The effect of rasa rumangsa (self-awareness and empathy) on the subjective burden of families caring for individuals with schizophrenia: Social support as a mediator
DOI:
https://doi.org/10.21580/pjpp.v10i1.25099Keywords:
mediation, rasa rumangsa, schizophrenia, Sobel test, social support, subjective burdenAbstract
Families caring for schizophrenic individuals experience pressure due to their associated roles and responsibilities, a situation known as subjective burden. Cultural values influence decision-making related to caretaking behavior, including that based on the Javanese value of rasa rumangsa as an adaptive coping mechanism in caregiving contexts. Social support is a factor that helps to reduce the subjective burden of families taking care of schizophrenic individuals. This study examines social support as a mediator in the role of rasa rumangsa in relation to such subjective burden. The quantitative research used surveys for the data collection method, with 112 carer families of schizophrenic individuals chosen for the study by purposive sampling. The questionnaires used were 1) the Rasa Rumangsa Scale; 2) the Interpersonal Support Evaluation List (ISEL); and 3) the Zarit Burden Interview (ZBI). The hypothesis was tested using Jamovi version 2.6.13 with the medmod module, following Model 4 of Hayes' simple mediation framework. The results indicate that social support fully mediates the relationship between rasa rumangsa and the subjective burden of families caring for individuals with schizophrenia (indirect effect: ß = -.1137, p < .05, 95% CI = -.2186, -.0105). The implication of studying rasa rumangsa as a cultural coping mechanism can be an alternative way of explaining its relationship with the subjective burden of such families. In addition, the findings could also be used to develop mental health programs to improve social support, which will ultimately reduce the subjective burden.
Downloads
References
’Aini, Z. K., & Paskarini, I. (2022). Hubungan beban kerja fisik dan shift kerja dengan kelelahan kerja subjektif pekerja shift (Studi pada pekerja shift di Puskesmas Kepohbaru, Kab. Bojonegoro). Preventif: Jurnal Kesehatan Masyarakat, 13(4), 596–610. https://doi.org/10.22487/preventif.v13i4.330
Amalia, A., & Rahmatika, R. (2020). Peran dukungan sosial bagi kesejahteraan psikologis family caregiver orang dengan skizofrenia (ODS) rawat jalan. Jurnal Ilmu Keluarga dan Konsumen, 13(3), 228–238. https://doi.org/10.24156/jikk.2020.13.3.228
Amaresha, A. C., & Venkatasubramanian, G. (2012). Expressed emotion in schizophrenia: An overview. Indian Journal of Psychological Medicine, 34(1), 12–20. https://doi.org/10.4103/0253-7176.96149
American Psychological Association. (n.d.). Resilience: Adapted from the APA Dictionary of Psychology. American Psychological Association. https://www.apa.org/topics/resilience
Awad, A. G., & Voruganti, L. N. P. (2008). The burden of schizophrenia on caregivers. A review. PharmacoEconomics, 26(2), 149–162. https://doi.org/10.2165/00019053-200826020-00005
Bahari, K., Sunarno, I., & Mudayatiningsih, S. (2017). Beban keluarga dalam merawat anggota keluarga dengan gangguan jiwa berat. Jurnal Informasi Kesehatan Indonesia (JIKI), 3(1), 43. https://doi.org/10.31290/jiki.v(3)i(1)y(2017).page:43-53
Chen, L., Zhao, Y., Tang, J., Jin, G., Liu, Y., Zhao, X., Chen, C., & Lu, X. (2019). The burden, support and needs of primary family caregivers of people experiencing schizophrenia in Beijing communities: A qualitative study. BMC Psychiatry, 19(1), 75. https://doi.org/10.1186/s12888-019-2052-4
Chou, K.-R. (2000). Caregiver burden: A concept analysis. Journal of Pediatric Nursing, 15(6), 398–407. https://doi.org/10.1053/jpdn.2000.16709
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. M. (1985). Measuring the functional components of social support. In Social Support: Theory, Research and Applications (Vol. 24, pp. 73–94). Springer Netherlands. https://doi.org/10.1007/978-94-009-5115-0_5
Daryanto, S. S. (1999). Kawruh basa Jawa pepak. Apollo Lestari.
Di Lorenzo, R., Girone, A., Panzera, N., Fiore, G., Pinelli, M., Venturi, G., Magarini, F., & Ferri, P. (2021). Empathy and perceived burden in caregivers of patients with schizophrenia spectrum disorders. BMC Health Services Research, 21(1), 250. https://doi.org/10.1186/s12913-021-06258-x
DiMatteo, M. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology, 23(2), 207–218. https://doi.org/10.1037/0278-6133.23.2.207
Endraswara, S. (2013). Ilmu jiwa Jawa: Etika dan citarasa jiwa Jawa. Narasi.
Endraswara, S. (2018). Falsafah hidup Jawa: Menggali mutiara kebijakan dari intisari filsafat Kejawen. Cakrawala.
Folkman, S. (2013). Stress: Appraisal and Coping. In Encyclopedia of Behavioral Medicine (1st ed., pp. 1913–1915). Springer New York. https://doi.org/10.1007/978-1-4419-1005-9_215
Fontaine, K. L. (2003). Mental health nursing. Prentice Hall.
Frasia, Y. V., Zuhriyah, L., & Kapti, R. E. (2018). Faktor-faktor yang berhubungan dengan kesejahteraan subjektif caregiver orang dengan skizofrenia di Bantur Malang. Jurnal Kedokteran Brawijaya, 30(2), 142–147. https://doi.org/10.21776/ub.jkb.2018.030.02.12
Geertz, C. (1973). The Interpretation of Cultures. Basic Books.
Ghane, G., Ashghali Farahani, M., Seyedfatemi, N., & Haghani, H. (2016). Effectiveness of problem-focused coping strategies on the burden on caregivers of hemodialysis patients. Nursing and Midwifery Studies, 5(2). https://doi.org/10.17795/nmsjournal35594
Gusdiansyah, E., & Mailita, W. (2021). Hubungan dukungan keluarga dan beban keluarga dengan tingkatan skizofrenia. Jurnal Keperawatan Abdurrab, 5(1), 29–37. https://doi.org/10.36341/jka.v5i1.1788
Hayes, A. F. (2018). Partial, conditional, and moderated moderated mediation: Quantification, inference, and interpretation. Communication Monographs, 85(1), 4–40. https://doi.org/10.1080/03637751.2017.1352100
Hidayati, N. (2011). Dukungan sosial bagi keluarga anak berkebutuhan khusus. Insan, 13(1), 13–20.
Hogan, L., & John-Langba, J. (2016). Coping mechanisms of caregivers of persons diagnosed with severe mental illness in South Africa. Journal of Psychology Research, 6(10), 616–629. https://doi.org/10.17265/2159-5542/2016.10.006
Hu, Y., Guo, X., You, H., Liu, L., & Wang, Y. (2025). Mediating effect of social support on the relationships between caregiver burden and quality of life in family caregivers of people with dementia: a cross-sectional study in Rural China. BMC Nursing, 24(1), 37. https://doi.org/10.1186/s12912-024-02671-9
Huang, C., Lam, L., Plummer, V., & Cross, W. M. (2021). Feeling responsible: Family caregivers’ attitudes and experiences of shared decision-making regarding people diagnosed with schizophrenia: A qualitative study. Patient Education and Counseling, 104(7), 1553–1559. https://doi.org/10.1016/j.pec.2020.10.032
Huang, M.-F., Huang, W.-H., Su, Y.-C., Hou, S.-Y., Chen, H.-M., Yeh, Y.-C., & Chen, C.-S. (2015). Coping strategy and caregiver burden among caregivers of patients with dementia. American Journal of Alzheimer’s Disease & Other Dementias®, 30(7), 694–698. https://doi.org/10.1177/1533317513494446
Hunt, C. K. (2003). Concepts in caregiver research. Journal of Nursing Scholarship, 35(1), 27–32. https://doi.org/10.1111/j.1547-5069.2003.00027.x
Isaacs, A. (2005). Panduan belajar keperawatan kesehatan jiwa dan psikiatrik (3rd ed.). EGC.
Kate, N., Grover, S., Kulhara, P., & Nehra, R. (2013). Relationship of caregiver burden with coping strategies, social support, psychological morbidity, and quality of life in the caregivers of schizophrenia. Asian Journal of Psychiatry, 6(5), 380–388. https://doi.org/10.1016/j.ajp.2013.03.014
Khusaifan, S. J., & El Keshky, M. E. S. (2017). Social support as a mediator variable of the relationship between depression and life satisfaction in a sample of Saudi caregivers of patients with Alzheimer’s disease. International Psychogeriatrics, 29(2), 239–248. https://doi.org/10.1017/S1041610216001824
Kim, B., Kim, J. I., Na, H. R., Lee, K. S., Chae, K., & Kim, S. (2021). Factors influencing caregiver burden by dementia severity based on an online database from Seoul dementia management project in Korea. BMC Geriatrics, 21(1), 649. https://doi.org/10.1186/s12877-021-02613-z
Kim, U., Yang, K. S., & Hwang, K. K. (2006). Indigenous and cultural psychology (Uichol Kim, K.-S. Yang, & K.-K. Hwang (eds.)). Springer. https://doi.org/10.1007/0-387-28662-4
Leng, A., Xu, C., Nicholas, S., Nicholas, J., & Wang, J. (2019). Quality of life in caregivers of a family member with serious mental illness: Evidence from China. Archives of Psychiatric Nursing, 33(1), 23–29. https://doi.org/10.1016/j.apnu.2018.08.010
Magnis-Suseno, F. (2003). Etika Jawa: Sebuah analisa falsafi tentang kebijaksanaan hidup Jawa. Gramedia.
Mora-Castañeda, B., Márquez-González, M., Fernández-Liria, A., Martínez Huertas, J. Á., Cabrera, I., Olmos, R., & O’Connell, D. (2023). The processes of stress and coping in informal caregivers of people diagnosed on the schizophrenia spectrum. A longitudinal study. Behavioral Psychology/Psicología Conductual, 31(1), 149–163. https://doi.org/10.51668/bp.8323109n
Moritsugu, J., Vera, E., Wong, F. Y., & Duffy, K. G. (2019). Community psychology. Routledge. https://doi.org/10.4324/9780429021558
Navidian, A., Kermansaravi, F., & Rigi, S. N. (2012). The effectiveness of a group psycho-educational program on family caregiver burden of patients with mental disorders. BMC Research Notes, 5(1), 399. https://doi.org/10.1186/1756-0500-5-399
Ong, H. L., Vaingankar, J. A., Abdin, E., Sambasivam, R., Fauziana, R., Tan, M.-E., Chong, S. A., Goveas, R. R., Chiam, P. C., & Subramaniam, M. (2018). Resilience and burden in caregivers of older adults: Moderating and mediating effects of perceived social support. BMC Psychiatry, 18(1), 27. https://doi.org/10.1186/s12888-018-1616-z
Pabebang, Y., Handayani Mangapi, Y., & Kelong, P. (2022). Faktor-faktor yang berhubungan dengan mekanisme koping pada lansia di Lembang Benteng Ka’do Kecamatan Kapalapitu Kabupaten Toraja Utara tahun 2019. Jurnal Ilmiah Kesehatan Promotif, 6(2), 157–169. https://doi.org/10.56437/jikp.v6i2.68
Parija, S., Yadav, A. K., Sreeraj, V. S., Patel, A. K., Yadav, J., & Jain, R. K. (2016). Caregiver burden and expressed emotion in caregivers of patients with schizophrenia. Journal of Psychosocial Rehabilitation and Mental Health, 3(2), 83–87. https://doi.org/10.1007/s40737-016-0061-x
Peng, M.-M., Xing, J., Tang, X., Wu, Q., Wei, D., & Ran, M.-S. (2022). Disease-related risk factors for caregiver burden among family caregivers of persons with schizophrenia: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 19(3), 1862. https://doi.org/10.3390/ijerph19031862
Peristianto, S. V., Subandi, S., & Utami, M. S. (2023). A phenomenological study on caretaking families of schizophrenic individuals: Does the family feel burdened? In International Conference of Psychology: International Conference on Indigenous Treatment and Contemporary Psychology (pp. 76–88). https://doi.org/10.2991/978-2-38476-080-0_11
Peristianto, S. V., Subandi, S., & Utami, M. S. (2025). Empathy and self-awareness (rasa rumangsa) in the Javanese cultural context. Culture & Psychology, 31(2), 713–733. https://doi.org/10.1177/1354067X251315737
Peristianto, S. V., Subandi, S., & Utami, M. S. (2022). Family burden of schizophrenic individuals in Asia: Review. Proceedings of International Conference on Psychological Studies (ICPSYCHE), 3, 131–139. https://doi.org/.
Poegoeh, D. P., & Hamidah, H. (2016). Peran dukungan sosial dan regulasi emosi terhadap resiliensi keluarga penderita skizofrenia. Insan: Jurnal Psikologi dan Kesehatan Mental, 1(1), 12–21. https://doi.org/10.20473/jpkm.V1I12016.12-21
Rafiyah, I., & Sutharangsee, W. (2011). Review: Burden on family caregivers caring for patients with schizophrenia and its related factors. Nurse Media Journal of Nursing, 1(1), 29–41. https://ejournal.undip.ac.id/index.php/medianers/article/view/745
Raj, E., Shiri, S., & Jangam, K. (2016). Subjective burden, psychological distress, and perceived social support among caregivers of persons with schizophrenia. Indian Journal of Social Psychiatry, 32(1), 42. https://doi.org/10.4103/0971-9962.176767
Rodakowski, J., Skidmore, E. R., Rogers, J. C., & Schulz, R. (2012). Role of social support in predicting caregiver burden. Archives of Physical Medicine and Rehabilitation, 93(12), 2229–2236. https://doi.org/10.1016/j.apmr.2012.07.004
Srivastava, S. (2005). Perception of burden by caregivers of patients with schizophrenia. Indian Journal of Psychiatry, 47(3), 148. https://doi.org/10.4103/0019-5545.55938
Subandi, S., & Utami, M. S. (2006). Pola perilaku mencari bantuan pada keluarga pasien gangguan jiwa. Jurnal Psikologi, 23(2), 1–10. https://jurnal.ugm.ac.id/jpsi/article/view/10044
Sureskiarti, E., Mentari, M., Masnina, R., & Milkhatun, M. (2019). The performance of nurses to improve the responsibility quality of nursing services. Indonesian Journal of Global Health Research, 2(4), 411–418. https://doi.org/10.37287/ijghr.v2i4.250
Taylor, S. E., Peplau, L. A., & Sears, D. O. (2006). Social psychology. Pearson Prentice Hall.
Theodora, M., Sahrani, R., & Roswiyani, R. (2023). The mediating effect of forgiveness on the relationship between spirituality and psychological well-being in adults with history of childhood bullying. Psikohumaniora: Jurnal Penelitian Psikologi, 8(2), 241–258. https://doi.org/10.21580/pjpp.v8i2.17829
Triandis, H. C. (1996). The psychological measurement of cultural syndromes. American Psychologist, 51(4), 407–415. https://doi.org/10.1037/0003-066X.51.4.407
Uhlhaas, P. J., & Mishara, A. L. (2006). Perceptual anomalies in schizophrenia: Integrating phenomenology and cognitive neuroscience. Schizophrenia Bulletin, 33(1), 142–156. https://doi.org/10.1093/schbul/sbl047
Wardani, I. A. K., & Kurniawan, L. S. (2024). Analisis karakteristik depresi pada beban caregiver skizofrenia di Poliklinik Jiwa RSUP Prof Dr I.G.N.G Ngoerah Denpasar. Paedagogy: Jurnal Ilmu Pendidikan dan Psikologi, 4(1), 23–30. https://doi.org/10.51878/paedagogy.v4i1.2759
Xian, M., & Xu, L. (2020). Social support and self-rated health among caregivers of people with dementia: The mediating role of caregiving burden. Dementia, 19(8), 2621–2636. https://doi.org/10.1177/1471301219837464
Xu, L., Xu, T., Tan, W., Yan, B., Wang, D., Li, H., Lin, Y., Li, K., Wen, H., Qin, X., Sun, X., Guan, L., Bass, J. K., Ma, H., & Yu, X. (2020). Household economic burden and outcomes of patients with schizophrenia after being unlocked and treated in rural China. Epidemiology and Psychiatric Sciences, 29, e81. https://doi.org/10.1017/S2045796019000775
Yang, Z., Tian, Y., Fan, Y., Liu, L., Luo, Y., Zhou, L., & Yu, H. (2019). The mediating roles of caregiver social support and self-efficacy on caregiver burden in Parkinson’s disease. Journal of Affective Disorders, 256, 302–308. https://doi.org/10.1016/j.jad.2019.05.064
Yu, Y., Liu, Z.-W., Li, T.-X., Li, Y.-L., Xiao, S.-Y., & Tebes, J. K. (2020). Test of the stress process model of family caregivers of people living with schizophrenia in China. Social Science & Medicine, 259, 113113. https://doi.org/10.1016/j.socscimed.2020.113113
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist, 20(6), 649–655. https://doi.org/10.1093/geront/20.6.649
Zauszniewski, J. A., Bekhet, A. K., & Suresky, M. J. (2010). Resilience in family members of persons with serious mental illness. Nursing Clinics of North America, 45(4), 613–626. https://doi.org/10.1016/j.cnur.2010.06.007
Zhang, Y., Li, J., Zhang, Y., Chen, C., Guan, C., Zhou, L., Zhang, S., Chen, X., & Hu, X. (2024). Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. European Journal of Oncology Nursing, 68, 102509. https://doi.org/10.1016/j.ejon.2024.102509
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Psikohumaniora: Jurnal Penelitian Psikologi
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright of the accepted article shall be assigned to the publisher of the journal. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to published articles.
In line with the license, authors and any users (readers and other researchers) are allowed to share and adapt the material only for non-commercial purposes. In addition, the material must be given appropriate credit, provided with a link to the license, and indicated if changes were made. If authors remix, transform, or build upon the material, authors must distribute their contributions under the same license as the original.
