{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:46:08Z","timestamp":1760240768087,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BD\/13508\/2003"],"award-info":[{"award-number":["SFRH\/BD\/13508\/2003"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The experience of caregiving in severe mental illness is a valuable concept for research and clinical practice as it can provide access to the idiosyncratic assessment of negative and positive dimensions of informal caregiving, thus allowing the design of interventions focused on reducing risk factors and promoting protective factors. This study was aimed at testing explanatory models of negative and positive experiences of caregiving considering the role of the caregiver\u2019s perceptions of difficulties, satisfaction, and coping. A convenience sample of 159 informal caregivers of patients with schizophrenia was used in this study. Different variables were considered: (1) perception of difficulties (Caregiver\u2019s Assessment of Difficulties Index); (2) perception of satisfaction (Caregiver\u2019s Assessment of Satisfaction Index); (3) perception of coping (Caregiver\u2019s Assessment of Managing Index); and (4) the experience of caregiving (Experience of Caregiving Inventory). Using structural equation modeling, the results revealed the following: (1) the perception of difficulties and of satisfaction coexist; (2) the negative experiences of caregiving are predominantly explained by the perception of difficulties and of coping with stress; and (3) the positive experiences of caregiving are mainly explained by the perception of sources of intrapersonal satisfaction, while the perception of coping does not have robust predictive value.<\/jats:p>","DOI":"10.3390\/ijerph16193530","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T03:26:32Z","timestamp":1569209192000},"page":"3530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Paths to Negative and Positive Experiences of Informal Caregiving in Severe Mental Illness: A Study of Explanatory Models"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9175-1536","authenticated-orcid":false,"given":"Lu\u00edsa","family":"Campos","sequence":"first","affiliation":[{"name":"Faculty of Education and Psychology, Universidade Cat\u00f3lica Portuguesa, 4169-005 Porto, Portugal"},{"name":"Research Centre for Human Development, Universidade Cat\u00f3lica Portuguesa, 4169-005 Porto, Portugal"}]},{"given":"Carlos","family":"Mota Cardoso","sequence":"additional","affiliation":[{"name":"Faculty of Psychology and Educational Sciences of the University of Porto, R. Alfredo Allen, 4200-135 Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Marques-Teixeira","sequence":"additional","affiliation":[{"name":"Faculty of Psychology and Educational Sciences of the University of Porto, R. Alfredo Allen, 4200-135 Porto, Portugal"},{"name":"Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences of the University of Porto, 4200-135 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"ref_1","first-page":"855","article-title":"Perspectivas actuais do tratamento da esquizofrenia na comunidade","volume":"12","author":"Xavier","year":"1997","journal-title":"Acta Med. Port."},{"key":"ref_2","first-page":"165","article-title":"Question\u00e1rio de problemas familiares: Desenvolvimento da vers\u00e3o portuguesa de um instrumento de avalia\u00e7\u00e3o de sobrecarga familiar","volume":"3","author":"Xavier","year":"2002","journal-title":"Psicol. Sa\u00fade Doen\u00e7as"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/S0362-3319(01)00136-7","article-title":"An interdisciplinary look at the deinstitutionalization of the mentally ill","volume":"38","author":"Krieg","year":"2001","journal-title":"J. Soc. Sci."},{"key":"ref_4","first-page":"453","article-title":"Comment mesurer la charge des aidants naturels de personnes souffrant de schizophr\u00e9nie?","volume":"162","author":"Reine","year":"2004","journal-title":"Ann. Med. Psychol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/BF00782883","article-title":"Objective and subjective dimensions of family burden\u2014Towards an integrative framework for research","volume":"25","author":"Schene","year":"1990","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1111\/j.1365-2648.1989.tb01483.x","article-title":"Addressing the needs of informal carers: A neglected area of nursing practice","volume":"14","author":"Nolan","year":"1989","journal-title":"J. Adv. Nurs."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/j.1365-2648.1990.tb01853.x","article-title":"Stress in the eye of the beholder: Reconceptualizing the measurement of carer burden","volume":"15","author":"Nolan","year":"1990","journal-title":"J. Adv. Nurs."},{"key":"ref_8","unstructured":"Nolan, M., Grant, G., and Keady, J. (1996). Understanding Family Care: A Multidimensional Model of Caring and Coping, Open University Press."},{"key":"ref_9","unstructured":"Nolan, M., Grant, G., and Keady, J. (1998). Assessing the Needs of Family Carers: A Guide for Practioners, Pavilion Publications."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"822","DOI":"10.12968\/bjon.1995.4.14.822","article-title":"CAMI: A basis of assessment and support with family carers","volume":"4","author":"Nolan","year":"1995","journal-title":"Br. J. Nurs."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1001\/jama.2012.29","article-title":"Caregiving burden, stress, and health effects among family caregivers of adult cancer patients","volume":"307","author":"Bevans","year":"2012","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1177\/1049732302239413","article-title":"Redefining parental identity: Caregiving and schizophrenia","volume":"13","author":"Milliken","year":"2003","journal-title":"Qual. Health Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1080\/mhn.24.8.757.773","article-title":"Parents as caregivers for children with schizophrenia: Moral dilemmas and moral agency","volume":"24","author":"Milliken","year":"2003","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1177\/1078390304269497","article-title":"The effect of disturbing illness behaviors on siblings of persons with schizophrenia","volume":"10","author":"Lively","year":"2004","journal-title":"J. Am. Psychiatr. Nurses"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1080\/01612840305301","article-title":"Families living with severe mental illness: A literature review","volume":"24","author":"Saunders","year":"2003","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1080\/016128400248301","article-title":"The family and schizophrenia","volume":"21","author":"Wuerker","year":"2000","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1177\/107484070000600403","article-title":"Conceptual approaches to studying family caregiving for persons with severe mental illness","volume":"6","author":"Rungreangkulkij","year":"2000","journal-title":"J. Fam. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/S0897-1897(03)00007-7","article-title":"Burden of family caregivers with schizophrenic patients in Korea","volume":"16","author":"Lim","year":"2003","journal-title":"Appl. Nurs. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1177\/002076406601200301","article-title":"The schizophrenic patient in the community and his effect on the household","volume":"12","author":"Hoenig","year":"1966","journal-title":"Int. J. Soc. Psychiatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/S0272-7358(98)00076-2","article-title":"Factors associated with caregiver burden in mental disorder: A critical review of the research literature","volume":"19","author":"Baronet","year":"1999","journal-title":"Clin. Psychol. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1741-3729.2003.00137.x","article-title":"The Impact of Family Relations on Caregivers\u2019 Positive and Negative Appraisal of their Caretaking Activities","volume":"52","author":"Baronet","year":"2003","journal-title":"Fam. Relat."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1037\/h0079437","article-title":"Burdens and gratifications of caregiving: Appraisal of parental care of adults with schizophrenia","volume":"63","author":"Bulger","year":"1993","journal-title":"Am. J. Orthopsychiatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00127-003-0618-3","article-title":"Evaluating a model of caregiving for people with psychosis","volume":"38","author":"Joyce","year":"2003","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/BF00796381","article-title":"Instruments measuring family or caregiver burden in severe mental disorder","volume":"29","author":"Schene","year":"1994","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/BF00785760","article-title":"Caring for relatives with serious mental disorder: The development of the Experience of Caregiving Inventory","volume":"31","author":"Szmukler","year":"1996","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_26","unstructured":"Campos, L. (2009). Doen\u00e7a Mental e Presta\u00e7\u00e3o de Cuidados, Universidade Cat\u00f3lica."},{"key":"ref_27","unstructured":"Lazarus, R., and Folkman, S. (1984). Stress, Appraisal and Coping, Springer Publishing Company."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/0020764009352822","article-title":"Experience of caregiving in schizophrenia: A study from India","volume":"57","author":"Aggarwal","year":"2011","journal-title":"Int. J. Soc. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1192\/bjp.171.1.26","article-title":"Appraisal, psychological adjustment and expressed emotion in relatives of patients suffering from schizophrenia","volume":"171","author":"Barrowclough","year":"1997","journal-title":"Br. J. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1034\/j.1600-0447.2003.00156.x","article-title":"The Family Questionnaire (FQ): A scale for measuring symptom appraisal in relatives of schizophrenic patients","volume":"108","author":"Quinn","year":"2003","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s00127-012-0516-7","article-title":"Impact of psychosis on Portuguese caregivers: A cross-cultural exploration of burden, distress, positive aspects and clinical-functional correlates","volume":"48","author":"Xavier","year":"2013","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1037\/0002-9432.76.4.545","article-title":"Changes in caregiving satisfaction and information needs among relatives of adults with mental illness: Results of a randomized evaluation of a family-led education intervention","volume":"76","author":"Bennett","year":"2006","journal-title":"Am. J. Orthopsychiatr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1093\/hsw\/27.2.145","article-title":"Parents of mentally ill adult children living at home: Rewards of caregiving","volume":"27","author":"Schwartz","year":"2002","journal-title":"Health Soc. Work"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7","DOI":"10.5498\/wjp.v6.i1.7","article-title":"Gender differences in caregiving among family\u2014Caregivers of people with mental illnesses","volume":"22","author":"Sharma","year":"2016","journal-title":"World J. Psychiatry"},{"key":"ref_35","first-page":"101","article-title":"Experience of caregiving with caregivers of patients with first-episode psychosis","volume":"18","author":"Mo","year":"2008","journal-title":"Hong Kong J. Psychiatry"},{"key":"ref_36","unstructured":"Campos, L. (2008). Os Caminhos Das Experi\u00eancias Positivas e Negativas Na Presta\u00e7\u00e3o De Cuidados Informais Na Esquizofrenia. [Ph.D. Thesis, Faculty of Psychology and Education Sciences of University of Porto]."},{"key":"ref_37","unstructured":"Brito, L. (2000). A Sa\u00fade Mental Dos Prestadores De Cuidados a Familiares Idosos. [Master\u2019s Thesis, Faculty of Medicine of University of Porto]."},{"key":"ref_38","unstructured":"Sass, H., and Robert, P. (2006). Psychological distress in mothers of anorexia nervosa patients attending a Portuguese clinical outpatient practice. Proceedings of the XIV Congress of the Association of European Psychiatrists, Nice, France, 4\u20138 March 2006, European Psychiatry."},{"key":"ref_39","unstructured":"Fitzmaurice, G., Laird, N., and Ware, J. (2004). Review of Generalized Linear Models. Applied Longitudinal Analysis, Wiley-Interscience."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1080\/03610919408813210","article-title":"A cautionary note on inference for marginal regression models with longitudinal data and general correlated response data","volume":"23","author":"Pepe","year":"1994","journal-title":"Commun. Stat. Simul. Comput."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff Criteria for Fit Indexes in Covariance Structure Analysis: Conventional Criteria Versus New Alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Struct. Equ. Model. Multidiscip. J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1192\/bjp.178.3.248","article-title":"Relatives of patients with severe psychotic disorders: Factors that influence contact frequency","volume":"178","author":"Harvey","year":"2001","journal-title":"Br. J. Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1037\/0002-9432.73.3.324","article-title":"Relatives of patients with severe mental disorders: Unique traits and experiences of primary, nonprimary, and lone caregivers","volume":"73","author":"Harvey","year":"2003","journal-title":"Am. J. Orthopsychiatr."},{"key":"ref_44","first-page":"75","article-title":"Caregiving experience for chinese caregivers of persons suffering from severe mental disorders","volume":"17","author":"Lau","year":"2007","journal-title":"Hong Kong J. Psychiatry"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/S0920-9964(03)80354-7","article-title":"Family caregiving of people with first-episode psychosis: Rewards of caregiving","volume":"60","author":"Tennakoon","year":"2003","journal-title":"Schizophr. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1017\/S0033291799002342","article-title":"Attributions of causality, responsibility and blame for positive and negative symptom behaviours in caregivers of persons with schizophrenia","volume":"30","author":"Provencher","year":"2000","journal-title":"Psychol. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Gilligan, C. (1993). In a Different Voice: Psychological Theory and Women\u2019s Development, Harvard University Press.","DOI":"10.4159\/9780674037618"},{"key":"ref_48","unstructured":"Gon\u00e7alves-Pereira, M. (1996). Repercuss\u00f5es da Doen\u00e7a Mental na Fam\u00edlia. Um Estudo de Familiares de Doentes Psic\u00f3ticos. [Master\u2019s Thesis, Faculty of Medical Sciences of University of Lisbon]."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1471-6712.2007.00516.x","article-title":"Ranked motives of long-term care providing family caregivers","volume":"22","author":"Kolmer","year":"2008","journal-title":"Scand. J. Caring Sci."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1002\/per.2410010304","article-title":"Transactional theory and research on emotions and coping","volume":"1","author":"Lazarus","year":"1987","journal-title":"Eur. J. Personal."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/19\/3530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:22:37Z","timestamp":1760188957000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/19\/3530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,20]]},"references-count":50,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2019,10]]}},"alternative-id":["ijerph16193530"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16193530","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2019,9,20]]}}}