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Yu H, Sun YJ, Qin MN, Ren JX, Yu K, Song J, Zhou YQ, Liu L. Perception of risk of relapse among patients with first episode and recurrent schizophrenia: a descriptive phenomenological study. BMC Psychiatry 2023; 23:582. [PMID: 37563579 PMCID: PMC10413637 DOI: 10.1186/s12888-023-05023-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/12/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Patients suffering from schizophrenia are at a higher risk of relapse. The perception of the risk of relapse in patients is critical for relapse prevention. In the field of psychiatry, the study of risk perception of relapse has been neglected. METHODS We carried out a qualitative study using a descriptive phenomenological approach. Data were collected at two psychiatric hospitals in China. In total, 22 patients with schizophrenia were recruited through purposive sampling. Face to face semi-structured in-depth interviews were conducted. Interview recordings were transcribed by the research team, and transcripts were analysed by two independent coders with Colaizzi's descriptive analysis framework. The consolidated criteria for reporting qualitative research checklist were used for reporting. RESULTS The data of first-episode patients yielded three themes: (i) lack of knowledge about disease recognition and medical treatment; (ii) overoptimistic estimation of the risk of relapse; (iii) perceived importance of treatment. For first-relapse patients : (i) initial awareness of relapse warning signs; (ii) lack of systematic and accurate assessment of disease information; (iii) the perception that drug withdrawal is related to relapse. Patients with multiple relapses: (i) susceptibility to relapse: confusion and powerlessness; (ii) the severity of relapse: suicidal thoughts and behavior; (iii) effects of perceived benefits and barriers of medication behaviour. CONCLUSIONS In schizophrenic patients with first-episode, first-relapse, and multiple relapses, there were dynamic changes in the perception of disease relapse risk and medication behaviour. Medical workers must improve risk awareness education. They should provide patients with scientific, accurate, and timely communication channels, and dynamically assess and manage the risk of relapse in various patients.
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Affiliation(s)
- Hong Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Yu-Jing Sun
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Meng-Nan Qin
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Jia-Xin Ren
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Kai Yu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Jin Song
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
| | - Yu-Qiu Zhou
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China.
| | - Li Liu
- Department of Nursing, Harbin Medical University Daqing Campus, Heilongjiang, 163319, Daqing, China
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Laranjeira C, Carvalho D, Valentim O, Moutinho L, Morgado T, Tomás C, Gomes J, Querido A. Therapeutic Adherence of People with Mental Disorders: An Evolutionary Concept Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3869. [PMID: 36900879 PMCID: PMC10001153 DOI: 10.3390/ijerph20053869] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
Patient therapeutic adherence lies at the core of mental health care. Health Care professionals and organizations play a major role in promoting adherence among people with mental disorders. However, defining therapeutic adherence remains complex. We used Rodgers' evolutionary concept analysis to explore the concept of therapeutic adherence in the context of mental health. We conducted a systematic literature search on Medline/PubMed and CINAHL for works published between January 2012 and December 2022. The concept analysis showed that major attributes of therapeutic adherence include patient, microsystem and meso/exosystem-level factors. Antecedents are those related to patients, such as their background, beliefs and attitudes, and acceptance of mental illness-and those related to patient-HCP therapeutic engagement. Lastly, three different consequences of the concept emerged: an improvement in clinical and social outcomes, commitment to treatment, and the quality of healthcare delivery. We discuss an operational definition that emerged from the concept analysis approach. However, considering the concept has undergone evolutionary changes, further research related to patient adherence experiences in an ecological stance is needed.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Daniel Carvalho
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - Olga Valentim
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Lídia Moutinho
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Nursing School of Lisbon (ESEL), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Av. Prof. Egas Moniz, 1600-096 Lisboa, Portugal
| | - Tânia Morgado
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
- Pediatric Hospital, Coimbra Hospital and University Centre, R. Dr. Afonso Romão, 3000-602 Coimbra, Portugal
- The Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Catarina Tomás
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
| | - João Gomes
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Hospital Center of Leiria–Hospital de Santo André, R. de Santo André, 2410-197 Leiria, Portugal
| | - Ana Querido
- School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Rua de Santo André—66–68, Campus 5, 2410-541 Leiria, Portugal
- Group Innovation & Development in Nursing (NursID), Center for Health Technology and Services Research (CINTESIS@RISE), 4200-450 Porto, Portugal
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Türkoğlu Dikmen SN, Yüksel A, Bahadir-Yilmaz E. The effect of medication adherence on psychosocial adjustment to body weight, image, and self-esteem in patients with schizophrenia. Perspect Psychiatr Care 2022; 58:2505-2512. [PMID: 35388488 DOI: 10.1111/ppc.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/20/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The present study aimed to evaluate the effect of medication adherence on psychosocial adjustment to body weight, image, and self-esteem in patients with schizophrenia. DESIGN AND METHODS This cross-sectional and correlational study consisted of 154 patients with schizophrenia registered in a Community Mental Health Center. FINDINGS The patients had moderate psychosocial adjustment to body weight, image, and self-esteem, and 56.5% had poor medication adherence. There was a significant positive correlation between participants' medication adherence and psychosocial adjustment to body weight, image, and self-esteem. PRACTICE IMPLICATIONS Psychiatric nurses should support patients regarding medication adherence, and psychosocial adjustment to body weight, image, and self-esteem.
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Affiliation(s)
| | - Arzu Yüksel
- Department of Psychiatric Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
| | - Emel Bahadir-Yilmaz
- Department of Psychiatric Nursing, Faculty of Health Sciences, Giresun University, Giresun, Turkey
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Yıldırım Üşenmez T, Gültekin A, Erkan FM, Bayar BD, Can SY, Şanlı ME. The effect of mindfulness on medication adherence in individuals diagnosed with Schizophrenia: A cross-sectional study. Perspect Psychiatr Care 2022; 58:2585-2591. [PMID: 35474214 DOI: 10.1111/ppc.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The aim of this study is to determine the effect of mindfulness on medication adherence in individuals diagnosed with schizophrenia. MATERIALS AND METHODS This cross-sectional study was conducted with 147 individuals diagnosed with schizophrenia. The data were collected using the Descriptive Characteristics Form, Morisky Medication Adherence Scale, and Mindful Attention Awareness Scale. RESULTS A strong positive correlation was determined between the mindfulness level and medication adherence of the individuals diagnosed with schizophrenia. Furthermore, mindfulness of the individuals diagnosed with schizophrenia was statistically significant in explaining medication adherence (p < 0.05) and mindfulness predicted medication adherence by 64%. CONCLUSION It was observed that the individuals' mindfulness level was low and half of the participants had low medication adherence. Moreover, as their mindfulness level increased, so did their medication adherence.
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Affiliation(s)
- Tülay Yıldırım Üşenmez
- Department of Nursing, Atatürk Health Sciences Faculty, Dicle University, Diyarbakir, Turkey
| | - Abdurrezzak Gültekin
- Department of Psychiatric Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Fatma Melike Erkan
- Department of Psychiatric Nursing, Faculty of Nursing, Inonu University, Malatya, Turkey
| | - Behiye Dilmen Bayar
- Department of Medical Services and Techniques, Vocational Higher School of Health Services, Mardin Artuklu University, Mardin, Turkey
| | - Sevinç Yaşar Can
- Department of Medical Services and Techniques, Vocational Higher School of Health Services, Mardin Artuklu University, Mardin, Turkey
| | - Mehmet Emin Şanlı
- Department of Medical Services and Techniques, Vocational Higher School of Health Services, Batman University, Batman, Turkey
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Uncertainty in illness among individuals with schizophrenia: a phenomenology study in Indonesia. JOURNAL OF PUBLIC MENTAL HEALTH 2022. [DOI: 10.1108/jpmh-03-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Individuals with schizophrenia experience uncertainty due to the unpredictable symptoms, the course of the illness and poor knowledge about the disease, treatment and prognosis. Uncertainty in illness is linked with poor treatment outcomes, coping strategies, check-up decisions and psychological distress. This study aims to explore the uncertainty in illness among individuals with schizophrenia.
Design/methodology/approach
Eight individuals with schizophrenia living in the community were interviewed regarding their illness. The phenomenology approach was used to collect and analyze the data.
Findings
Three themes emerged from the findings of the study; the unpredictable course of the illness, compliance amid uncertainty and uncertainty of information about their illness. This study provides an essential overview of how patients with schizophrenia live in uncertain conditions.
Originality/value
It should be considered by various parties, particularly the community mental health nurses working with individuals with schizophrenia. Considering the uncertainty of illness while looking after or interacting with patients and their family is significant in improving adequate mental health-care delivery.
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Mental Health Nurses’ Tacit Knowledge of Strategies for Improving Medication Adherence for Schizophrenia: A Qualitative Study. Healthcare (Basel) 2022; 10:healthcare10030492. [PMID: 35326970 PMCID: PMC8955025 DOI: 10.3390/healthcare10030492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 02/01/2023] Open
Abstract
Non-adherence to medication among patients with schizophrenia is an important clinical issue with very complex reasons. Since medication administration is an essential nursing responsibility, improving strategies for patient medication compliance must be fully understood. This study aimed to explore the strategies mental health nurses (MHNs) implement in clinically improving patients with schizophrenia and to describe the nurses’ tacit knowledge of application strategies. A qualitative study with purposeful sampling was used. Twenty-five experienced MHNs in a psychiatric hospital in central Taiwan were given an in-depth interview. The texts were content-analyzed using NVivo 12 Pro software. MHNs promote medication adherence among patients with schizophrenia using the following strategies: establishing a conversational relationship, overall assessment of non-adherence to medication, understanding the disease and adjusting the concept of medication, incorporating interpersonal connection feedback, and building supportive resources. This study explored the strategies of MHNs that incorporated knowledge in managing treatment adherence in patients with schizophrenia. The findings add knowledge to clinical nursing practice about medication adherence among patients with schizophrenia.
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Suen YN, Yeung ETW, Chan SKW, Hui CLM, Lee EHM, Chang WC, Chan CYH, Chen CEYH. Integration of biological and psychological illness attributional belief in association with medication adherence behaviour: A path analysis. Early Interv Psychiatry 2021; 15:1686-1695. [PMID: 33461243 DOI: 10.1111/eip.13114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/14/2020] [Accepted: 01/04/2021] [Indexed: 01/18/2023]
Abstract
AIM This study aimed to determine the association of biological (BAB) and psychological illness attributional beliefs (PAB) with medication adherence behaviour in patients with psychosis in Hong Kong. METHODS A cross-sectional survey of 301 outpatients with psychosis in Hong Kong was conducted from August to October 2016. The survey included a set of questionnaires examining patient medication adherence behaviours (using five behavioural items from the Medication Adherence Rating Scale), illness attributional belief, insight into the illness, and attitudes towards antipsychotics and medical professionals. The associations between these variables were analysed using path analysis and adjusted for covariates of perceived social support, experience of side-effects, and gender. RESULTS The data fit a model in which medication adherence behaviour was associated with illness attributional belief, insight, and attitudes (chi-square = 32.33, p = .26; RMSEA = 0.02; SRMR = 0.04; and CFI = 0.97). BAB was positively and directly associated with medication adherence behaviour. PAB was positively and indirectly associated with medication adherence behaviour through insight into the illness and attitude towards medical professionals. PAB can strengthen the relationship between BAB and insight, and only the high PAB group exhibited a positive relationship between BAB and attitude towards medical professionals. CONCLUSIONS An integration of biological and psychological attributional beliefs in patients with psychosis is essential for better medication adherence behaviour. Future interventions should aim to modify patients' illness attributional beliefs by integrating both biological and psychological illness attribution to improve medication adherence.
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Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Emily Tsz Wa Yeung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
| | - Candice Yu Hay Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong
| | - Chan Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, PokfuLam, Hong Kong.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, PokfuLam, Hong Kong
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Nuño L, Guilera G, Rojo E, Gómez-Benito J, Barrios M. An Integrated Account of Expert Perspectives on Functioning in Schizophrenia. J Clin Med 2021; 10:jcm10184223. [PMID: 34575332 PMCID: PMC8465628 DOI: 10.3390/jcm10184223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/09/2021] [Indexed: 11/28/2022] Open
Abstract
An integrated and interdisciplinary care system for individuals with schizophrenia is essential, which implies the need for a tool that assesses the difficulties and contextual factors of relevance to their functioning, and facilitates coordinated working across the different professions involved in their care. The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) cover these requirements. This study aimed to evaluate the content validity of the ICF-CSs for schizophrenia from the perspective of experts. Six three-round Delphi studies were conducted with expert panels from different professional backgrounds which have played a significant role in the treatment of individuals with schizophrenia (psychiatry, psychology, nursing, occupational therapy, social work and physiotherapy). In total, 790 experts from 85 different countries participated in the first round. In total, 90 ICF categories and 28 Personal factors reached expert consensus (reached consensus from four or more professional perspectives). All the categories in the brief version of the ICF-CS for schizophrenia reached consensus from all the professional perspectives considered. As for the comprehensive version, 89.7% of its categories reached expert consensus. The results support the worldwide content validity of the ICF-CSs for schizophrenia from an expert perspective and underline the importance of assessing functioning by considering all the components implied.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neuroscience (ICN), Hospital Clinic, 08036 Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Correspondence:
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, 08830 Sant Boi de Llobregat, Spain;
- Department of Psychiatry, International University of Catalonia, 08007 Barcelona, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08007 Barcelona, Spain; (G.G.); (J.G.-B.); (M.B.)
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neurosciences, University of Barcelona, 08007 Barcelona, Spain
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Kalimashe L, du Plessis E. Mental healthcare users' self-reported medication adherence and their perception of the nursing presence of registered nurses in primary healthcare. Health SA 2021; 26:1618. [PMID: 34394970 PMCID: PMC8335782 DOI: 10.4102/hsag.v26i0.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/02/2021] [Indexed: 11/24/2022] Open
Abstract
Background Medication adherence remains a challenge in the management of mental healthcare users (MHCUs), despite it being regarded as crucial for better health outcomes. Nurses at primary healthcare (PHC) facilities can play an important role through nursing presence in enhancing MHCUs’ medication adherence. Aim This article aimed to investigate the relationship between MHCUs’ self-reported medication adherence and their perception of the nursing presence by registered nurses in PHC. Setting An urban health district in Gauteng province, South Africa. Methods A quantitative, descriptive correlational, cross-sectional design was used. The sample included 180 MHCUs. Data were collected using the Medication Adherence Rating Scale and the Presence of Nursing Scale. Results The overall adherence level of respondents was partially adherent, with an average score of 6.45 out of a total score of 10. Respondents also reported a low level of perceived nursing presence demonstrated by registered nurses, with an average score of 72.2 out of 125. The results indicated a positive correlation between respondents’ self-reported medication adherence and their perceived nursing presence of registered nurses as evidenced by the positive value of the correlation coefficient of 0.69 with a corresponding significance probability value of 0.000 (r = 0.69; p = 0.00). Conclusion The level of perceived nursing presence demonstrated by registered nurses played a significant role in influencing MHCUs’ level of medication adherence. The registered nurses can improve MHCUs’ medication adherence by demonstrating nursing presence skills such as good listening skills and taking care of MHCUs as individuals and not as a disease. Contribution The results of this study confirm that there is a correlation between nursing presence and medication adherence. This holds significant value for future research in nursing presence. These findings also provide registered nurses in PHC with a valuable tool to improve medication adherence, namely nursing presence.
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Affiliation(s)
- Lillian Kalimashe
- Department of Health, Faculty of Health Sciences, West Rand Health District, Gauteng Department of Health, Johannesburg, South Africa
| | - Emmerentia du Plessis
- NuMIQ Research Focus Area, Faculty of Health Science, North-West University, Potchefstroom, South Africa
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Triveni D, Grover S, Chakrabarti S. Does religiosity in persons with schizophrenia influence medication adherence. Indian J Psychiatry 2021; 63:228-232. [PMID: 34211214 PMCID: PMC8221202 DOI: 10.4103/psychiatry.indianjpsychiatry_413_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/20/2020] [Accepted: 10/22/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Little information is available regarding the effect of religiosity and spirituality on medication adherence in patients with schizophrenia. AIM This study aimed to evaluate the association of medication adherence with different aspects of religiosity and spirituality in patients with schizophrenia. MATERIALS AND METHODS One hundred patients with schizophrenia were evaluated on religiousness measure scale and Duke Religion Index (DUREL); Brief Religious Coping Scale (Brief RCOPE); World Health Organization Quality of Life Spirituality, Religiosity, and Personal Beliefs (WHOQoL-SRPB); and Brief Adherence Rating Scale (BARS). RESULTS A higher level of religiosity as assessed by the religiousness measure scale, private religious activities and intrinsic religiosity as per DUREL, positive religious coping, and all the domains of WHOQOL-SRPB was associated with better medication compliance as assessed by the percentage of doses of medications consumed in the last 1 month as evaluated by using BARS. CONCLUSION The present study suggests that a higher level of religiosity and spirituality were associated with better medication compliance.
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Affiliation(s)
- Davuluri Triveni
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Surmann M, Falke S, von Gruchalla L, Maisch B, Uhlmann C, Arolt V, Lencer R. Understanding the multidimensional phenomenon of medication adherence attitudes in psychosis. Psychiatry Res 2021; 295:113601. [PMID: 33296816 DOI: 10.1016/j.psychres.2020.113601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/23/2020] [Indexed: 01/10/2023]
Abstract
There is an urgent need for a better understanding of the multidimensional factors of medication adherence attitudes in patients with psychosis in order to enhance adherence as up to 75% of patients stop or change their medication within a year. 81 patients with psychosis were assessed on symptom expression, self-stigmatization, adherence attitudes, QoL, social support and therapeutic alliance judged by patients and clinicians. Regression analyses were used to test whether better QoL, more social support and a better therapeutic alliance are associated with more positive and less negative adherence attitudes. More positive clinician input, higher state anxiety and lower levels of self-stigmatization predicted more positive adherence attitudes, while less positive collaboration with the clinician and higher levels of self-stigmatization were associated with more negative adherence attitudes. QoL and social support were unrelated to adherence attitudes. The quality of the therapeutic alliance perceived by patients appears crucial regarding their medication adherence attitudes. Thus, clinicians' focus on psychotic symptom expression is not sufficient to achieve goal agreement. Rather, it is imperative to consider the individual subjective needs of patients as a key element for sustained therapeutic alliance.
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Affiliation(s)
- Marian Surmann
- Department of Mental Health, University of Muenster, Germany
| | - Sebastian Falke
- Department of Mental Health, University of Muenster, Germany
| | | | | | | | - Volker Arolt
- Department of Mental Health, University of Muenster, Germany; Otto-Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Germany
| | - Rebekka Lencer
- Department of Mental Health, University of Muenster, Germany; Otto-Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Germany.
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Drivenes K, Vederhus JK, Haaland VØ, Ruud T, Hauge YL, Regevik H, Falk RS, Tanum L. Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport. Medicine (Baltimore) 2020; 99:e18635. [PMID: 31895824 PMCID: PMC6946431 DOI: 10.1097/md.0000000000018635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This cross sectional study examined patients' perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting. The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.A cross-sectional study was performed. The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire. Diagnosis and treatment information were obtained at the clinical visits and from patient records.Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study. The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86-89) and a convergent validity toward the available variables. The MedSupport mean score was 3.8 (standard deviation.9, median 3.8). Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support. Patients diagnosed with behavioral and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.The MedSupport inventory was suitable for assessing the patients' perceived support from health care service regarding their medication. Awareness of differences in patients' perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.
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Affiliation(s)
- Karin Drivenes
- Division of Mental Health and Addiction Services Sørlandet Hospital
- South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand
| | | | - Vegard Øksendal Haaland
- Addiction Unit, Sørlandet Hospital
- Clinical Neuroscience Research Group, Department of Psychology, The Faculty of Social Sciences
| | - Torleif Ruud
- Clinic for Health Services Research and Psychiatry, Institute of clinical medicine, University of Oslo
- Department of R&D in Mental health service, Akershus university hospital
| | - Yina Luk Hauge
- South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand
| | - Hilde Regevik
- Division of Mental Health and Addiction Services Sørlandet Hospital
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo
| | - Lars Tanum
- Department of R&D in Mental health service, Akershus university hospital
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway
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13
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Nuño L, Barrios M, Moller MD, Calderón C, Rojo E, Gómez-Benito J, Guilera G. An international survey of Psychiatric-Mental-Health Nurses on the content validity of the International Classification of Functioning, Disability and Health Core Sets for Schizophrenia. Int J Ment Health Nurs 2019; 28:867-878. [PMID: 30834663 DOI: 10.1111/inm.12586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2019] [Indexed: 12/12/2022]
Abstract
The International Classification of Functioning, Disability and Health (ICF) Core Sets for schizophrenia describe the key problems in functioning that are experienced by individuals with this disorder. This study examines the content validity of these Core Sets and aims to identify the most frequent problems faced by people with schizophrenia, considering for this analysis the perspective of Psychiatric-Mental-Health Nurses. The study complied with the COREQ checklist for qualitative studies. A total of 101 nurses from 30 countries covering all six World Health Organization regions participated in a Delphi study. Their responses in Round 1 were linked to ICF categories, retaining those reported by at least 5% of participants. In Round 2, they were asked to rate the relevance of each of these categories to the nursing care of patients with schizophrenia. This process was repeated in Round 3. A total of 2327 concepts were extracted in Round 1 and linked to ICF categories. Following the analysis, 125 categories and 31 personal factors were presented to the experts in rounds 2 and 3. Consensus (defined as agreement ≥75%) was reached for 97 of these categories and 29 personal factors. These categories corresponded to all those (N = 25) in the Brief Core Set and 87 of the 97 categories of the Comprehensive Core Set for schizophrenia. Ten new categories emerged. The Delphi process identified the problems in functioning that nurses encounter when treating individuals with schizophrenia, and the results supported the content validity of the Core Sets. We conclude that these Core Sets offer a comprehensive framework for structuring clinical information and guiding the treatment process.
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Affiliation(s)
- Laura Nuño
- Clinical Institute of Neuroscience (ICN), Hospital Clinic, Barcelona, Spain.,Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Maite Barrios
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Mary D Moller
- School of Nursing, Pacific Lutheran University, Tacoma, Washington, USA
| | - Caterina Calderón
- Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain.,Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Emilio Rojo
- Hospital Benito Menni CASM, Sisters Hospitallers, Sant Boi de Llobregat, Spain.,Department of Psychiatry, International University of Catalonia, Sant Cugat del Vallès, Spain
| | - Juana Gómez-Benito
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
| | - Georgina Guilera
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain.,Group on Measurement Invariance and Analysis of Change (GEIMAC), Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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14
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Harris B, Panozzo G. Barriers to recovery-focused care within therapeutic relationships in nursing: Attitudes and perceptions. Int J Ment Health Nurs 2019; 28:1220-1227. [PMID: 31140710 DOI: 10.1111/inm.12611] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 01/23/2023]
Abstract
There are numerous barriers to the therapeutic relationship between nurses and persons with schizophrenia, such as time constraints, communication issues and the requirements of practice policies. The main point of this paper is that the nature of these barriers is such that the nurse may not conceptualize these as barriers or be aware of how his or her responses to these can further entrench existing barriers to relationship or create new ones. If the nurse is not aware of how he or she responds to time pressure, frustration or lack of clarity of practice policy and address this, there is a risk that the patient may perceive the nurse's actions as lacking in care, presence or involvement. As consumers increasingly embrace recovery approaches to mental health that prioritize therapeutic activities within the context of collaborative relationship, psychiatric nurses, with a long tradition of therapeutic relationship, can rise to meet them. It is suggested here that this can only occur if nurses are fully aware of barriers to relationship, their responses to these and the impact of these on relationship with patients. Suggestions for educational and empirical work to further raise awareness and promote understanding of this process are provided.
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Affiliation(s)
| | - Gina Panozzo
- DePaul University, Chicago, Illinois, USA
- Benedictine University, Lisle, Illinois, USA
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