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Dwi Heppy Rochmawati
Universitas Islam Sultan Agung, Semarang, Indonesia

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Factors influencing family support and family burden in caring for family members with a history of violent behavior: A systematic review Andre Soares Dos Santos; Dwi Heppy Rochmawati; Wahyu Endang Setyowati
Lentera Perawat Vol. 7 No. 2 (2026): April - June
Publisher : School of Health Sciences Al-Ma'arif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52235/lp.v7i2.717

Abstract

Background: Family caregivers play a central role in caring for relatives with severe mental illness, particularly those with a history of violent behavior. In this context, caregivers are required to provide continuous supervision, emotional support, and practical assistance, while also managing fear, stigma, and prolonged caregiving demands. These conditions may influence both family support and family burden through a complex interaction of clinical, psychosocial, and structural factors. Objective: This study aimed to systematically identify, analyze, and synthesize the factors influencing family support and family burden in caring for family members with a history of violent behavior. Methods: This study employed a systematic review design. A comprehensive literature search was conducted in PubMed, Scopus, ProQuest, SAGE Journals, and ClinicalKey for Nursing for studies published between 2015 and 2025. Quantitative, qualitative, and mixed-method studies were included if they examined determinants of family support or caregiver burden among family caregivers of individuals with severe mental illness involving aggression or a history of violent behavior. Study selection, data extraction, and methodological quality appraisal were conducted independently by two reviewers using standardized procedures and the Joanna Briggs Institute critical appraisal tools. Results: Ten studies met the inclusion criteria. The review identified three major domains influencing family support and family burden: clinical factors, psychosocial factors, and structural factors. Patient aggression, symptom severity, relapse, and poor social functioning consistently increased caregiver burden. Psychosocial factors, particularly affiliated stigma, emotional distress, gendered caregiving roles, and family relationship patterns, further intensified burden and reduced caregiving resilience. Structural barriers, including limited access to mental health services, weak care coordination, insufficient caregiver involvement in decision-making, and economic hardship, also weakened family support capacity. Intervention evidence suggested that family psychoeducation and structured support may reduce caregiver burden, although their effectiveness varied across contexts. Conclusion: Family support and family burden in the care of relatives with a history of violent behavior are shaped by interrelated clinical, psychosocial, and structural determinants. Family-centered and context-sensitive mental health interventions are needed to reduce caregiver burden and strengthen sustainable family support.  
The mediating role of sleep quality in the relationship between workload and employees’ job stress: A systematic review Liwingston Filemon Mona; Iskim Luthfa; Muh Abdurrouf; Dwi Heppy Rochmawati
Lentera Perawat Vol. 7 No. 2 (2026): April - June
Publisher : School of Health Sciences Al-Ma'arif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52235/lp.v7i2.727

Abstract

Background: Workload is a major occupational factor that contributes to employees’ job stress and may also impair sleep quality. Increasing evidence suggests that sleep quality is not merely an outcome of work strain, but may function as an important mechanism through which workload influences psychological well-being. However, the mediating role of sleep quality in the relationship between workload and employees’ job stress has not been systematically synthesized across occupational settings. Objective: This systematic review aimed to examine the mediating role of sleep quality in the relationship between workload and employees’ job stress and to synthesize current evidence on how sleep quality explains or modifies this association across employee populations. Methods: This study employed a systematic review design. Literature searches were conducted in Scopus, PubMed, ScienceDirect, ProQuest, and ClinicalKey for Nursing for articles published between 2015 and 2025. Studies were included if they involved employees or workers, examined workload or work-related stress, assessed sleep quality, and reported job stress-related outcomes. Study selection, data extraction, and quality appraisal were conducted systematically, and the findings were synthesized narratively because of heterogeneity in study designs, measures, and analytical approaches. Results: The search identified 2,264 records, and 12 studies were included in the final synthesis. The included studies consistently showed that higher workload or work-related stress was associated with poorer sleep quality across diverse occupational groups. Sleep quality emerged as a recurrent mediating factor linking occupational burden with adverse outcomes, including burnout, depressive symptoms, daytime dysfunction, and reduced well-being. Additional psychological mechanisms, such as rumination, anxiety, and depression, frequently strengthened this pathway, whereas physical activity, resilience, and social support appeared to buffer the negative effects. Conclusion: Sleep quality plays a significant mediating role in the relationship between workload and employees’ job stress. Interventions to reduce job stress should therefore address not only workload management, but also sleep health and related psychological factors in the workplace.