الفهرس 
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Abstract
Family caregivers of patients with psychotic disorders often experience high levels of care burden, which can have negative impacts on their physical and mental health. Self-efficacy and hope are considered as an important factor in promoting resilience and coping among caregivers. Self-efficacy and hope can help psychiatric nurses develop effective interventions to support caregivers and improve the quality of care provided to patients. By improving self-efficacy and hope, caregivers may be better equipped to manage the challenges of caregiving and maintain their own well-being. Therefore, this study provides a starting point to understand the relationship between self-efficacy, hope, and care burden.
This study aimed to assess the self-efficacy, hope, and care burden among family caregivers of patients with psychotic disorders. And, to identify the relationship between self-efficacy, hope, and care burden among family caregivers of patients with psychotic disorders.
This study utilized a descriptive correlational research design. It was conducted at the outpatient clinics of El-Maamoura Hospital for Psychiatric Medicine in Alexandria.
The study subjects were a convenient sample of 220 family caregivers of patients with psychotic disorders who meet the following criteria will be recruited for this study: adult (not less than 21 years old) taking care of patient with psychotic disorder and regularly attending the outpatient department, living with the patient in the same household for at least 6 months and free from substance use.
Four tools were used for data collection:
Tool I: A Socio-Demographic and Clinical Data, Structured interview Schedule:
This interview schedule was developed by the researcher to elicit data about the general socio-demographic characteristics of both patients and family caregivers.
Tool II: Generalized Self- Efficacy Scale (GSE):
The generalized self-efficacy (GSE) scale is a self-report instrument used to measure self -efficacy. The scale was first constructed as a 20 items scale then summarized to a 10-item scale by Schwarzer & Jerusalem, (1995). This scale was valid and reliable (Cronbach alpha = 0.88) by Ramzani et al., (2019). In this study the previous version scale will be utilized.
Tool III: Adult Hope Scale:
The Adult Hope Scale was developed by Snyder et al., (1991). This scale includes 12 items to measure the level of hope.It is divided into two subscales namely, agency (4 items), and pathways (4 items). The remaining 4 items are fillers. This scale was valid and reliable (Cronbach alpha = 0.75) by Francisquini et al., (2020). In this study the previous version scale will be utilized.
Tool IV: Caregivers Burden Inventory (CBI):
The Caregiver Burden Inventory (CBI) is a self-report instrument developed by Novak & Guest, (1989). The CBI is a 24-item survey tool; Used to measure the caregiver burdenon five different dimensions (factors) which are time dependent burden (5 items); developmental burden (5 items); physical burden(4 items); social burden (5 items); and emotional burden (5 items). In this study, the Arabic version of CBI was utilized. The psychometric properties for Arabic version were proved which had content validity and reliability with Cronbach’s alpha values for the 5 factors as 0.85, 0.85, 0.86, 0.73, and 0.77 respectively (Abo kahla, 2018).
Method
• Approval from the Research Ethics Committee, Faculty of Nursing- Alexandria University was obtained.
• Written permissions were obtained to conduct the study from official authorities of General Secretariat of Mental Health and El-Maamoura Hospital for Psychiatric Medicine.
• The researcher developed Tool I (A Socio-Demographic and Clinical Data Structured interview Schedule).
• Tools II and III were translatedto Arabic and tested for content validity by a jury of 5 experts in the field.
• A pilot study was carried out on 20 family caregivers attending the outpatient clinic and meeting the inclusion criteria of the study sample.
• Tools II and III were tested for reliability through Cronbach alpha test on family caregivers of those attending the outpatient clinic.
• Collection of data was done during the period from October to December 2022.
• The data were computerized and verified using the SPSS (Statistical Package for Social Science) to perform tabulation and statistical analysis.
The following are the main results revealed by the study:
I. Socio demographicand clinical characteristics of the studied family caregivers and their patients with psychotic disorders: -
1. Socio demographic and clinical characteristics of the studied family caregivers of patients with psychotic disorders: -
- The majority of studied family caregivers (71.8%) are female.
- The age of family caregivers ranges from 23 to 75 years, with a mean age of 50.77 ± 11.46, while 27.7% of the family caregivers are over 60 years old.
- Most family caregivers (90%) have a first-degree relationship.
- 92.3% of family caregivers are employed, but 84.5% of them do not have enough income.
- (81.8%) claim to understand the nature of mental illness, but a significant proportion (68.2%) perceive mental illness as a myth.
- 29.1% of family caregivers have a positive history of mental illness, with 40.6% having a first-degree relative with mental illness.
- 80% of family caregivers are solely responsible for patient care.
2. Socio demographic and clinical characteristics of patients with psychotic disorders: -
- The results show that more than half (60.5%) of the patients are male, with an age range between 19 and 68 years and a mean age of 37.98 ± 12.03.
- In terms of marital status, the majority of patients (60%) are single.
- 69.1% of the patients are currently unemployed, and95% do not have enough monthly income.
- 65.9% have been diagnosed with schizophrenia and the duration of illness for patients ranged from 6 months to 50 years, with a mean of 13.09 ± 10.36.
- 38.9% citing fear of addiction and suspiciousness, and 37.3% claiming a lack of insight as the main reasons for non-compliance.
II. Self-efficacy among family caregivers of patients with psychotic disorders:
- 20.5% of studied family caregivers report lower self-efficacy. While 52.3% of the studied subjects have moderate level of self-efficacy.
- The total mean score of the studied family caregivers of patients with psychotic disorders is 25.50 ± 6.69.
III. Hope among family caregivers of patients with psychotic disorders:
- Half of the studied family caregivers have a lower level of hope, as evidenced by a mean total hope score of 40.86 ± 14.52.
- Regarding agency adult hope subscale, 42.3% of the family caregivers have a lower level of hope. Also, 28.5% of the studied family caregivers have a moderate level of hope, with a mean score of 19.31 ± 8.40.
- Regarding the Pathway adult hope subscale, the results indicate that 55.0% of family caregivers had a lower level of hope, while 30.0% of the studied family caregivers had a moderate level of hope, with a mean score of 21.55 ± 7.32.
IV.Care burden among family caregivers of patients with psychotic disorders.
- 82.3%, have a higher degree of burden, with a total mean score of 49.23 ± 14.40.
- 83.6% of the studied family caregivers have a higher risk of burnout on the Time Dependent Burden subscale, with a mean score of 11.61 ± 3.88.
- 79.5% of the caregivers scored high on the Developmental Burden subscale, with a mean score of 10.41 ± 3.53.
V. Correlation ship between self-efficacy, hope and Care burden among family caregivers of patients with psychotic disorders.
- There is astatistically significant negative correlations between GSE and overall caregiving burden subscales (rs= -0.371, P<0.001).
- The Adult Hope Scale shows highly significant negative correlations with overall caregiving burden subscales (rs = -0.419, P<0.001).
- GSE is highly positively correlated with overall adult hope subscales (rs =0.845, p <0.001).
In conclusion, this study sheds light on the complex relationship between self-efficacy, hope, and care burden among family caregivers of patients with psychotic disorders. The findings suggest that lower levels of self-efficacy and hope may be associated with higher levels of care burden. This highlights the importance of assessing the hope and efficacy of caregivers in addition to providing practical support for family to provide the patient’s care. Overall, by assessing self-efficacy and hope provide opportunities to assess positive construct of mental health.
Accordingly, the following are the main recommendations of the presentstudy: -
1. Provide support and education to caregivers: Caregivers of patients with psychotic disorders should be provided with support and education to help them manage the challenges of caregiving.
2. Providing respite care is a temporary break from caregiving responsibilities and can provide caregivers with time to rest and recharge.
3. Offer interventions to enhance caregiver well-being: Interventions aimed at enhancing caregiver self-efficacy and hope could include hope therapy, cognitive-behavioral therapy, and stress-management training.
4. ConductFurther research is needed to better understand another positive aspect of psychology such as optimism, happiness and self-soothing of caregivers of patients with psychotic disorders, as well as research on the factors that may moderate or mediate the relationship between self-efficacy, hope, and care burden.