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All Journal International Journal of Public Health Science (IJPHS) Jurnal NERS
Mulud, Zamzaliza Abdul
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Health Professions Nursing

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Determinants of caregiver burden in community-dwelling caregivers of patients with severe and persistent mental illness Mulud, Zamzaliza Abdul; Goodwin, John; Mohamad, Norfidah; Wahab, Patimah Abdul
International Journal of Public Health Science (IJPHS) Vol 14, No 1: March 2025
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v14i1.24074

Abstract

Loss of independence due to cognitive and functional ability is the main challenge experienced by individuals with severe mental illness. This study aimed to investigate the associated factors of caregiver burden among caregivers of individuals with severe and persistent mental illness living in the community. We used a cross-sectional design with open-ended questions to determine the contributing factors to caregiver burden. A self-administered questionnaire was used to measure caregiver burden and resilience (n=201). Caregiver burden and resilience were operationalized using the caregiver burden inventory scale (CBI) and Connor-Davidson resilience scale (CD-RS), respectively. The findings showed that the caregivers were experiencing a moderate level of caregiver burden (M=30.7, SD=20.3). Caregiving-related stressors are the most important predictor of caregiver burden, explaining 28.3% of the variance in caregiver burden. Finally, the hierarchical analysis found that resilience, caregiver-related stressors, and socio-demographic factors contributed to 52.4% of the variance in caregiver burden. New factors that contributed to the burden, such as lack of support and knowledge deficit, emerged from the qualitative findings. The results highlighted the growing evidence of the role of caregivers' socio-demographic variables, caregiving-related stressors, and resilience to caregiver burden.
Prevalence and determinants of depression among community- dwelling older adults with chronic diseases Mulud, Zamzaliza Abdul; Mohamad, Norfidah
International Journal of Public Health Science (IJPHS) Vol 12, No 2: June 2023
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v12i2.22194

Abstract

The older population continues to grow globally, and data related to the prevalence of depressive symptoms among this population in Malaysia is scarce. Thus, this study aimed to determine the prevalence and determinants of depression symptoms among community-dwelling older adults in Malaysia. A cross-sectional study was conducted among 220 outpatients with chronic diseases. The level of depression was operationalized using the Malay version of the Geriatric Depression Scale. The prevalence of depression among community-dwelling older adults was 16.4%. Female (OR =8.86, 95% CI=1.10–7.53, p=0.03), Chinese ethnic group (OR=4.73, 95% CI= 1.04– 21.48, p=0.04), multimorbidity (OR=3.36, 95% CI=1.07–12.60, p=0.04) and presence of pain (OR=6.67, 95% CI=2.41–18.45, p<0.01) were associated to depressive symptoms. However, higher resilience was associated with lower risk of depressive symptoms in this population (OR=0.88, 95% CI=0.88–0.93, p<0.01). The prevalence of depressive symptoms among older adults with chronic diseases is higher than in previous data. Early identification of depression in this population is crucial for effective chronic disease management.
Navigating care: family information needs and responsibilities in the context of schizophrenia caregiving Fitryasari, Rizki; Nurlela, Lela; Syadiyah, Hidayatus; Yusuf, Ah; Maliah, Iin; Ambarwati, Galuh Adjeng; Mulud, Zamzaliza Abdul; Diba, Rafidah Farah; Sari, Dianis Wulan
Jurnal Ners Vol. 19 No. 3 (2024): AUGUST 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v19i3.58359

Abstract

Introduction: : Families of schizophrenia patients need   to obtain information from health services about how to care for them. Limited information and understanding of responsibilities in caring are still obstacles to becoming an empowered family in caring for patients with schizophrenia. The study aimed to explore family needs regarding information from health services and family responsibilities when caring for patients with schizophrenia. Methods: This study used a descriptive qualitative design. The study involved families who cared for patients with schizophrenia in Surabaya, Indonesia. Twenty participants were obtained using purposive sampling techniques and the sample size was determined by data saturation. Data were collected using in-depth interviews, field notes and interview question guides. The data were processed with content analysis. Results: The results showed eight themes. Families need information about patient conditions, medication, routine control, and counseling for patient conditions as well as for families. The family describes the responsibilities carried out for the patient as providing support for patient treatment, fulfilling daily needs, helping with social skills, and providing activities in spare time. Conclusions: Adequate information from health services regarding both the patient's condition and family counseling can help to meet the demands of care, which stimulates families to be more empowered to carry out care responsibilities and has an impact on the ability to care better Keywords: counseling, empowerment, family, mental disorder, responsibility, schizophrenia
The impact of self-care behavior on quality of life among patients with heart failure in Malaysia: a cross-sectional study Mohamad, Norfidah; Mulud, Zamzaliza Abdul; Chan, Chong Mei; Razak, Hairil Rashmizal Abdul; Esa, Nor Masita
Jurnal Ners Vol. 20 No. 3 (2025): VOLUME 20 ISSUE 3 (AUGUST 2025)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v20i3.67901

Abstract

Introduction: Individuals with heart failure anticipate adjustment to self-care behaviors following hospital discharge. Self-care in heart failure includes medication adherence, dietary modifications, symptom monitoring, and activity adjustment. Adequate self-care behavior may contribute to enhanced outcomes, decreased hospitalization, and improved quality of life in patients with heart failure. This study aimed to determine the level of self-care behavior, quality of life, and its relationships among patients with heart failure. Methods: A cross-sectional study using purposive sampling was conducted among 200 heart failure patients at a teaching hospital in Selangor, Malaysia. The sample size was determined using G*Power to ensure adequate statistical power. Data were collected using the Self-Care of Heart Failure Index (SCHFI) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive statistics, Pearson’s correlation, and multiple linear regression were used in this study. Results: The results indicated that the total mean score of self-care behavior was 145.42 and SD=16.23. Most patients demonstrated good quality of life (n=73, 36.5%), moderate quality of life (n=62, 31%), and poor quality of life (n=65, 32.5 %). Pearson's correlation revealed a significant (p<0.001) correlation (r = 0.651) between self-care behavior and quality of life. Conclusions: In conclusion, this study demonstrated that higher levels of self-care are associated with better quality of life in patients with heart failure. It is recommended that nurses provide individualized self-care education at discharge, focusing on medication adherence, symptom monitoring, and lifestyle changes to improve quality of life.
Caregiver Burden and Depression Among Caregivers of Patients with Chronic Disease Mohamad, Norfidah; Mulud, Zamzaliza Abdul; Tutienande , Nurfeekah Afzatul; Sazaly, Nur Nadhrah; Ibrahim, Nurul Hazirah
Jurnal Ners Vol. 19 No. 2 (2024): MAY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v19i2.51301

Abstract

Introduction: Caring for people with chronic diseases is physically and emotionally demanding. It can also have adverse effects on the caretaker, such as depression. Caregiver burden describes the psychological and financial strains of providing care. Depression in caregivers' manifests as concern, indecision, and an inability to feel the future. Chronic disease is a condition that takes a long time to treat and may progressively get worse over time. This study aims to identify the level of caregiver burden and depression and the correlation between burden and depression among caregivers of patients with chronic diseases. Methods: A self-administered questionnaire containing the Caregiver Burden Inventory and Beck Depression Inventory was used to measure caregiver burden and depression among 217 caregivers of patients with chronic diseases in a teaching hospital in the Klang Valley. Results: The findings showed that the majority of caregivers experienced a mild burden (n = 168, 77.4%), a moderate burden (n = 43, 19.8%), and a severe burden (n = 6, 2.8%). Following mild depression (n = 17, 7.8%), moderate depression (n = 15, 6.9%), and severe depression (n = 4, 1.8%), some caregivers experienced minimal depression (n = 181, 83.4%). According to Pearson's analysis, the link between caregiver burden and depression was statistically significant (p<0.000) with a positive correlation (r = 0.408). Conclusion: In this study, caregivers experienced burden and depression due to providing care. Future studies should incorporate support and resources for caregivers, including respite care and counselling that can promote overall well-being.
Understanding predictors of caregivers’ treatment-seeking behavior for mental health: the roles of stigma, motivation, relationship, and literacy Fitryasari, Rizki; Iswanti, Dwi Indah; Sari, Dianis Wulan; Nurlela, Lela; Marthoenis, Marthoenis; Warsini, Sri; Mulud, Zamzaliza Abdul
Jurnal Ners Vol. 20 No. 4 (2025): VOLUME 20 ISSUE 4 (NOVEMBER 2025)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v20i4.75117

Abstract

Introduction: Caregivers play a crucial role in seeking timely treatment for individuals with mental disorders. However, reliance on traditional healing practices often leads to delayed medical care. This study aims to identify predictors of caregivers' treatment-seeking efforts, focusing on the role of stigma, motivation, relationship with the patient, and mental health literacy. Methods: A cross-sectional study involving 301 caregivers of patients with mental disorders was conducted in two mental hospitals using cluster sampling. Variables studied include sociodemographic factors, caregiving burden, stigma, social support, motivation, mental health literacy, and treatment-seeking behavior. The data were collected through validated questionnaires as instruments. Multivariate regression analysis was performed to identify significant predictors of treatment-seeking behavior. Results: The study revealed that caregivers' relationship with the patient, perceived stigma, caregiving motivation, and mental health literacy significantly predicted treatment-seeking behavior (p < 0.05). Mental health literacy emerged as the strongest predictor (β = 0.349), followed by motivation (β = 0.202), stigma (β = -0.125), and relationship with the patient (β = -0.108). Together, these variables explained 23.4% of the variance in treatment-seeking efforts. Conclusions: Mental health literacy is the most influential factor in caregivers' efforts to seek medical treatment. Interventions aimed at increasing mental health literacy and reducing stigma are critical to enhancing caregivers' engagement with formal healthcare services. Findings support the development of culturally appropriate education and support programs to improve mental health outcomes.
Co-Authors Ah Yusuf, Ah Ambarwati, Galuh Adjeng Chan, Chong Mei Dianis Wulan Sari Diba, Rafidah Farah Dwi Indah Iswanti Esa, Nor Masita Goodwin, John Ibrahim, Nurul Hazirah Koesoemo, Rizki Fitryasari Patra Lela Nurlela M. Marthoenis Maliah, Iin Mohamad, Norfidah Razak, Hairil Rashmizal Abdul Sazaly, Nur Nadhrah Sri Warsini Syadiyah, Hidayatus Tutienande , Nurfeekah Afzatul Wahab, Patimah Abdul