The data collection will be done by analysing primary and secondary research articles. The primary research articles will be important for this study as they provide fresh and updated data in quantitative form which may be available elsewhere. The secondary research articles are seen to include wide amount of knowledge provided by various expertise to ensure the authenticity and validity of the existing information. Moreover, secondary research articles are most comprehensive and deliver extensive analysis. The secondary and primary research articles will be analysed by using CASP tool to retrieve information from them to execute the study. The Critical Appraisal Skill Programme tool is focused on helping individuals to understand and make sense of the facts and evidence present in the articles to gather proper information (Brooke-Sumner et al. 2015). Thus, the CASP tool will be used in this study so that an effective evidence-based approach is able to be undertaken for identifying the impact of family intervention on patients recovering from schizophrenia belong from minority communities. The data analysis will be done by framing four key themes under which the findings are to be presented. The thematic analysis will be used because it offers flexibility to the researcher to form well-suited sets of data required for successful execution of the study (Kurtz et al. 2016).

Presentation of findings

The findings of the study will be presented in a comprehensive, analytical and descriptive manner. The key to write findings in an effective way is to ensure that they are present in such a format that is easily understood by the readers. Thus, the findings will be presented in a proper manner so that the reader understands the content of the study. The findings that will be presented in the study will involve information regarding the factors and challenges related to family intervention and the way issues can be resolved and family intervention impact on the patients recovering from schizophrenia belong from the minority communities.

Conclusion

In summary, the proposed literature review will study indication designed to confirm that the implementation of family intervention in the care promotes persons centre care (Doombos, 2001) by exploring the different family interventions models in the community and its effects on both the patients and the health care system ( Dirik et al 2017). It is usually argue that stigma in mental health still remains a serious social problem which has a multitude of consequences on the individual concerned as well their families (Celenkosini, 2017). The author will wish to further explore the ability of these families to recognise early signs and symptoms depending on their knowledge and the outcome of this intervention to the health care system and mental health care provisions (Dirik, 2017). During the search, the author will follow to ethical principles and summarise the article's findings using `PQRS` framework ( Ulu &Akyol) and the Critical Appraisal CASP tool will help with the process of critically appraising the selected articles (Taylor, Hassain&Gadoud, 2013).