Web-Based Psychoeducation Program for Improving Coping Mechanisms Among Family Caregivers of People with Schizophrenia: A Quasi-Experimental Study

Vollständiger Abstract

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Background/Objectives: Family caregivers of people with schizophrenia experience substantial psychological and practical demands associated with long-term caregiving. This study examined whether participation in a web-based digital psychoeducation program was associated with longitudinal changes in coping mechanisms among family caregivers of people with schizophrenia. Methods: A non-randomized quasi-experimental pretest–posttest control-group study was conducted at a mental health hospital in Indonesia. The final analytic sample comprised 202 family caregivers of people with schizophrenia, with 101 participants in the intervention group and 101 in the control group. The intervention comprised 10 structured web-based psychoeducation modules delivered over 10 weeks. Coping was assessed using the Brief COPE Inventory and summarized into problem-focused, emotion-focused, and avoidance coping domains. Linear mixed-effects models were used as the primary adjusted longitudinal analysis, with study group, time, group-by-time interaction, age group, and marital status included as fixed effects. Wilcoxon signed-rank and Mann–Whitney U tests were retained as complementary unadjusted analyses, while baseline-adjusted linear regression models were used as sensitivity analyses. Results: Significant group-by-time interactions were observed for problem-focused coping and emotion-focused coping. The adjusted between-group difference in change was 0.450 points (95% CI: 0.357–0.544; partial ηp2 = 0.312; p < 0.001) for problem-focused coping and 0.263 points (95% CI: 0.137–0.390; partial ηp2 = 0.078; p < 0.001) for emotion-focused coping. In contrast, no statistically significant differential change was observed for avoidance coping (adjusted difference in change = 0.074 points, 95% CI: −0.055 to 0.204; partial ηp2 = 0.006; p = 0.259). Baseline-adjusted sensitivity analyses produced a consistent overall pattern. Conclusions: Participation in the 10-week web-based digital psychoeducation program was associated with greater longitudinal improvements in problem-focused and emotion-focused coping, but not avoidance coping. Given the non-randomized design and baseline differences between groups, these findings should be interpreted as adjusted longitudinal associations rather than definitive evidence of causal efficacy. The program may therefore represent an accessible complementary approach to supporting caregiver adaptation in long-term schizophrenia care.