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ItemA longitudinal study of the health and wellbeing of a population based sample of caregivers of people with psychosis: influences of patients’ clinical factors and carer characteristics( 2014)Background: Few studies have examined the experiences of carers of people with psychosis within a prevalence framework. Aiming to obtain generalisable results concerning carers, this carer study was conducted utilising the recruitment of people with psychosis within the Second Australian prevalence study of psychotic disorders: the Survey of High Impact Psychosis (SHIP). The study examined the social connectedness, psychological health, feelings of grief, quality of life and caregiving consequences of carers of people with psychosis. The main hypothesis was that carers’ psychological health, social connectedness, quality of life, level of grief and caregiving consequences would deteriorate over time. A second hypothesis was that the predictors of carers’ psychological health, quality of life, grief, social connectedness and caregiving consequences were a combination of patients’ clinical factors and carer characteristics. Methods: The study recruited 98 caregivers of SHIP participants in Victoria at baseline. The carers completed questionnaires consisting of validated instruments to measure psychological health, quality of life, grief, social connectedness and caregiving consequences. A follow-up interview one year later was conducted to evaluate changes in carers’ health and wellbeing and to evaluate predictive factors contributing to the consequences of caregiving over time. The study re-interviewed 78 carers at follow-up. Clinical (patient-related) factors were extracted from the SHIP database. Using both clinical and carer variables, descriptive, correlation, regression and cross-lagged statistical analyses were conducted. Results: A significant percentage of the carers experienced social isolation, psychological distress, prominent grief, poor quality of life and negative caregiving consequences. There were no statistically significant changes between baseline and follow-up scores for almost all the carers’ health and wellbeing variables. The exception was that carers had poorer perception of their quality of life regarding their physical health after one year. Regression analyses showed that the predictors of carers’ psychological health, quality of life, grief, social connectedness and caregiving consequences were a combination of clinical factors and carer characteristics. The clinical factors found to predict these outcomes were: course of mental disorder, cognitive functioning and functioning level. Carer characteristics found to predict these outcomes were: baseline caregiving outcome scores, age, gender and education level. Cross-lagged analysis suggested that higher functioning level of the person with psychosis as perceived by the caregiver at baseline led to better carer social connection, less grief and higher satisfaction in psychological health over time. Conclusion: Due to the sampling frame of SHIP participants, results of this study are likely to be representative of carers of people with psychosis. Caregivers’ perception of the functioning levels of people with psychosis was found to be crucial in determining their own health and wellbeing. As carers’ health and wellbeing remained consistently poor over time, it is important to review the practice implications within the recovery framework and delivery of psychosocial rehabilitation services to support recovery for both carers and their relatives with psychosis. Specifically, there is a need to provide interventions that address carers’ physical health as they perceived their physical health to have deteriorated after one year.