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Published in: BMC Psychiatry 1/2016

Open Access 01-12-2016 | Research article

An exploration of caregiver burden for children with nodding syndrome (lucluc) in Northern Uganda

Authors: Janet Nakigudde, Byamah Brian Mutamba, William Bazeyo, Seggane Musisi, Okello James

Published in: BMC Psychiatry | Issue 1/2016

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Abstract

Background

Caregivers of patients with chronic illnesses are often uncompensated for work that is physically demanding, time consuming and emotionally and economically draining. This is particularly true for caregivers of children with nodding syndrome, an emergent neurological disorder of unknown etiology in resource poor settings in Africa.
We aimed to explore perceptions of caregivers regarding challenges that a typical caregiver faces when caring for a child with nodding syndrome.

Methods

We used a qualitative exploratory study design with focus group discussions and in-depth interviews to collect data. We analyzed data using the qualitative analysis software package of NVivo and thematic query building.

Results

Emergent themes centered on burden of care with emotional agony as the most prominent. Subthemes reflecting the burden of care giving included child and caregiver safety concerns, burnout, social isolation and rejection, and homicidal ideation. Caregivers also complained of physical and financial constraints associated with the care of children with nodding syndrome.

Conclusions

The findings point to a high burden of care for caregivers of children with nodding syndrome and suggests the need to incorporate community-based psychosocial and mental health care services for the caregivers of affected children into the national health system response.
Literature
1.
go back to reference Idro et al. Is nodding syndrome an onchrerca volvulus induced neuro inflammatory disorder? Uganda’s story of research in understanding the disease. International Journal of Infectious disease. 2016. Idro et al. Is nodding syndrome an onchrerca volvulus induced neuro inflammatory disorder? Uganda’s story of research in understanding the disease. International Journal of Infectious disease. 2016.
2.
go back to reference WHO. International Scientific Meeting on Nodding Syndrome. 2012. WHO. International Scientific Meeting on Nodding Syndrome. 2012.
3.
go back to reference Jilek LA. Mental Diseases And Epilepsy In Tropical Africa. Fortschr Neurol Psychiatr Grenzgeb. 1964;32:213–59.PubMed Jilek LA. Mental Diseases And Epilepsy In Tropical Africa. Fortschr Neurol Psychiatr Grenzgeb. 1964;32:213–59.PubMed
4.
go back to reference Kaiser C, Pion S, Boussinesq M. Head nodding syndrome and river blindness: a parasitologic perspective. Epilepsia. 2009;50(10):2325–6.CrossRefPubMed Kaiser C, Pion S, Boussinesq M. Head nodding syndrome and river blindness: a parasitologic perspective. Epilepsia. 2009;50(10):2325–6.CrossRefPubMed
5.
go back to reference Goudsmit J, Van der Waals F. Endemic epilepsy in an isolated region of Liberia. West Afr Epilepsy Lancent. 1983;1:528–9.CrossRef Goudsmit J, Van der Waals F. Endemic epilepsy in an isolated region of Liberia. West Afr Epilepsy Lancent. 1983;1:528–9.CrossRef
7.
go back to reference Nyungura JL. Investigation into the Nodding Syndrome in Witto Payam, West Equatoria State. South Sudan Med J. 2010;4:3–6. Nyungura JL. Investigation into the Nodding Syndrome in Witto Payam, West Equatoria State. South Sudan Med J. 2010;4:3–6.
8.
go back to reference Idro R. Nodding syndrome in Ugandan Children; Clinical features, brain imaging andcomplications. 1st International confernece on Nodding syndrome, Kampala. 2012. Idro R. Nodding syndrome in Ugandan Children; Clinical features, brain imaging andcomplications. 1st International confernece on Nodding syndrome, Kampala. 2012.
9.
go back to reference Mukolo A, Heflinger CA, Wallston WA. The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry. 2010;49(2):92–103. quiz 198.PubMedPubMedCentral Mukolo A, Heflinger CA, Wallston WA. The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry. 2010;49(2):92–103. quiz 198.PubMedPubMedCentral
10.
go back to reference Buchmann K. ‘You sit in fear’: understanding perceptions of nodding syndrome in post-conflict northern Uganda. Global Health Action [Online], 7 (2014): n. pag. Web. 6 May. 2016. Buchmann K. ‘You sit in fear’: understanding perceptions of nodding syndrome in post-conflict northern Uganda. Global Health Action [Online], 7 (2014): n. pag. Web. 6 May. 2016.
12.
go back to reference Archbold P. Mutuality and preparedness as predictors of caregiver role strain. Res Nurs Health. 1990;13(6):375–84.CrossRefPubMed Archbold P. Mutuality and preparedness as predictors of caregiver role strain. Res Nurs Health. 1990;13(6):375–84.CrossRefPubMed
13.
go back to reference Nolan MR, Grant G, Ellis NC. Stress is in the eye of the beholder: Reconceptualising the measurement of carer burden. J Adv Nurs. 1990;21:256–65.CrossRef Nolan MR, Grant G, Ellis NC. Stress is in the eye of the beholder: Reconceptualising the measurement of carer burden. J Adv Nurs. 1990;21:256–65.CrossRef
14.
go back to reference Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress orocess: An overview of conceots and their measures. Gerontologist. 1990;3i(5):583–94.CrossRef Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress orocess: An overview of conceots and their measures. Gerontologist. 1990;3i(5):583–94.CrossRef
15.
go back to reference Lawton MP, Kleban M, Moss M, Rovine M, Glicksman A. Measuring Caregiving Appraisa. J Gerontol. 1989;44(3):61–71.CrossRef Lawton MP, Kleban M, Moss M, Rovine M, Glicksman A. Measuring Caregiving Appraisa. J Gerontol. 1989;44(3):61–71.CrossRef
16.
go back to reference Osbert M. Caregiving demands and appraisal of stress among family caregivers. Cancer Nurs. 1989;12(4):209–15. Osbert M. Caregiving demands and appraisal of stress among family caregivers. Cancer Nurs. 1989;12(4):209–15.
17.
go back to reference Zarit SH, Reever KE, Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly:correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed Zarit SH, Reever KE, Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly:correlates of feelings of burden. Gerontologist. 1980;20(6):649–55.CrossRefPubMed
18.
go back to reference Poulshock S, Deimling G. Families caring for elders in residence:issues in the measurement of burden. J Gerontol. 1984;39(2):230–9.CrossRefPubMed Poulshock S, Deimling G. Families caring for elders in residence:issues in the measurement of burden. J Gerontol. 1984;39(2):230–9.CrossRefPubMed
19.
go back to reference Grad J, Sainsbury P. The effect that patients have on their families in a community care and a control psychiatric service- a two year follow-up. Br J Psychiatry. 1968;114:265–78.CrossRefPubMed Grad J, Sainsbury P. The effect that patients have on their families in a community care and a control psychiatric service- a two year follow-up. Br J Psychiatry. 1968;114:265–78.CrossRefPubMed
20.
go back to reference Hoenig J, Hamilton MW. The schizophrenic patient in the community and his effect on thehousehold. Int J Soc Psychiatry. 1966;12:165–76.CrossRefPubMed Hoenig J, Hamilton MW. The schizophrenic patient in the community and his effect on thehousehold. Int J Soc Psychiatry. 1966;12:165–76.CrossRefPubMed
21.
go back to reference Montgomery RJ, Gonyea VJG, Hooyman NR. Caregiving and the experience of subjective and objective burden. Fam Relations. 1985;34:19–26.CrossRef Montgomery RJ, Gonyea VJG, Hooyman NR. Caregiving and the experience of subjective and objective burden. Fam Relations. 1985;34:19–26.CrossRef
22.
go back to reference Platt S. Measuring the burden of psychiatric illness on the family: An evaluation of some rating scales. Psychol Med. 1985;15:383–93.CrossRefPubMed Platt S. Measuring the burden of psychiatric illness on the family: An evaluation of some rating scales. Psychol Med. 1985;15:383–93.CrossRefPubMed
23.
go back to reference Kosberg JI, Cairl R, Keller D. Components of burden: Interventive implications. Gerontologist. 1990;30:236–42.CrossRefPubMed Kosberg JI, Cairl R, Keller D. Components of burden: Interventive implications. Gerontologist. 1990;30:236–42.CrossRefPubMed
24.
go back to reference Kuei-Ru C. Caregiver burden:A concept analysis. J Pediatr Nurs. 2000;115:6. Kuei-Ru C. Caregiver burden:A concept analysis. J Pediatr Nurs. 2000;115:6.
25.
go back to reference Walker L, Avant K. Strategies for Theory Construction in Nursing Appleton & Lange International Journal of Caring Sciences. 1988. Walker L, Avant K. Strategies for Theory Construction in Nursing Appleton & Lange International Journal of Caring Sciences. 1988.
26.
go back to reference Woods NF, Haberman MR, Packard NJ. Demands of illness and individual dydac and family adaptation in chronic illnesss. West J Nurs Res. 1993;15:10–25. Pubmed:8421914.CrossRefPubMed Woods NF, Haberman MR, Packard NJ. Demands of illness and individual dydac and family adaptation in chronic illnesss. West J Nurs Res. 1993;15:10–25. Pubmed:8421914.CrossRefPubMed
27.
go back to reference Kang SY. Predictors of emotional strain among spouse and adult child caregivers. J Gerontol Soc Work. 2006;47:1,107–131.CrossRef Kang SY. Predictors of emotional strain among spouse and adult child caregivers. J Gerontol Soc Work. 2006;47:1,107–131.CrossRef
28.
go back to reference Montgomery RV, Datwyler MM. Women and Men in the caregiving role. Generations. 1990;137–152. Montgomery RV, Datwyler MM. Women and Men in the caregiving role. Generations. 1990;137–152.
29.
go back to reference Dowler JM. Jordan-Simpson, Adams O. Gender inequalities in caregiving in Canada. Health Rep. 1992;4:125–36.PubMed Dowler JM. Jordan-Simpson, Adams O. Gender inequalities in caregiving in Canada. Health Rep. 1992;4:125–36.PubMed
30.
go back to reference Parks SM, Pilisuk M, Patterson TL, Semple SJ, Shaw WS, et al. Caregiver Burden: Gender and the Psychological Costs of Caregiving. Am J Orthopsych. 1991;61:501–9.CrossRef Parks SM, Pilisuk M, Patterson TL, Semple SJ, Shaw WS, et al. Caregiver Burden: Gender and the Psychological Costs of Caregiving. Am J Orthopsych. 1991;61:501–9.CrossRef
31.
go back to reference Raina P, O’Donnell M, Schwellnus H, Rosenbaum P, King G, Brehaut J, Russell M, Swinton S, King M, Wong S, Walter D, Wood E. Caregiving process and caregiver burden: Conceptual models to guide research and practice. E. BMC Pediatrics. 2004. Raina P, O’Donnell M, Schwellnus H, Rosenbaum P, King G, Brehaut J, Russell M, Swinton S, King M, Wong S, Walter D, Wood E. Caregiving process and caregiver burden: Conceptual models to guide research and practice. E. BMC Pediatrics. 2004.
33.
go back to reference Fisher GA, Benson PR, Tessler RC. Family response to mental illness. Research in Community and Mental Health. 6, 203–236. Fisher GA, Benson PR, Tessler RC. Family response to mental illness. Research in Community and Mental Health. 6, 203–236.
34.
go back to reference Sarkar S. Impact of caregiving role in the quality of life of family caregivers for persons with alzheimer’s disease”, All Theses, Dissertations, and other capstone projects. 2015. p. Paper 395. Sarkar S. Impact of caregiving role in the quality of life of family caregivers for persons with alzheimer’s disease”, All Theses, Dissertations, and other capstone projects. 2015. p. Paper 395.
35.
go back to reference Buchmann K. “You sit in fear” understanding perceptions of nodding syndrome in post conflict northern Uganda. Global Health Action. 2014;7:10-3402/gha.v7.25069. Buchmann K. “You sit in fear” understanding perceptions of nodding syndrome in post conflict northern Uganda. Global Health Action. 2014;7:10-3402/gha.v7.25069.
36.
go back to reference UBOS. Uganda National Household Survey Report. 2010. UBOS. Uganda National Household Survey Report. 2010.
37.
go back to reference Pfeiffer A, Elbert T. PTSD, depression and anxiety among formerabductees in Northern Uganda. BMC Confl Health. 2011;5:14.CrossRef Pfeiffer A, Elbert T. PTSD, depression and anxiety among formerabductees in Northern Uganda. BMC Confl Health. 2011;5:14.CrossRef
38.
go back to reference Krishna SV. Burden of care in the home:Issues for community management advances in Psychiatric treatment. 1997;3:146–153 Krishna SV. Burden of care in the home:Issues for community management advances in Psychiatric treatment. 1997;3:146–153
39.
go back to reference Sisk RJ. Caregiver burden and health promotion. Int J Nurs Stud. 2000;37:43.CrossRef Sisk RJ. Caregiver burden and health promotion. Int J Nurs Stud. 2000;37:43.CrossRef
40.
go back to reference Kurzban R, Leary MR. Evolutionary origins of stigmatization: the functions of social exclusion. Psychol Bull. 2001;127(2):187–208.CrossRefPubMed Kurzban R, Leary MR. Evolutionary origins of stigmatization: the functions of social exclusion. Psychol Bull. 2001;127(2):187–208.CrossRefPubMed
41.
go back to reference Kenneth GM, Kenneth CL. Active life expectancy estimates for the U.S. elderly population: a multidimensional continuous-mixture model of functional change applied to completed cohorts, 1982–1996. Demography. 2000;37:253.CrossRef Kenneth GM, Kenneth CL. Active life expectancy estimates for the U.S. elderly population: a multidimensional continuous-mixture model of functional change applied to completed cohorts, 1982–1996. Demography. 2000;37:253.CrossRef
42.
go back to reference Bukuluki P, Ddumba-Nyanzi I, Kisuule J, Ovuga E, Lien L, Kaawa-Mafigiri D. Nodding syndrome in post-conflict Northern Uganda:A human security perspective. Global Health Gov. 2012;6:1. Bukuluki P, Ddumba-Nyanzi I, Kisuule J, Ovuga E, Lien L, Kaawa-Mafigiri D. Nodding syndrome in post-conflict Northern Uganda:A human security perspective. Global Health Gov. 2012;6:1.
43.
go back to reference Kim H, Chang M, Rose K, Kim S. Predictors of caregiver burden in caregivers of individuals with dementia. J Adv Nurs. 2012;68(4):846–55.CrossRefPubMed Kim H, Chang M, Rose K, Kim S. Predictors of caregiver burden in caregivers of individuals with dementia. J Adv Nurs. 2012;68(4):846–55.CrossRefPubMed
44.
go back to reference Ahola KHJ, Perhoniem R, Mutanen P. Relationship between burnout and depressive symptoms: A study using the person-centred approach. Burnout Research: 2013;29–37. Ahola KHJ, Perhoniem R, Mutanen P. Relationship between burnout and depressive symptoms: A study using the person-centred approach. Burnout Research: 2013;29–37.
45.
go back to reference Okello E, Ekblad S. Lay concepts of depression among the Baganda of Uganda. Transcult Psychiatry. 2006;287–313. Okello E, Ekblad S. Lay concepts of depression among the Baganda of Uganda. Transcult Psychiatry. 2006;287–313.
46.
go back to reference Miyashita M, Narita Y, Sakamoto A, Kawada N, Akiyama M, Kayama M, Suzukamo Y, Fukuhara S. Care burden and depression in caregivers caring for patients with intractable neurological diseases at home in Japan. J Neurol Sci. 2009;276(1–2):148–52.CrossRefPubMed Miyashita M, Narita Y, Sakamoto A, Kawada N, Akiyama M, Kayama M, Suzukamo Y, Fukuhara S. Care burden and depression in caregivers caring for patients with intractable neurological diseases at home in Japan. J Neurol Sci. 2009;276(1–2):148–52.CrossRefPubMed
47.
go back to reference Brouwer WB, Van Exel NJ, Van de Berg B, Dinant HJ, Koopmanschap MA, Van den Bos GA. Burden of caregiving: evidence of objective burden, subjective burden, and quality of life impacts on informal caregivers of patients with rheumatoid arthritis. Arthritis Rheum. 2004;51(4):570–5772.CrossRefPubMed Brouwer WB, Van Exel NJ, Van de Berg B, Dinant HJ, Koopmanschap MA, Van den Bos GA. Burden of caregiving: evidence of objective burden, subjective burden, and quality of life impacts on informal caregivers of patients with rheumatoid arthritis. Arthritis Rheum. 2004;51(4):570–5772.CrossRefPubMed
48.
go back to reference Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009;115(18):4362–73.CrossRefPubMed Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009;115(18):4362–73.CrossRefPubMed
Metadata
Title
An exploration of caregiver burden for children with nodding syndrome (lucluc) in Northern Uganda
Authors
Janet Nakigudde
Byamah Brian Mutamba
William Bazeyo
Seggane Musisi
Okello James
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2016
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-016-0955-x

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