with mental disorders continue to live with their family members, making the family a primary pillar of support for these

individuals. Reintegrating individuals with schizophrenia into the community remains a challenge. According to Fitryasari et al.

(2018), family members of individuals with schizophrenia face difficulties associated with the disease itself and struggle with

time constraints, financial burden, societal pressures, and the emotional and physical toll from taking care of their loved one

with schizophrenia. Traditionally, researchers have considered such caregiving to be a negative experience for the caregiver.

However, more recent studies have challenged this assumption. Caregivers have been reported to develop unique coping

mechanisms throughout their caregiving experience to meet the requirements of caregiving, resulting in positive experiences

and even the discovery of new meaning in life. This adaptive process and its acknowledgment serve to empower caregivers (Gater

et al., 2014; Yang & Tung, 2015). This study was conducted to explore the perspectives and experiences of family members of

individuals with schizophrenia to determine how they responded to hospitalization, community reintegration, and the disease

itself, throughout different stages of onset, as well as their feelings, thoughts, and responses regarding various challenges in

this journey. This study aimed to provide valuable insights for caregivers who may have feelings of frustration associated with

caregiving and to determine whether narrative sharing can aid in the recognition of underappreciated yet powerful values among

family members.

In this qualitative study, four family members aged 33–73 living with employed individuals with schizophrenia were

included. Women outnumbered men (ratio: 3:1). All family members were engaged in home-based care and regular medical

checkups, and they all had previous work experiences, with two of them currently employed. A formal interview protocol was

formulated to obtain a comprehensive understanding of two primary dimensions: (1) the caregiving experiences of family

members across different stages of schizophrenia and (2) the difficulties faced by these family members and their coping

mechanisms. A narrative analysis approach involving a macrostructure, microcontent model, supplemented by Labov’s narrative

structure analysis, was used for data analysis. This analytical approach retained the sequential order of the participants’ narrative units, enhancing the integrity of narrative flow (Tsai et al., 2014).

Participant experiences were used as a case study to illustrate the individual’s narrative life story of living with employed individuals with schizophrenia. A cross-case analysis revealed several stages involved in the process of living with an individual  with schizophrenia. The first stage involves nervousness and response to the disease. At this stage, the caregiver experiences the symptoms of the disease alone, often relying on religion for spiritual support, and they attempt to address and modify the

unusual behaviors of their family member with schizophrenia. The second stage involves the caregiver using their rationality

to deal with the situation. At this stage, the caregiver employs rational thinking in their decision-making process while seeking

professional medical interventions to alleviate their emotional distress. The third stage involves active learning and information

seeking. At this stage, the caregiver follows a proactive approach to acquiring knowledge regarding the symptoms of

schizophrenia, reduce self-repression, gain support through social interactions, and actively seek social resources; these are done

to induce changes in the internal and external environment, to monitor the patient’s medical condition, to overcome challenges

and move forward, to adopt appropriate standards of dealing life events, and to help patients learn how to be responsible.

Generally, shifts in personal perspectives reveal new meanings. Therefore, accompanying individuals with schizophrenia

throughout their journey enables caregivers to continually learn and adapt .

Distinct patterns were observed in the caregiving experiences of family members supporting individuals with schizophrenia

during their reintegration into the community. With schizophrenia serving as a catalyst for increased responsibility, the

caregiving journey began with family members experiencing a major influence on their lives and emotional states, triggered by

the initial shock of the disease. This period was marked by high emotional tension, with feelings of helplessness, hopelessness,

guilt, and anxiety (Liu & Lin, 2017). Shifting from a fact-oriented perspective to an inner motivational drive enabled caregivers

to redirect their life trajectories. A deeper understanding of schizophrenia can enable family members to adapt with greater

flexibility to their caregiving roles (Amagai et al., 2016). Throughout their caregiving journey, family members tended to

develop the following adaptation strategies and coping mechanisms. The first mechanism was to transition from isolation to

seeking support. Initially, caregivers may choose to endure and repress their emotions in isolation. However, over time, they

started to proactively seek resources and support. Social support is linked to positive outcomes among caregivers of individuals

with schizophrenia (Balaban et al., 2017; Morton et al., 2015). The second mechanism was to adopt an active and flexible

approach to caregiving. During the caregiving process, caregivers tended to shift from passive adherence to medical advice to

active and flexible engagement. In this process, acceptance served as a key cognitive coping strategy, which involved accepting

the inherent unfairness of the caregiving scenario and recognizing the impossibility of returning to a previous state (Azman et

al., 2017; Zegwaard et al., 2013).

This study has the following implications for research and practice. When a family member has schizophrenia, providing

a stable medical intervention and gaining a comprehensive understanding of schizophrenia during the early stages of the

disease are essential. Encouraging family members to focus on improving their patient’s conditions may also alleviate feelings

of self-blame and guilt associated with hospitalizing their loved ones. In addition, actively acquiring knowledge regarding

schizophrenia may provide family members with a greater sense of control throughout the caregiving process and help them

gradually accept the disease and modify their negative perceptions of it. Spirituality provides family members with a sense of

solace. It enables them to express and mitigate the negative emotions experienced during the caregiving process. Establishing

resource-based connections highlights the proactive role that family members must play in seeking and establishing social

support networks. These networks not only provide immediate support but also potentially serve as resources for individuals

with schizophrenia to engage with others and secure employment upon their reintegration into the community.

In terms of research limitations, the recruitment criteria for the participants presented several challenges. Given that

relatively few employed individuals have schizophrenia, and considering the willingness of their family members to overcome

stigma and share their experiences, this study encountered limitations in terms of the number of participants. These limitations

were further compounded by the age and kinship differences between the participants, in addition to the presence of only one

male participant. Consequently, the research data may not have been as rich or diverse as it ought to have been, potentially

hindering a comprehensive understanding of the process through which family members support individuals with schizophrenia during their reintegration into the community. Future research may benefit from specifying the relationship between patients and their family members and should examine the severity of the disease while considering variables such as age, gender, and disease stage. This approach may yield a more holistic view of the experiences of family members assisting in the reintegration

of individuals with schizophrenia into the community.