Burden and quality of life among caregivers of psychiatric inpatients in a neuropsychiatric hospital in Southeast Nigeria: a cross-sectional study

Burden and quality of life among caregivers of psychiatric inpatients in a neuropsychiatric hospital in Southeast Nigeria: a cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Burden and quality of life among caregivers of psychiatric inpatients in a neuropsychiatric hospital in Southeast Nigeria: a cross-sectional study Pamela Chidera Onyia, Luke Oche Peter, Babatunde Ishola Omotowo, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9074474/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Caregivers of individuals with severe mental illness often experience substantial psychological, social, and financial strain that may negatively affect their quality of life (QoL). Evidence on caregiver burden in psychiatric inpatient settings in Nigeria remains limited. This study assessed the burden and QoL of caregivers of psychiatric inpatients at the Federal Neuropsychiatric Hospital Enugu (FNHE) in Southeast Nigeria. Methods A descriptive cross-sectional study was conducted among 214 caregivers of psychiatric inpatients selected through consecutive sampling. Caregiver burden and QoL were assesses using structured questionnaires adapted from the Zarit Burden Interview and the WHOQoL-BREF. Data were analyzed using IBM SPSS Statistics version 20. Frequencies and percentages were used to summarize categorical responses, while the chi-square test was used to assess associations between caregiver burden, quality of life, and socio-demographic variables. Statistical significance was set at p < 0.05. Results Most caregivers were aged 25–44 years (43.9%), female (57.0%), married (53.3%), and self-employed (63.1%). Nearly half had tertiary education (43.9%), and siblings constituted the largest proportion of caregivers (44.9%). Approximately 40.7% had provided care for more than three years. Overall, 45.8% reported little or no burden, 37.9% experienced mild to moderate burden, and 0.9% reported severe burden. Financial strain (43.9%) and emotional exhaustion (29.9%) were commonly reported challenges. Regarding QoL, 43.9% of respondents reported moderate QoL, 33.6% reported good QoL, and 11.2% reported poor QoL. Satisfaction was relatively high in some domains, with 76.2% satisfied with their ability to perform daily activities and 58.9% satisfied with personal relationships; however, 43.9% expressed dissatisfaction with their financial situation. Caregiver burden was significantly associated with QoL (p < 0.001), with higher burden linked to poorer QoL. Among socio-demographic factors, only caregiving duration was significantly associated with caregiver burden (p = 0.001). Conclusions Caregivers of psychiatric inpatients demonstrated notable resilience despite experiencing financial and emotional challenges. Increased caregiver burden was associated with poorer QoL, highlighting the need for targeted psychosocial and economic support interventions to improve caregiver well-being in psychiatric care settings. Clinical trial number: not applicable caregiver burden quality of life psychiatric inpatients neuropsychiatric hospital mental illness psychosocial support 1. Background Mental health conditions are a major and growing public health concern globally, affecting individuals across all demographic groups and contributing substantially to morbidity and disability [ 1 ]. They encompass a range of disorders and psychosocial disabilities characterized by significant distress, impaired functioning, and elevated risk of self-harm. Globally, mental disorders accounted for approximately 14% of disability-adjusted life years (DALYs) in 2019, affecting nearly 970 million people, most commonly through anxiety and depressive disorders [ 2 , 3 ]. Severe mental illness can reduce life expectancy and heighten vulnerability to human rights violations, while the economic impact is largely driven by productivity losses [ 4 , 5 ]. In low- and middle-income countries such as Nigeria, this burden is intensified by stigma, inadequate mental health services, and limited treatment resources [ 6 ]. Psychiatric inpatients often require extensive support due to impaired capacity to perform daily activities [ 7 ]. This responsibility frequently falls on informal caregivers, whose critical role exposes them to emotional strain, financial hardship, and social isolation—collectively termed caregiver burden [ 8 – 10 ]. Burden can manifest as psychological distress, disrupted relationships, and reduced quality of life (QoL), with implications for both caregiver well-being and patient outcomes [ 11 , 12 ]. QoL, defined by the WHO as an individual’s perception of their position in life within the context of culture and value systems, is often compromised among caregivers due to prolonged caregiving demands, stigma, and limited support [ 13 , 14 ]. In Nigeria, caregivers frequently shoulder these responsibilities with minimal formal assistance [ 15 ]. Although prior Nigerian studies have examined aspects of caregiver burden and QoL, notable gaps remain. Most studies focused on specific disorders such as schizophrenia or bipolar disorder [ 10 , 16 ], emphasized financial and social stressors without exploring broader psychosocial dimensions [ 17 ], or reported high burden and distress without examining variations across caregiver subgroups [ 15 ]. Few studies have investigated the relationship between caregiver burden and QoL in a general inpatient psychiatric population, or considered how sociodemographic factors and caregiving duration influence this interaction. The Federal Neuropsychiatric Hospital, Enugu, serves a diverse population of individuals with severe mental illness who rely heavily on caregivers [ 18 ]. Despite their essential role, caregivers in this setting remain understudied. This study therefore assessed the burden and quality of life of caregivers of psychiatric inpatients, and examined the association between caregiver burden, QoL, and socio-demographic characteristics. Findings from this study provide evidence to inform the development of targeted psychosocial and economic support interventions that enhance caregiver well-being and improve patient care outcomes. 2. Methods 2.1 Study Area The study was conducted at the Federal Neuropsychiatric Hospital, Enugu State, Nigeria, a major tertiary mental health facility serving the southeastern region. The hospital provides specialized psychiatric care and attracts caregivers from diverse socioeconomic and cultural backgrounds. This setting offers a relevant context for examining caregiver burden and quality of life (QoL). Enugu State is located in the South-East geopolitical zone of Nigeria and is characterized by a rapidly growing population with diverse cultural and economic activities [ 19 ]. As a referral center within this region, the hospital provides an appropriate environment for assessing caregiving challenges influenced by limited mental health resources and sociocultural expectations. 2.2 Study Design The study adopted a descriptive cross-sectional design using a quantitative approach. 2.3 Study Population The study population comprised primary caregivers of psychiatric inpatients admitted to the hospital, defined as individuals who assumed principal responsibility for the daily care of the patient. Caregivers were eligible if they were aged 18 years or older, had provided care for at least three months, and gave written informed consent. Paid or professional caregivers, as well as caregivers receiving psychiatric treatment or those with cognitive impairments that could hinder participation, were excluded from the study. 2.4 Sample Size Determination The minimum sample size was calculated using Fisher’s formula for cross-sectional studies: $$n=\frac{{Z}^{2}*p(1-p)}{{d}^{2}}$$ Where n – minimum sample size required Z – Z-score corresponding to 95% confidence level (1.96) p – Prevalence of burden of caregivers of mentally ill patients attending an outpatient psychiatric clinic at a Nigerian tertiary health institution, set at 12.7% [ 15 ] d – Margin of error tolerated (0.05) Hence, To account for potential non-response and incomplete questionnaires, a 20% adjustment (34 participants) was added, resulting in a total sample size of 204, which was rounded up to 215 for convenience. 2.5 Sampling Technique A consecutive sampling technique was adopted in the study. All eligible caregivers who met the inclusion criteria and were present during the data collection period were recruited until the required sample size was reached. 2.6 Instrument for Data Collection Data were collected using a structured, interviewer-administered questionnaire comprising three sections. Section A captured demographic and socioeconomic characteristics, including age, sex, marital status, education, employment, income, relationship to the patient, and duration of caregiving. Section B assessed caregiver burden using items adapted from the Zarit Burden Interview, rated on a 5-point Likert scale. Section C measured quality of life using domains adapted from the WHOQOL-BREF, rated on a 5-point satisfaction scale. The questionnaire was reviewed and validated by a public health expert to ensure content validity. Internal consistency of the adapted scales was assessed using Cronbach’s alpha, yielding values of 0.772 for the caregiver burden scale and 0.733 for the quality of life scale, indicating acceptable reliability. 2.7 Data Collection Procedure Data were collected over a four-week period by a trained research assistant. Eligible caregivers were approached during patient admissions, clinic visits, and follow-up sessions. Written informed consent was obtained prior to participation, and questionnaires were administered through face-to-face interviews to accommodate participants with varying literacy levels. Participant confidentiality and anonymity were strictly maintained throughout the study. 2.8 Data Analysis Data were analyzed using IBM SPSS version 20. Variables were summarized using descriptive statistics. Chi-square tests assessed associations between categorical variables, with statistical significance set at p < 0.05. 3. Results 3.1 Socio-demographic characteristics of caregivers A total of 214 caregivers participated in the study (Table 1 ). The largest age group was 25–44 years, accounting for 43.9% (n = 94) of respondents. Females comprised 57.0% (n = 122), and over half were married (53.3%, n = 114). Regarding education, 43.9% (n = 94) had completed tertiary education, while the majority were self-employed (63.1%, n = 135). Most caregivers were siblings of the patients (44.9%, n = 96). Monthly income was predominantly within the ₦20,000–₦50,000 range (29.0%, n = 62). In terms of caregiving experience, 40.7% (n = 87) had provided care for more than three years. Table 1 Socio-demographic characteristics of respondents (N = 214) Variable Category Frequency (n) Percent (%) Age Group 18–24 years 39 18.20 25–44 years 94 43.90 45–64 years 65 30.40 65 years and above 16 7.50 Sex Female 122 57.00 Male 92 43.00 Marital Status Divorced/Separated 5 2.30 Married 114 53.30 Single 78 36.40 Widowed 17 7.90 Educational Level No formal education 4 1.9 Primary education 33 15.40 Secondary education 83 38.80 Tertiary education 94 43.90 Employment Status Employed (full-time) 46 21.50 Employed (part-time) 7 3.30 Self-employed 135 63.10 Unemployed 25 11.70 Relationship with the Patient Child 37 17.30 Parent 60 28.00 Sibling 96 44.90 Spouse 21 9.80 Monthly Income (₦) Below ₦20,000 59 27.60 ₦20,000–₦50,000 62 29.00 ₦50,000–₦100,000 46 21.50 Above ₦100,000 47 22.00 Duration as Caregiver Less than 6 months 77 36.00 6 months to 1 year 25 11.70 1–3 years 25 11.70 More than 3 years 87 40.70 Results are presented as frequencies and percentages. The monthly income is in the Nigerian Naira (₦) 3.2 Caregiver burden of psychiatric inpatients Assessment of caregiver burden (Table 2 ) revealed varied experiences among respondents. Over half of caregivers (56.1%, n = 120) reported that caregiving had never adversely affected their physical health. Emotional strain was experienced occasionally by 32.2% (n = 69) of respondents, while social isolation was uncommon, with 89.3% (n = 191) indicating they never felt isolated from family or friends. Time-related demands were notable: 28.0% (n = 60) sometimes and 25.7% (n = 55) always perceived caregiving as consuming excessive time. Financial burden was substantial, with 43.9% (n = 94) reporting that caregiving always affected their financial stability. A lack of support was consistently reported by 24.8% (n = 53), and emotional exhaustion was evident, with 29.9% (n = 64) always feeling emotionally drained. Despite these challenges, the majority of caregivers (87.4%, n = 187) never felt resentment toward the patient. Table 2 Caregiver burden of respondents (N = 214) Statement Response Frequency (n) Percent (%) Caregiving has negatively impacted my physical health Always 17 7.90 Never 120 56.10 Quite often 18 8.40 Rarely 8 3.70 Sometimes 51 23.80 I feel stressed due to my caregiving responsibilities Always 55 25.70 Never 67 31.30 Quite often 14 6.50 Rarely 9 4.20 Sometimes 69 32.20 I feel isolated from family and friends because of caregiving Always 1 0.50 Never 191 89.30 Quite often 5 2.30 Rarely 6 2.80 Sometimes 11 5.10 I feel caregiving is taking too much of my time Always 55 25.70 Never 75 35.00 Quite often 13 6.10 Rarely 11 5.10 Sometimes 60 28.00 Caregiving has affected my financial stability Always 94 43.90 Never 58 27.10 Quite often 10 4.70 Rarely 12 5.60 Sometimes 40 18.70 I do not have enough support to manage caregiving responsibilities Always 53 24.80 Never 101 47.20 Quite often 13 6.10 Rarely 8 3.70 Sometimes 39 18.20 I feel emotionally drained because of caregiving Always 64 29.90 Never 74 34.60 Quite often 16 7.50 Rarely 8 3.70 Sometimes 52 24.30 I feel resentful toward the patient because of caregiving Always 3 1.40 Never 187 87.40 Quite often 7 3.30 Rarely 5 2.30 Sometimes 12 5.60 Results are presented as frequencies and percentages 3.3 Level of caregiver burden The analysis of overall caregiver burden (Table 3 ) showed that nearly half of the respondents (45.8%, n = 98) experienced little or no burden, while 37.9% (n = 81) reported mild to moderate burden. A small proportion (0.9%, n = 2) experienced severe burden. Table 3 Level of caregiver burden (N = 214) Burden Level Frequency (n) Percent (%) Little or no burden 98 45.80 Mild to moderate burden 81 37.90 Moderate to severe burden 33 15.40 Severe burden 2 0.90 Total 214 100.00 Results are presented as frequencies and percentages 3.4 Quality of life of caregivers Assessment of caregivers’ quality of life (Table 4 ) indicated generally positive outcomes across several domains. Over half of respondents (53.7%, n = 115) were very satisfied with their overall health, and a substantial majority (76.2%, n = 163) reported high satisfaction with their physical ability to perform daily activities. Emotional well-being was more varied: 44.9% (n = 96) were very satisfied, while 20.6% (n = 44) expressed dissatisfaction. Personal relationships were largely strong, with 58.9% (n = 126) very satisfied. Financial stability remained a key concern, as 43.9% (n = 94) reported being very dissatisfied. Regarding stress management, 41.6% (n = 89) were very satisfied. Although 20.6% (n = 44) reported a lack of external support, the majority indicated satisfaction with available support. Finally, more than half of caregivers (52.8%, n = 113) reported high satisfaction with their caregiving role. Table 4 Quality of life of caregivers of psychiatric inpatients (N = 214) Quality of Life Indicator Response Frequency (n) Percent (%) Overall health Very satisfied 115 53.70 Satisfied 40 18.70 Neutral 23 10.70 Dissatisfied 27 12.60 Very dissatisfied 9 4.20 Physical ability to perform daily activities Very satisfied 163 76.20 Satisfied 36 16.80 Neutral 8 3.70 Dissatisfied 5 2.30 Very dissatisfied 2 0.90 Emotional well-being Very satisfied 96 44.90 Satisfied 41 19.20 Neutral 26 12.10 Dissatisfied 44 20.60 Very dissatisfied 7 3.30 Personal relationships Very satisfied 126 58.90 Satisfied 50 23.40 Neutral 21 9.80 Dissatisfied 9 4.20 Very dissatisfied 8 3.70 Financial stability Very dissatisfied 94 43.90 Dissatisfied 41 19.20 Neutral 21 9.80 Satisfied 29 13.60 Very satisfied 29 13.60 Ability to cope with stress Very satisfied 89 41.60 Satisfied 60 28.00 Neutral 37 17.30 Dissatisfied 22 10.30 Very dissatisfied 6 2.80 Support received from others Very satisfied 75 35.00 Satisfied 53 24.80 Neutral 31 14.50 Dissatisfied 44 20.60 Very dissatisfied 11 5.10 Satisfaction with caregiving Very satisfied 113 52.80 Satisfied 53 24.80 Neutral 30 14.00 Dissatisfied 16 7.50 Very dissatisfied 2 0.90 Results are presented as frequencies and percentages 3.5 Level of Caregivers’ Quality of Life The distribution of overall quality of life among caregivers (Table 5 ) showed that the largest proportion (43.9%, n = 94) reported a moderate level of QoL, followed by 33.6% (n = 72) who described their QoL as good. Smaller proportions reported poor (11.2%, n = 24) or very poor QoL (0.9%, n = 2). Table 5 Level of caregivers’ quality of life (N = 214) Quality of Life Level Frequency (n) Percent (%) Very poor 2 0.90 Poor 24 11.20 Moderate 94 43.90 Good 72 33.60 Very good 22 10.30 Total 214 100.00 Results are presented as frequencies and percentages 3.6 Test of Hypotheses Hypothesis 1 H₀ : There is no significant association between caregiver burden and the quality of life (QoL) of caregivers of psychiatric inpatients. H₁ There is a significant association between caregiver burden and the quality of life (QoL) of caregivers of psychiatric inpatients. Chi-square analysis (Table 6 ) revealed a statistically significant association between caregiver burden and quality of life among psychiatric inpatient caregivers (χ²(12) = 113.562, p < 0.001). Caregivers experiencing little or no burden predominantly reported good (49.0%, n = 48) or very good QoL (18.4%, n = 18), whereas those with moderate to severe burden were more likely to report moderate (57.6%, n = 19) or poor QoL (33.3%, n = 11). Table 6 Association between level of caregiver burden and quality of life of caregivers (N = 214) Caregiver Burden Very Poor QoL Poor QoL Moderate QoL Good QoL Very Good QoL Total χ² df p-value Little or no burden 0 4 28 48 18 98 Mild to moderate burden 1 9 46 24 1 81 Moderate to severe burden 0 11 19 0 3 33 Severe burden 1 0 1 0 0 2 Column Total 2 24 94 72 22 214 113.562 12 < .001* *Statistically significant Hypothesis 2 H₀ Socio-demographic factors are not significantly associated with caregiver burden. H₁ Socio-demographic factors are significantly associated with caregiver burden. Chi-square analyses (Table 7 ) indicated that, among all socio-demographic variables examined, only the duration of caregiving was significantly associated with caregiver burden (χ² = 26.918, df = 9, p = 0.001). Other variables, including age, sex, marital status, education, employment, relationship to the patient, and monthly income, were not significantly associated with burden (p > 0.05), although monthly income approached borderline significance (p = 0.055). Table 7 Association between socio-demographic variables and level of caregiver burden (N = 214) Variable χ² Df p-value Age Group 7.845 9 0.55 Sex 6.758 3 0.08 Marital Status 11.038 9 0.273 Educational Level 11.557 9 0.239 Employment Status 11.199 12 0.512 Relationship to Patient 13.404 9 0.145 Monthly Income 16.6 9 0.055 Duration as Caregiver 26.918 9 0.001* *Statistically significant 4. Discussion The socio-demographic profile of caregivers in this study highlights a predominantly young and economically active population. The largest age group (25–44 years) aligns with findings in Ethiopia, where the mean caregiver age was approximately 38 years [ 20 ]. This stage of life often involves balancing employment, parenting, and caregiving, which may amplify both psychological and economic strain. Females constituted the majority of caregivers, consistent with studies by Abayomi et al. [ 17 ], Jeyagurunathan et al. [ 21 ], and Souza et al. [ 22 ], reflecting the disproportionate caregiving burden assumed by women. This pattern mirrors traditional gender roles in African and global contexts, where women are expected to provide emotional and physical support within families. In Nigeria, the absence of formal support systems may further exacerbate this gendered burden. More than half of the caregivers were married, similar to the 65.2% reported by Jeyagurunathan et al. [ 21 ]. While marital status may offer additional emotional or financial support, it may also introduce competing family obligations, creating a dual burden. Notably, almost half had tertiary education, higher than levels reported in some previous studies, possibly reflecting better educational access among urban Nigerian caregivers [ 22 , 23 ]. A majority were self-employed, indicative of Nigeria’s informal economic structure, where small-scale business and daily earnings predominate. As highlighted by Okafor and Emedoh [ 16 ], lack of structured work benefits such as paid leave or health insurance may intensify stress when caregiving interferes with income-generating activities. Interestingly, siblings represented the largest group of caregivers, diverging from studies where parents, particularly mothers, are the primary caregivers [ 21 , 22 ]. This may reflect evolving familial roles in Nigeria due to parental migration, aging, or economic incapacity. Most caregivers earned between ₦20,000 and ₦50,000 monthly, highlighting significant financial constraints. Similar low-income patterns have been associated with higher caregiver burden and reduced QoL in other studies, likely compounding caregiving stress and limiting access to support or respite care [ 20 , 24 ]. A substantial proportion had been caregiving for more than three years, reflecting the chronic nature of psychiatric conditions. This aligns with previous findings which emphasize that prolonged caregiving is associated with emotional exhaustion, financial strain, and declining health outcomes [ 15 , 25 , 26 ]. The findings of this study highlight the complex and multifaceted nature of caregiver burden among those caring for psychiatric inpatients. 45.8% of caregivers reported little or no burden, 37.9% experienced mild to moderate burden, and only 0.9% reported severe burden, indicating predominantly moderate stress levels. This pattern aligns with previous studies [ 27 , 28 ], which similarly identified mild to moderate burden as the most common experience among psychiatric caregivers, reflecting the cumulative stress of long-term engagement with unpredictable mental illness. Emotional and financial burdens emerged as the most prominent stressors, while physical strain and social isolation were comparatively lower. Although more than half reported no adverse impact on physical health—a contrast to the more physically taxing effects noted by Von Kardorff et al. [ 26 ]—29.9% felt emotionally drained consistently, and 32.2% experienced intermittent stress. These findings are consistent with previous studies, all of which documented high levels of psychological distress, anxiety, and depression among caregivers in emotionally demanding psychiatric settings [ 15 , 21 , 25 ]. Financial strain was particularly pronounced, with almost half indicating caregiving always affected their financial stability. This corroborates prior research emphasizing the economic impact of caregiving, especially among self-employed or low-income caregivers [ 17 , 20 , 22 ]. Limited resources may restrict access to medications, transportation, or adequate nutrition, further exacerbating stress and reducing caregiver well-being. In addition, 24.8% of caregivers reported consistently lacking sufficient support, echoing findings from Ndikuno et al. [ 24 ] and Stanley et al. [ 25 ]. Insufficient family or institutional support intensifies emotional and logistical strain and may undermine sustained caregiving. Despite these challenges, majority of caregivers reported never feeling resentment toward the patient, reflecting cultural and moral expectations in collectivist societies such as Nigeria. However, suppressed resentment may mask underlying psychological strain [ 16 ]. These findings underscore the urgent need for targeted interventions, including financial assistance, psychosocial support, and counseling, as recommended in previous studies, to mitigate the cumulative effects of long-term caregiving for psychiatric inpatients [ 25 , 27 ]. The findings indicate that caregivers of psychiatric inpatients generally reported a moderately positive quality of life (QoL). These outcomes reflect the complex interplay between resilience, socio-economic status, emotional strain, and available support. The results align partly with Ndikuno et al. [ 24 ] and Hsiao et al. [ 27 ], who identified moderate to poor QoL among caregivers, although the present study shows a comparatively higher proportion of positive outcomes. This difference may stem from variations in healthcare infrastructure, cultural expectations, or internal coping mechanisms among Nigerian caregivers. Domain-specific analysis revealed that physical ability and satisfaction with the caregiving role were relatively high, whereas emotional and financial well-being were notable sources of concern. Specifically, 20.6% reported dissatisfaction with emotional well-being, and 43.9% were very dissatisfied with financial stability. These findings echo Abayomi et al. [ 17 ] and Souza et al. [ 22 ], emphasizing financial strain as a leading contributor to caregiver distress. Given that most caregivers were self-employed earning less than ₦50,000 monthly, economic pressures likely exacerbate stress and limit access to supportive resources. Satisfaction with personal relationships and the caregiving role suggests strong intrinsic motivation and a cultural sense of familial duty, consistent with Von Kardorff et al. [ 26 ]. However, emotional outcomes were mixed: while almost half were very satisfied with emotional well-being, 20.6% were dissatisfied, and 41.6% reported high satisfaction with stress management, reflecting the heterogeneity of caregiver experiences as noted by Jeyagurunathan et al. [ 21 ]. These findings underscore the importance of individualized psychosocial interventions and structured support systems—including peer networks, counseling, and psychoeducation—to enhance coping capacity and QoL, as advocated by Stanley et al. [ 25 ] and Hsiao et al. [ 27 ]. Despite a generally moderate-to-good QoL, financial and emotional challenges remain substantial, highlighting the urgent need for interventions aimed at alleviating burden and sustaining caregiving capacity for psychiatric inpatients. The present study demonstrated a strong and statistically significant association between caregiver burden and quality of life (QoL), highlighting the profound impact of caregiving stress on overall well-being. Caregivers reporting little or no burden indicated higher QoL. In contrast, those experiencing moderate to severe burden were more likely to report “moderate” or “poor”, emphasizing the negative ripple effects of caregiving demands. These findings are consistent with prior research. Srivastava et al. [ 28 ] identified a significant negative correlation between caregiver burden and QoL among dementia caregivers, while Ukpong and Ibigbami [ 10 ] reported similar trends among caregivers of patients with schizophrenia and bipolar disorder. Psychological distress stemming from caregiving burden has been shown to predict lower QoL across physical, emotional, and social domains [ 21 , 25 ]. Among socio-demographic factors, only duration of caregiving was significantly associated with caregiver burden. Other factors—including age, sex, marital status, education, employment, income, and relationship to the patient—were not statistically significant, although monthly income approached borderline significance (p = .055). Interestingly, longer caregiving duration correlated with lower perceived burden, contrary to studies such as Hsiao et al. [ 27 ], which reported higher burden with prolonged caregiving. This discrepancy may reflect the influence of cultural norms in Nigeria, where extended caregiving fosters adaptive coping and communal support, mitigating stress over time. The lack of significant associations between caregiver burden and sex, education, employment, or patient relationship contrasts with previous findings [ 17 , 20 , 22 , 23 ]. This may be explained by the more balanced gender distribution in the current sample, equitable sharing of caregiving responsibilities, or homogeneity in educational and employment backgrounds. Although monthly income did not reach statistical significance, financial strain emerged as a major stressor, with nearly 44% of caregivers reporting that caregiving always affected their financial stability. This aligns with prior studies highlighting income and financial hardship as key contributors to caregiver burden [ 16 , 17 ]. The borderline significance observed may reflect limitations in income stratification or sample homogeneity, suggesting that future research should employ more granular income measures to better capture its impact. These findings underscore that caregiver burden is a multidimensional construct influenced by both situational and contextual factors, and its mitigation requires culturally tailored interventions, including psychosocial support, financial assistance, and strategies to enhance adaptive coping over the course of caregiving. Limitations of the Study This study adapted and modified items from the Zarit Burden Interview and WHOQOL-BREF to fit the local context, rather than using the full standardized instruments. While this approach may limit direct comparability with other studies using the full scales, internal consistency for both adapted measures was acceptable (Cronbach’s alpha = 0.772 for caregiver burden and 0.733 for quality of life), supporting the reliability of the findings. 5. Conclusions This study examined burden and quality of life (QoL) among caregivers of psychiatric inpatients at the Federal Neuropsychiatric Hospital, Enugu State, Nigeria. Findings indicate that while nearly half of caregivers experienced little or no burden, a substantial proportion reported mild to moderate burden, with financial strain, emotional exhaustion, and time-related demands being particularly prevalent. Quality of life varied across domains: caregivers generally reported satisfaction with physical health and personal relationships, yet dissatisfaction was notable in financial stability and emotional well-being. A statistically significant association between caregiver burden and QoL was observed, confirming that higher burden is linked to lower quality of life. Among socio-demographic factors, only the duration of caregiving showed a significant association with burden, underscoring the impact of prolonged caregiving on well-being. These results highlight the influence of contextual, cultural, and systemic factors on caregiver experiences and emphasize the need for targeted, culturally sensitive interventions. To improve caregiver well-being, mental health institutions should establish structured support programs, including caregiver support groups, peer counseling, and psychoeducation, to help manage psychological and emotional demands. Financial assistance and subsidies, particularly for caregivers from low-income households, could alleviate economic strain. Periodic mental health screenings and counseling services would address stress, anxiety, and emotional exhaustion, while part-time or temporary respite care could provide caregivers with opportunities to recover from physical and emotional fatigue. Policymakers should recognize caregivers as essential members of the care team, integrate their needs into national mental health strategies, and promote public awareness campaigns to reduce stigma and strengthen social support networks. Interventions should also be sensitive to the duration of caregiving, providing intensive orientation and guidance for new caregivers and sustained emotional, psychosocial, and financial support for long-term caregivers. Abbreviations DALYs Disability–Adjusted Life Years FNHE Federal Neuropsychiatric Hospital, Enugu QoL Quality of Life WHO World Health Organization WHOQoL BREF–World Health Organization Quality of Life–Brief Version Declarations Ethics approval and consent to participate The study adhered strictly to international ethical guidelines as outlined in the Declaration of Helsinki. Ethical approval was obtained from the University of Nigeria Teaching Hospital Health Research Ethics Committee (NHREC/05/01/2008B-FWA00002458-1RB00002323) and the Research Ethics Committee of the Federal Neuropsychiatric Hospital, Enugu (FNHE/HTR/REA/VOL11/134). Written informed consent was obtained from all participants. Participation was voluntary, confidentiality was assured, and caregivers were informed of their right to withdraw at any stage. Consent for publication Not applicable Availability of data and materials The datasets supporting the conclusions of this article are included within the article (and its additional files). Competing interests The authors declare that they have no competing interests. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors’ contributions PCO was involved in conceptualization of the study, resources mobilization, obtaining ethical clearance, field work, and revising the manuscript. LOP designed the study methodology, supervised data collection, performed data analysis, and drafted the manuscript. IPE collected the data and was involved with the management of the hospital to make caregivers available for the interviews. BIO contributed to conceptualization, methodology, questionnaire validation, supervision, and provided critical revisions to the manuscript. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work. Acknowledgments The authors sincerely appreciate the access granted and the support provided by the management of the Federal Neuropsychiatric Hospital, Enugu, which greatly facilitated the conduct of this study. References Hossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, et al. Epidemiology of mental health problems in COVID-19: A review. F1000Research. 2020;9:636. World Health Organization. Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders . Accessed 9 Mar 2026. World Health Organization. Mental health. https://www.who.int/health-topics/mental-health#tab=tab_1 . Accessed 9 Mar 2026. Galderisi S, Heinz A, Kastrup M, Beezhold J, Sartorius N. Toward a new definition of mental health. 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Caregiver burden, psychological distress and self-esteem among relative caregivers of mentally ill patients in a Nigerian tertiary health institution. J Fam Soc Res. 2024;3(2):1–12. Okafor CJ, Emedoh T. Caregivers of schizophrenia patients in Calabar: Extent and predictors of burden. Calabar J Health Sci. 2020;4(2):48–56. Abayomi O, Akinhanmi AO, Adelufosi AO. Psychiatric morbidity and subjective burden among carers of outpatients of a psychogeriatric clinic in southwestern Nigeria. J Cross Cult Gerontol. 2015;30:439–50. Nwedu AB. Exploration of the lived experience of young adults diagnosed with a mental illness and being treated at a Nigerian psychiatric hospital regarding their mental health problems [master’s thesis]. United Kingdom: University of Salford; 2019. Iyi EA. A review of Enugu (Enugu State, Nigeria) urban growth and development. J Res Environ Earth Sci. 2014;1(3):44–51. Ayalew M, Workicho A, Tesfaye E, Hailesilasie H, Abera M. Burden among caregivers of people with mental illness at Jimma University Medical Center, Southwest Ethiopia: A cross-sectional study. Ann Gen Psychiatry. 2019;18:1–11. Jeyagurunathan A, Sagayadevan V, Abdin E, Zhang Y, Chang S, Shafie S, et al. Psychological status and quality of life among primary caregivers of individuals with mental illness: A hospital based study. Health Qual Life Outcomes. 2017;15:1–14. Souza ALR, Guimarães RA, Araújo Vilela D, Assis RM, Almeida Cavalcante Oliveira LM, Souza MR, et al. Factors associated with the burden of family caregivers of patients with mental disorders: A cross-sectional study. BMC Psychiatry. 2017;17:1–10. Inogbo CF, Olotu SO, James BO, Nna EO. Burden of care amongst caregivers who are first degree relatives of patients with schizophrenia. Pan Afr Med J. 2017;28(1). Ndikuno C, Namutebi M, Kuteesa J, Mukunya D, Olwit C. Quality of life of caregivers of patients diagnosed with severe mental illness at the national referral hospitals in Uganda. BMC Psychiatry. 2016;16:1–9. Stanley S, Balakrishnan S, Ilangovan S. Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. J Ment Health. 2017;26(2):134–41. Von Kardorff E, Soltaninejad A, Kamali M, Eslami Shahrbabaki M. Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia—A qualitative exploratory study. Nord J Psychiatry. 2016;70(4):248–54. Hsiao CY, Lu HL, Tsai YF. Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: A cross-sectional study. Qual Life Res. 2020;29(10):2745–57. Srivastava G, Tripathi RK, Tiwari SC, Singh B, Tripathi SM. Caregiver burden and quality of life of key caregivers of patients with dementia. Indian J Psychol Med. 2016;38(2):133–6. Additional Declarations No competing interests reported. Supplementary Files BURDENANDQUALITYOFLIFEDATASET.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9074474","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":604413523,"identity":"94bddd54-2c9e-417e-9504-39ce41a5eb3c","order_by":0,"name":"Pamela Chidera Onyia","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Pamela","middleName":"Chidera","lastName":"Onyia","suffix":""},{"id":604413526,"identity":"5555b2a2-aa88-476e-9e71-5320cc615069","order_by":1,"name":"Luke Oche Peter","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYBCDBAZ2BmYGhgogk5m5gYBiZqgWZhDrDEiAkRQtjG0gNgEt5uz9Bx9XVNjl8TPzGBt8nFcbzd8O1PKjYhtOLZY9h5kNz5xJLpZs5jFOnLnteO6Mw4wNjD1nbuPUYnAjmU2yse1A4obDPMaHebcdy20AamFmbMOj5f5j9p8gLftBWv7OOZY7n6CWG8xsjGBbgH5JZmyoyd1ASItlT7KxZMOZ5MQZh9mKDXuOHcjdCNRyEJ9fzNkPPvzYUGGX2N/evFniR01d7rzzhw8++FGBx2Fo/MNg8gBO9Vi01OFTPApGwSgYBSMUAAAIf1uh+SZnoQAAAABJRU5ErkJggg==","orcid":"","institution":"University of Nigeria","correspondingAuthor":true,"prefix":"","firstName":"Luke","middleName":"Oche","lastName":"Peter","suffix":""},{"id":604413527,"identity":"8b461eb1-0a49-4002-899d-34b09cfd4d19","order_by":2,"name":"Babatunde Ishola Omotowo","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Babatunde","middleName":"Ishola","lastName":"Omotowo","suffix":""},{"id":604413528,"identity":"d7fb0153-6506-48c8-b198-3a260bb67358","order_by":3,"name":"Idongesit Peter Essien","email":"","orcid":"","institution":"University of Nigeria","correspondingAuthor":false,"prefix":"","firstName":"Idongesit","middleName":"Peter","lastName":"Essien","suffix":""}],"badges":[],"createdAt":"2026-03-09 14:55:00","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9074474/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9074474/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104786576,"identity":"14367f56-f485-4588-a83f-7025b75461e8","added_by":"auto","created_at":"2026-03-17 08:17:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1683283,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9074474/v1/011e831a-eafd-4998-92ba-65439d00d40e.pdf"},{"id":104498595,"identity":"c2bab292-0820-481d-93cb-6d92e5c9b8de","added_by":"auto","created_at":"2026-03-12 13:21:07","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":40667,"visible":true,"origin":"","legend":"","description":"","filename":"BURDENANDQUALITYOFLIFEDATASET.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-9074474/v1/250890e10267fab13eecd8d1.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Burden and quality of life among caregivers of psychiatric inpatients in a neuropsychiatric hospital in Southeast Nigeria: a cross-sectional study","fulltext":[{"header":"1. Background","content":"\u003cp\u003eMental health conditions are a major and growing public health concern globally, affecting individuals across all demographic groups and contributing substantially to morbidity and disability [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. They encompass a range of disorders and psychosocial disabilities characterized by significant distress, impaired functioning, and elevated risk of self-harm. Globally, mental disorders accounted for approximately 14% of disability-adjusted life years (DALYs) in 2019, affecting nearly 970\u0026nbsp;million people, most commonly through anxiety and depressive disorders [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Severe mental illness can reduce life expectancy and heighten vulnerability to human rights violations, while the economic impact is largely driven by productivity losses [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In low- and middle-income countries such as Nigeria, this burden is intensified by stigma, inadequate mental health services, and limited treatment resources [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePsychiatric inpatients often require extensive support due to impaired capacity to perform daily activities [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. This responsibility frequently falls on informal caregivers, whose critical role exposes them to emotional strain, financial hardship, and social isolation\u0026mdash;collectively termed caregiver burden [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Burden can manifest as psychological distress, disrupted relationships, and reduced quality of life (QoL), with implications for both caregiver well-being and patient outcomes [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. QoL, defined by the WHO as an individual\u0026rsquo;s perception of their position in life within the context of culture and value systems, is often compromised among caregivers due to prolonged caregiving demands, stigma, and limited support [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In Nigeria, caregivers frequently shoulder these responsibilities with minimal formal assistance [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough prior Nigerian studies have examined aspects of caregiver burden and QoL, notable gaps remain. Most studies focused on specific disorders such as schizophrenia or bipolar disorder [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], emphasized financial and social stressors without exploring broader psychosocial dimensions [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], or reported high burden and distress without examining variations across caregiver subgroups [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Few studies have investigated the relationship between caregiver burden and QoL in a general inpatient psychiatric population, or considered how sociodemographic factors and caregiving duration influence this interaction.\u003c/p\u003e \u003cp\u003eThe Federal Neuropsychiatric Hospital, Enugu, serves a diverse population of individuals with severe mental illness who rely heavily on caregivers [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Despite their essential role, caregivers in this setting remain understudied. This study therefore assessed the burden and quality of life of caregivers of psychiatric inpatients, and examined the association between caregiver burden, QoL, and socio-demographic characteristics. Findings from this study provide evidence to inform the development of targeted psychosocial and economic support interventions that enhance caregiver well-being and improve patient care outcomes.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Study Area\u003c/h2\u003e \u003cp\u003eThe study was conducted at the Federal Neuropsychiatric Hospital, Enugu State, Nigeria, a major tertiary mental health facility serving the southeastern region. The hospital provides specialized psychiatric care and attracts caregivers from diverse socioeconomic and cultural backgrounds. This setting offers a relevant context for examining caregiver burden and quality of life (QoL). Enugu State is located in the South-East geopolitical zone of Nigeria and is characterized by a rapidly growing population with diverse cultural and economic activities [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. As a referral center within this region, the hospital provides an appropriate environment for assessing caregiving challenges influenced by limited mental health resources and sociocultural expectations.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Design\u003c/h2\u003e \u003cp\u003eThe study adopted a descriptive cross-sectional design using a quantitative approach.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Study Population\u003c/h2\u003e \u003cp\u003eThe study population comprised primary caregivers of psychiatric inpatients admitted to the hospital, defined as individuals who assumed principal responsibility for the daily care of the patient. Caregivers were eligible if they were aged 18 years or older, had provided care for at least three months, and gave written informed consent. Paid or professional caregivers, as well as caregivers receiving psychiatric treatment or those with cognitive impairments that could hinder participation, were excluded from the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Sample Size Determination\u003c/h2\u003e \u003cp\u003eThe minimum sample size was calculated using Fisher\u0026rsquo;s formula for cross-sectional studies:\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$n=\\frac{{Z}^{2}*p(1-p)}{{d}^{2}}$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eWhere\u003c/p\u003e \u003cp\u003en \u0026ndash; minimum sample size required\u003c/p\u003e \u003cp\u003eZ \u0026ndash; Z-score corresponding to 95% confidence level (1.96)\u003c/p\u003e \u003cp\u003ep \u0026ndash; Prevalence of burden of caregivers of mentally ill patients attending an outpatient psychiatric clinic at a Nigerian tertiary health institution, set at 12.7% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003cp\u003ed \u0026ndash; Margin of error tolerated (0.05)\u003c/p\u003e \u003cp\u003eHence,\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/127393_c7e80a1c9bb65875/127393_custom_files/img1773321437.png\" style=\"width: 251px;\"\u003e\u003c/p\u003e\n\u003cp\u003eTo account for potential non-response and incomplete questionnaires, a 20% adjustment (34 participants) was added, resulting in a total sample size of 204, which was rounded up to 215 for convenience.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Sampling Technique\u003c/h2\u003e \u003cp\u003eA consecutive sampling technique was adopted in the study. All eligible caregivers who met the inclusion criteria and were present during the data collection period were recruited until the required sample size was reached.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.6 Instrument for Data Collection\u003c/h2\u003e \u003cp\u003eData were collected using a structured, interviewer-administered questionnaire comprising three sections. Section A captured demographic and socioeconomic characteristics, including age, sex, marital status, education, employment, income, relationship to the patient, and duration of caregiving. Section B assessed caregiver burden using items adapted from the Zarit Burden Interview, rated on a 5-point Likert scale. Section C measured quality of life using domains adapted from the WHOQOL-BREF, rated on a 5-point satisfaction scale. The questionnaire was reviewed and validated by a public health expert to ensure content validity. Internal consistency of the adapted scales was assessed using Cronbach\u0026rsquo;s alpha, yielding values of 0.772 for the caregiver burden scale and 0.733 for the quality of life scale, indicating acceptable reliability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.7 Data Collection Procedure\u003c/h2\u003e \u003cp\u003eData were collected over a four-week period by a trained research assistant. Eligible caregivers were approached during patient admissions, clinic visits, and follow-up sessions. Written informed consent was obtained prior to participation, and questionnaires were administered through face-to-face interviews to accommodate participants with varying literacy levels. Participant confidentiality and anonymity were strictly maintained throughout the study.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e2.8 Data Analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using IBM SPSS version 20. Variables were summarized using descriptive statistics. Chi-square tests assessed associations between categorical variables, with statistical significance set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Socio-demographic characteristics of caregivers\u003c/h2\u003e \u003cp\u003eA total of 214 caregivers participated in the study (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The largest age group was 25\u0026ndash;44 years, accounting for 43.9% (n\u0026thinsp;=\u0026thinsp;94) of respondents. Females comprised 57.0% (n\u0026thinsp;=\u0026thinsp;122), and over half were married (53.3%, n\u0026thinsp;=\u0026thinsp;114). Regarding education, 43.9% (n\u0026thinsp;=\u0026thinsp;94) had completed tertiary education, while the majority were self-employed (63.1%, n\u0026thinsp;=\u0026thinsp;135). Most caregivers were siblings of the patients (44.9%, n\u0026thinsp;=\u0026thinsp;96). Monthly income was predominantly within the ₦20,000\u0026ndash;₦50,000 range (29.0%, n\u0026thinsp;=\u0026thinsp;62). In terms of caregiving experience, 40.7% (n\u0026thinsp;=\u0026thinsp;87) had provided care for more than three years.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of respondents (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;24 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25\u0026ndash;44 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45\u0026ndash;64 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65 years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced/Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed (full-time)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed (part-time)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship with the Patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChild\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSibling\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpouse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Income (₦)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBelow ₦20,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e₦20,000\u0026ndash;₦50,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e₦50,000\u0026ndash;₦100,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbove ₦100,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration as Caregiver\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 months to 1 year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 3 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eResults are presented as frequencies and percentages. The monthly income is in the Nigerian Naira (₦)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Caregiver burden of psychiatric inpatients\u003c/h2\u003e \u003cp\u003eAssessment of caregiver burden (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) revealed varied experiences among respondents. Over half of caregivers (56.1%, n\u0026thinsp;=\u0026thinsp;120) reported that caregiving had never adversely affected their physical health. Emotional strain was experienced occasionally by 32.2% (n\u0026thinsp;=\u0026thinsp;69) of respondents, while social isolation was uncommon, with 89.3% (n\u0026thinsp;=\u0026thinsp;191) indicating they never felt isolated from family or friends. Time-related demands were notable: 28.0% (n\u0026thinsp;=\u0026thinsp;60) sometimes and 25.7% (n\u0026thinsp;=\u0026thinsp;55) always perceived caregiving as consuming excessive time. Financial burden was substantial, with 43.9% (n\u0026thinsp;=\u0026thinsp;94) reporting that caregiving always affected their financial stability. A lack of support was consistently reported by 24.8% (n\u0026thinsp;=\u0026thinsp;53), and emotional exhaustion was evident, with 29.9% (n\u0026thinsp;=\u0026thinsp;64) always feeling emotionally drained. Despite these challenges, the majority of caregivers (87.4%, n\u0026thinsp;=\u0026thinsp;187) never felt resentment toward the patient.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCaregiver burden of respondents (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStatement\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiving has negatively impacted my physical health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI feel stressed due to my caregiving responsibilities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI feel isolated from family and friends because of caregiving\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI feel caregiving is taking too much of my time\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCaregiving has affected my financial stability\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI do not have enough support to manage caregiving responsibilities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI feel emotionally drained because of caregiving\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eI feel resentful toward the patient because of caregiving\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuite often\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSometimes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Level of caregiver burden\u003c/h2\u003e \u003cp\u003eThe analysis of overall caregiver burden (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) showed that nearly half of the respondents (45.8%, n\u0026thinsp;=\u0026thinsp;98) experienced little or no burden, while 37.9% (n\u0026thinsp;=\u0026thinsp;81) reported mild to moderate burden. A small proportion (0.9%, n\u0026thinsp;=\u0026thinsp;2) experienced severe burden.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevel of caregiver burden (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurden Level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLittle or no burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild to moderate burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate to severe burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e214\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Quality of life of caregivers\u003c/h2\u003e \u003cp\u003eAssessment of caregivers\u0026rsquo; quality of life (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e) indicated generally positive outcomes across several domains. Over half of respondents (53.7%, n\u0026thinsp;=\u0026thinsp;115) were very satisfied with their overall health, and a substantial majority (76.2%, n\u0026thinsp;=\u0026thinsp;163) reported high satisfaction with their physical ability to perform daily activities. Emotional well-being was more varied: 44.9% (n\u0026thinsp;=\u0026thinsp;96) were very satisfied, while 20.6% (n\u0026thinsp;=\u0026thinsp;44) expressed dissatisfaction. Personal relationships were largely strong, with 58.9% (n\u0026thinsp;=\u0026thinsp;126) very satisfied. Financial stability remained a key concern, as 43.9% (n\u0026thinsp;=\u0026thinsp;94) reported being very dissatisfied. Regarding stress management, 41.6% (n\u0026thinsp;=\u0026thinsp;89) were very satisfied. Although 20.6% (n\u0026thinsp;=\u0026thinsp;44) reported a lack of external support, the majority indicated satisfaction with available support. Finally, more than half of caregivers (52.8%, n\u0026thinsp;=\u0026thinsp;113) reported high satisfaction with their caregiving role.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eQuality of life of caregivers of psychiatric inpatients (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuality of Life Indicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall health\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical ability to perform daily activities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional well-being\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersonal relationships\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFinancial stability\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAbility to cope with stress\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSupport received from others\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSatisfaction with caregiving\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery satisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.50\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery dissatisfied\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Level of Caregivers\u0026rsquo; Quality of Life\u003c/h2\u003e \u003cp\u003eThe distribution of overall quality of life among caregivers (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e) showed that the largest proportion (43.9%, n\u0026thinsp;=\u0026thinsp;94) reported a moderate level of QoL, followed by 33.6% (n\u0026thinsp;=\u0026thinsp;72) who described their QoL as good. Smaller proportions reported poor (11.2%, n\u0026thinsp;=\u0026thinsp;24) or very poor QoL (0.9%, n\u0026thinsp;=\u0026thinsp;2).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLevel of caregivers\u0026rsquo; quality of life (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuality of Life Level\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercent (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVery poor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePoor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43.90\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGood\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVery good\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e214\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e100.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eResults are presented as frequencies and percentages\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e3.6 Test of Hypotheses\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eHypothesis 1\u003c/strong\u003e \u003cp\u003e \u003cb\u003eH₀\u003c/b\u003e: There is no significant association between caregiver burden and the quality of life (QoL) of caregivers of psychiatric inpatients.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH₁\u003c/strong\u003e \u003cp\u003eThere is a significant association between caregiver burden and the quality of life (QoL) of caregivers of psychiatric inpatients.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eChi-square analysis (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e) revealed a statistically significant association between caregiver burden and quality of life among psychiatric inpatient caregivers (χ\u0026sup2;(12)\u0026thinsp;=\u0026thinsp;113.562, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Caregivers experiencing little or no burden predominantly reported good (49.0%, n\u0026thinsp;=\u0026thinsp;48) or very good QoL (18.4%, n\u0026thinsp;=\u0026thinsp;18), whereas those with moderate to severe burden were more likely to report moderate (57.6%, n\u0026thinsp;=\u0026thinsp;19) or poor QoL (33.3%, n\u0026thinsp;=\u0026thinsp;11).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between level of caregiver burden and quality of life of caregivers (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCaregiver Burden\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVery Poor QoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePoor QoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eModerate QoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eGood QoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVery Good QoL\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLittle or no burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild to moderate burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate to severe burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere burden\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eColumn Total\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e24\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e94\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e72\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e22\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e214\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e113.562\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003e12\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003e*Statistically significant\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003e\u003cb\u003eHypothesis 2\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH₀\u003c/strong\u003e \u003cp\u003eSocio-demographic factors are not significantly associated with caregiver burden.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eH₁\u003c/strong\u003e \u003cp\u003eSocio-demographic factors are significantly associated with caregiver burden.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eChi-square analyses (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e) indicated that, among all socio-demographic variables examined, only the duration of caregiving was significantly associated with caregiver burden (χ\u0026sup2; = 26.918, df\u0026thinsp;=\u0026thinsp;9, p\u0026thinsp;=\u0026thinsp;0.001). Other variables, including age, sex, marital status, education, employment, relationship to the patient, and monthly income, were not significantly associated with burden (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05), although monthly income approached borderline significance (p\u0026thinsp;=\u0026thinsp;0.055).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between socio-demographic variables and level of caregiver burden (N\u0026thinsp;=\u0026thinsp;214)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eχ\u0026sup2;\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge Group\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.845\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.758\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.273\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducational Level\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.557\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.239\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.512\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRelationship to Patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.404\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration as Caregiver\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26.918\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Statistically significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe socio-demographic profile of caregivers in this study highlights a predominantly young and economically active population. The largest age group (25\u0026ndash;44 years) aligns with findings in Ethiopia, where the mean caregiver age was approximately 38 years [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This stage of life often involves balancing employment, parenting, and caregiving, which may amplify both psychological and economic strain. Females constituted the majority of caregivers, consistent with studies by Abayomi et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], Jeyagurunathan et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], and Souza et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], reflecting the disproportionate caregiving burden assumed by women. This pattern mirrors traditional gender roles in African and global contexts, where women are expected to provide emotional and physical support within families. In Nigeria, the absence of formal support systems may further exacerbate this gendered burden. More than half of the caregivers were married, similar to the 65.2% reported by Jeyagurunathan et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. While marital status may offer additional emotional or financial support, it may also introduce competing family obligations, creating a dual burden. Notably, almost half had tertiary education, higher than levels reported in some previous studies, possibly reflecting better educational access among urban Nigerian caregivers [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. A majority were self-employed, indicative of Nigeria\u0026rsquo;s informal economic structure, where small-scale business and daily earnings predominate. As highlighted by Okafor and Emedoh [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], lack of structured work benefits such as paid leave or health insurance may intensify stress when caregiving interferes with income-generating activities. Interestingly, siblings represented the largest group of caregivers, diverging from studies where parents, particularly mothers, are the primary caregivers [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This may reflect evolving familial roles in Nigeria due to parental migration, aging, or economic incapacity. Most caregivers earned between ₦20,000 and ₦50,000 monthly, highlighting significant financial constraints. Similar low-income patterns have been associated with higher caregiver burden and reduced QoL in other studies, likely compounding caregiving stress and limiting access to support or respite care [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. A substantial proportion had been caregiving for more than three years, reflecting the chronic nature of psychiatric conditions. This aligns with previous findings which emphasize that prolonged caregiving is associated with emotional exhaustion, financial strain, and declining health outcomes [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe findings of this study highlight the complex and multifaceted nature of caregiver burden among those caring for psychiatric inpatients. 45.8% of caregivers reported little or no burden, 37.9% experienced mild to moderate burden, and only 0.9% reported severe burden, indicating predominantly moderate stress levels. This pattern aligns with previous studies [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], which similarly identified mild to moderate burden as the most common experience among psychiatric caregivers, reflecting the cumulative stress of long-term engagement with unpredictable mental illness. Emotional and financial burdens emerged as the most prominent stressors, while physical strain and social isolation were comparatively lower. Although more than half reported no adverse impact on physical health\u0026mdash;a contrast to the more physically taxing effects noted by Von Kardorff et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u0026mdash;29.9% felt emotionally drained consistently, and 32.2% experienced intermittent stress. These findings are consistent with previous studies, all of which documented high levels of psychological distress, anxiety, and depression among caregivers in emotionally demanding psychiatric settings [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Financial strain was particularly pronounced, with almost half indicating caregiving always affected their financial stability. This corroborates prior research emphasizing the economic impact of caregiving, especially among self-employed or low-income caregivers [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Limited resources may restrict access to medications, transportation, or adequate nutrition, further exacerbating stress and reducing caregiver well-being. In addition, 24.8% of caregivers reported consistently lacking sufficient support, echoing findings from Ndikuno et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and Stanley et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Insufficient family or institutional support intensifies emotional and logistical strain and may undermine sustained caregiving. Despite these challenges, majority of caregivers reported never feeling resentment toward the patient, reflecting cultural and moral expectations in collectivist societies such as Nigeria. However, suppressed resentment may mask underlying psychological strain [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These findings underscore the urgent need for targeted interventions, including financial assistance, psychosocial support, and counseling, as recommended in previous studies, to mitigate the cumulative effects of long-term caregiving for psychiatric inpatients [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe findings indicate that caregivers of psychiatric inpatients generally reported a moderately positive quality of life (QoL). These outcomes reflect the complex interplay between resilience, socio-economic status, emotional strain, and available support. The results align partly with Ndikuno et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and Hsiao et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], who identified moderate to poor QoL among caregivers, although the present study shows a comparatively higher proportion of positive outcomes. This difference may stem from variations in healthcare infrastructure, cultural expectations, or internal coping mechanisms among Nigerian caregivers. Domain-specific analysis revealed that physical ability and satisfaction with the caregiving role were relatively high, whereas emotional and financial well-being were notable sources of concern. Specifically, 20.6% reported dissatisfaction with emotional well-being, and 43.9% were very dissatisfied with financial stability. These findings echo Abayomi et al. [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e] and Souza et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], emphasizing financial strain as a leading contributor to caregiver distress. Given that most caregivers were self-employed earning less than ₦50,000 monthly, economic pressures likely exacerbate stress and limit access to supportive resources. Satisfaction with personal relationships and the caregiving role suggests strong intrinsic motivation and a cultural sense of familial duty, consistent with Von Kardorff et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. However, emotional outcomes were mixed: while almost half were very satisfied with emotional well-being, 20.6% were dissatisfied, and 41.6% reported high satisfaction with stress management, reflecting the heterogeneity of caregiver experiences as noted by Jeyagurunathan et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. These findings underscore the importance of individualized psychosocial interventions and structured support systems\u0026mdash;including peer networks, counseling, and psychoeducation\u0026mdash;to enhance coping capacity and QoL, as advocated by Stanley et al. [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] and Hsiao et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Despite a generally moderate-to-good QoL, financial and emotional challenges remain substantial, highlighting the urgent need for interventions aimed at alleviating burden and sustaining caregiving capacity for psychiatric inpatients.\u003c/p\u003e \u003cp\u003eThe present study demonstrated a strong and statistically significant association between caregiver burden and quality of life (QoL), highlighting the profound impact of caregiving stress on overall well-being. Caregivers reporting little or no burden indicated higher QoL. In contrast, those experiencing moderate to severe burden were more likely to report \u0026ldquo;moderate\u0026rdquo; or \u0026ldquo;poor\u0026rdquo;, emphasizing the negative ripple effects of caregiving demands. These findings are consistent with prior research. Srivastava et al. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] identified a significant negative correlation between caregiver burden and QoL among dementia caregivers, while Ukpong and Ibigbami [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] reported similar trends among caregivers of patients with schizophrenia and bipolar disorder. Psychological distress stemming from caregiving burden has been shown to predict lower QoL across physical, emotional, and social domains [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Among socio-demographic factors, only duration of caregiving was significantly associated with caregiver burden. Other factors\u0026mdash;including age, sex, marital status, education, employment, income, and relationship to the patient\u0026mdash;were not statistically significant, although monthly income approached borderline significance (p = .055). Interestingly, longer caregiving duration correlated with lower perceived burden, contrary to studies such as Hsiao et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], which reported higher burden with prolonged caregiving. This discrepancy may reflect the influence of cultural norms in Nigeria, where extended caregiving fosters adaptive coping and communal support, mitigating stress over time. The lack of significant associations between caregiver burden and sex, education, employment, or patient relationship contrasts with previous findings [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. This may be explained by the more balanced gender distribution in the current sample, equitable sharing of caregiving responsibilities, or homogeneity in educational and employment backgrounds. Although monthly income did not reach statistical significance, financial strain emerged as a major stressor, with nearly 44% of caregivers reporting that caregiving always affected their financial stability. This aligns with prior studies highlighting income and financial hardship as key contributors to caregiver burden [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The borderline significance observed may reflect limitations in income stratification or sample homogeneity, suggesting that future research should employ more granular income measures to better capture its impact. These findings underscore that caregiver burden is a multidimensional construct influenced by both situational and contextual factors, and its mitigation requires culturally tailored interventions, including psychosocial support, financial assistance, and strategies to enhance adaptive coping over the course of caregiving.\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations of the Study\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThis study adapted and modified items from the Zarit Burden Interview and WHOQOL-BREF to fit the local context, rather than using the full standardized instruments. While this approach may limit direct comparability with other studies using the full scales, internal consistency for both adapted measures was acceptable (Cronbach\u0026rsquo;s alpha\u0026thinsp;=\u0026thinsp;0.772 for caregiver burden and 0.733 for quality of life), supporting the reliability of the findings.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis study examined burden and quality of life (QoL) among caregivers of psychiatric inpatients at the Federal Neuropsychiatric Hospital, Enugu State, Nigeria. Findings indicate that while nearly half of caregivers experienced little or no burden, a substantial proportion reported mild to moderate burden, with financial strain, emotional exhaustion, and time-related demands being particularly prevalent. Quality of life varied across domains: caregivers generally reported satisfaction with physical health and personal relationships, yet dissatisfaction was notable in financial stability and emotional well-being. A statistically significant association between caregiver burden and QoL was observed, confirming that higher burden is linked to lower quality of life. Among socio-demographic factors, only the duration of caregiving showed a significant association with burden, underscoring the impact of prolonged caregiving on well-being. These results highlight the influence of contextual, cultural, and systemic factors on caregiver experiences and emphasize the need for targeted, culturally sensitive interventions.\u003c/p\u003e \u003cp\u003eTo improve caregiver well-being, mental health institutions should establish structured support programs, including caregiver support groups, peer counseling, and psychoeducation, to help manage psychological and emotional demands. Financial assistance and subsidies, particularly for caregivers from low-income households, could alleviate economic strain. Periodic mental health screenings and counseling services would address stress, anxiety, and emotional exhaustion, while part-time or temporary respite care could provide caregivers with opportunities to recover from physical and emotional fatigue. Policymakers should recognize caregivers as essential members of the care team, integrate their needs into national mental health strategies, and promote public awareness campaigns to reduce stigma and strengthen social support networks. Interventions should also be sensitive to the duration of caregiving, providing intensive orientation and guidance for new caregivers and sustained emotional, psychosocial, and financial support for long-term caregivers.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDALYs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDisability\u0026ndash;Adjusted Life Years\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFNHE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFederal Neuropsychiatric Hospital, Enugu\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eQoL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eQuality of Life\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHOQoL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBREF\u0026ndash;World Health Organization Quality of Life\u0026ndash;Brief Version\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered strictly to international ethical guidelines as outlined in the Declaration of Helsinki. Ethical approval was obtained from the University of Nigeria Teaching Hospital Health Research Ethics Committee (NHREC/05/01/2008B-FWA00002458-1RB00002323) and the Research Ethics Committee of the Federal Neuropsychiatric Hospital, Enugu (FNHE/HTR/REA/VOL11/134). Written informed consent was obtained from all participants. Participation was voluntary, confidentiality was assured, and caregivers were informed of their right to withdraw at any stage.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNot applicable\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets supporting the conclusions of this article are included within the article (and its additional files).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePCO was involved in conceptualization of the study, resources mobilization, obtaining ethical clearance, field work, and revising the manuscript. LOP designed the study methodology, supervised data collection, performed data analysis, and drafted the manuscript. IPE collected the data and was involved with the management of the hospital to make caregivers available for the interviews. BIO contributed to conceptualization, methodology, questionnaire validation, supervision, and provided critical revisions to the manuscript. All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors sincerely appreciate the access granted and the support provided by the management of the Federal Neuropsychiatric Hospital, Enugu, which greatly facilitated the conduct of this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHossain MM, Tasnim S, Sultana A, Faizah F, Mazumder H, Zou L, et al. 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BMC Psychiatry. 2016;16:1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStanley S, Balakrishnan S, Ilangovan S. Psychological distress, perceived burden and quality of life in caregivers of persons with schizophrenia. J Ment Health. 2017;26(2):134\u0026ndash;41.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVon Kardorff E, Soltaninejad A, Kamali M, Eslami Shahrbabaki M. Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia\u0026mdash;A qualitative exploratory study. Nord J Psychiatry. 2016;70(4):248\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHsiao CY, Lu HL, Tsai YF. Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: A cross-sectional study. Qual Life Res. 2020;29(10):2745\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSrivastava G, Tripathi RK, Tiwari SC, Singh B, Tripathi SM. Caregiver burden and quality of life of key caregivers of patients with dementia. Indian J Psychol Med. 2016;38(2):133\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"caregiver burden, quality of life, psychiatric inpatients, neuropsychiatric hospital, mental illness, psychosocial support","lastPublishedDoi":"10.21203/rs.3.rs-9074474/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9074474/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eCaregivers of individuals with severe mental illness often experience substantial psychological, social, and financial strain that may negatively affect their quality of life (QoL). Evidence on caregiver burden in psychiatric inpatient settings in Nigeria remains limited. This study assessed the burden and QoL of caregivers of psychiatric inpatients at the Federal Neuropsychiatric Hospital Enugu (FNHE) in Southeast Nigeria.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among 214 caregivers of psychiatric inpatients selected through consecutive sampling. Caregiver burden and QoL were assesses using structured questionnaires adapted from the Zarit Burden Interview and the WHOQoL-BREF. Data were analyzed using IBM SPSS Statistics version 20. Frequencies and percentages were used to summarize categorical responses, while the chi-square test was used to assess associations between caregiver burden, quality of life, and socio-demographic variables. Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eMost caregivers were aged 25\u0026ndash;44 years (43.9%), female (57.0%), married (53.3%), and self-employed (63.1%). Nearly half had tertiary education (43.9%), and siblings constituted the largest proportion of caregivers (44.9%). Approximately 40.7% had provided care for more than three years. Overall, 45.8% reported little or no burden, 37.9% experienced mild to moderate burden, and 0.9% reported severe burden. Financial strain (43.9%) and emotional exhaustion (29.9%) were commonly reported challenges. Regarding QoL, 43.9% of respondents reported moderate QoL, 33.6% reported good QoL, and 11.2% reported poor QoL. Satisfaction was relatively high in some domains, with 76.2% satisfied with their ability to perform daily activities and 58.9% satisfied with personal relationships; however, 43.9% expressed dissatisfaction with their financial situation. Caregiver burden was significantly associated with QoL (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with higher burden linked to poorer QoL. Among socio-demographic factors, only caregiving duration was significantly associated with caregiver burden (p\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eCaregivers of psychiatric inpatients demonstrated notable resilience despite experiencing financial and emotional challenges. Increased caregiver burden was associated with poorer QoL, highlighting the need for targeted psychosocial and economic support interventions to improve caregiver well-being in psychiatric care settings.\u003c/p\u003e\u003ch2\u003eClinical trial number:\u003c/h2\u003e \u003cp\u003enot applicable\u003c/p\u003e","manuscriptTitle":"Burden and quality of life among caregivers of psychiatric inpatients in a neuropsychiatric hospital in Southeast Nigeria: a cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-12 13:21:02","doi":"10.21203/rs.3.rs-9074474/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2d2c051c-259f-4357-8c8b-807c0976978e","owner":[],"postedDate":"March 12th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-17T07:53:38+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-12 13:21:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9074474","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9074474","identity":"rs-9074474","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}