Effectiveness of psychiatric nurse-led psychoeducationalinterventions in reducing caregiver burden and expressedemotion among families of patients with schizophrenia: Asystematic review

Abstract

Schizophrenia is a chronic psychiatric disorder that produces substantial cognitive, behavioural, emotional, and social impairment. Following the transition from institutional to community-based psychiatric care, family members have increasingly assumed responsibility for medication supervision, symptom monitoring, relapse recognition, behavioural management, and emotional and practical support. These responsibilities can contribute to significant caregiver burden and high levels of expressed emotion (EE), particularly criticism, hostility, and emotional overinvolvement. Psychiatric nurses are well positioned to provide structured family psychoeducation because of their continuous involvement with patients and caregivers across inpatient, outpatient, and community settings. This systematic review evaluated the effectiveness of psychiatric nurseled psychoeducational interventions in reducing caregiver burden and expressed emotion among families of individuals with schizophrenia. Secondary outcomes included medication adherence, relapse, rehospitalisation, family functioning, and caregiver coping. A systematic review design was used to identify and synthesise studies examining structured psychiatric nurse-led or nursefacilitated psychoeducational interventions for family caregivers of individuals with schizophrenia. Eligible interventions included illness education, medication counselling, relapseprevention planning, communication training, problem-solving, coping enhancement, stress management, and family support. Twenty-five eligible studies were included in the final narrative synthesis. Psychiatric nurse-led family psychoeducation is a valuable component of comprehensive schizophrenia care. Structured interventions can reduce caregiver burden and expressed emotion while strengthening treatment adherence, coping, communication, and relapse-prevention capacity. Integration of standardised family psychoeducation into routine psychiatric nursing practice may improve long-term outcomes for both individuals with schizophrenia and their caregivers