Effects of an Empowerment Program for Patients with Schizophrenia

Ju Hyun Woo; Ji Hye Jang; Jeong Hee Cho

doi:10.12934/jkpmhn.2018.27.2.123

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Woo, Jang, and Cho: Effects of an Empowerment Program for Patients with Schizophrenia

Original Article

J Korean Acad Psychiatr Ment Health Nurs 2018;27(2):123-134.

Published online: 17 June 2018

DOI: https://doi.org/10.12934/jkpmhn.2018.27.2.123

Effects of an Empowerment Program for Patients with Schizophrenia

Ju Hyun Woo¹, Ji Hye Jang², Jeong Hee Cho³

¹Department of Nursing, Ansan University, Ansan, Korea

²Department of Nursing, Gangneung Yeongdong University, Gangneung, Korea

³Department of Nursing, Keyo Hospital, Uiwang, Korea

Corresponding author: Jang, Ji Hye https://orcid.org/0000-0002-9076-0630 Department of Nursing, Gangneung Yeongdong University, 357 Gongie-ro, Gangneung 25521, Korea. Tel: +82-33-610-0452, Fax: +82-33-644-8809, E-mail: gogh0049@gmail.com

Received 16 February 201816 April 2018 Accepted 31 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to evaluate a ‘patient empowerment program for schizophrenia (PEPS)’ to improve problem solving ability, quality of life, and mental health literacy for hospitalized patients with schizophrenia.

Methods

The study was a non-equivalent control group non-synchronized design. Study participants were recruited from a psychiatric hospital in Republic of Korea. Of 56 participants, 20 were assigned to the experimental group and 36 to the control group. Data were collected from September, 2017 to January, 2018. Data analyses included chi-squared or Fisher's exact tests, t-tests, and repeated measure ANOVA with SPSS/WIN 21.0 program.

Results

After participating PEPS, the experimental group showed a significant increase in quality of life and mental health literacy compared to the control group. However, there were no significant differences in problem solving ability between the two groups.

Conclusion

Findings show that patients with schizophrenia receive benefits from PEPS in terms of quality of life and mental health literacy. However, further research is necessary to develop clinical strategies to improve their problem solving abilities.

Keywords: Schizophrenia, Psychotherapy, Power (psychology), Quality of life, Health literacy

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Figure 1.

Study design.

Table 1.

Description of Patients Empowerment Program for Schizophrenia (PEPS)

Components	Sessions	Contents
Mental health control	1	Orientation
	1	Term definition of schizophrenia
	2	Fact & stigma of schizophrenia
	2	Crisis management
	3	Depression & schizophrenia
		Diagnosis & progress of
		schizophrenia
Disease management plan	4	Proper drug taking
	4	Drug therapy
	5	Psychotherapy
	5	Living well
		Promise preparation
Personal ability development	6	Communication with family
	6	Support group
	7	Social contact
	7	Daily plan
	8	Discriminative treatment
	8	Occupational ability development
		Family planning
Physical health control	9	Healthy sexual life in woman
	9	Healthy sexual life in man
	10	Diabetes mellitus & heart disease
	11	Weight gain, alcohol, & cigarette
	12	Health & living habits

Table 2.

Homogeneity Test for Subject's General Characteristics (N=56)

Characteristics	Categories	Total	Exp. (n=20)	Cont. (n=36)	χ² or t	p
Characteristics	Categories	n (%)	n (%)	n (%)	χ² or t	p
Gender	Male	35 (62.5)	6 (30.0)	29 (80.6)	14.02	＜.001
Gender	Female	21 (37.5)	14 (70.0)	7 (19.4)
Age (year)^†	20~35	11 (19.6)	7 (35.0)	4 (11.0)	7.75	.053
	36~49	25 (44.6)	5 (25.0)	20 (55.6)
	50~59	15 (26.8)	5 (25.0)	10 (27.8)
	≥60	5 (9.0)	3 (15.0)	2 (5.6)
Educational level	≤High school	27 (48.2)	6 (30.0)	21 (58.3)	4.13	.054
Educational level	≥College	29 (51.8)	14 (70.0)	15 (41.7)
Religion	Have	40 (71.4)	15 (75.0)	25 (69.4)	0.19	.763
Religion	Have not	16 (28.6)	5 (25.0)	11 (30.6)
Health insurance	Medical insurance	45 (80.4)	19 (95.0)	26 (72.2)	4.23	.076
Health insurance	Medicare	11 (19.6)	1 (5.0)	10 (27.8)
Primary caregiver^†	Parents	29 (51.8)	11 (55.0)	18 (50.0)	6.69	.130
	Sibling	9 (16.1)	1 (5.0)	8 (22.2)
	Spouse	9 (16.1)	6 (30.0)	3 (8.3)
	Children	7 (12.4)	2 (10.0)	5 (13.9)
	Others	2 (3.6)	0 (0.0)	2 (5.6)
Number of hospitalizations^†	1	11 (19.6)	3 (15.0)	8 (22.2)	1.70	.651
	2~4	25 (44.6)	9 (45.0)	16 (44.4)
	5~7	5 (9.0)	3 (15.0)	2 (5.6)
	8	15 (26.8)	5 (25.0)	10 (27.8)
Disability registration	Yes	18 (32.1)	3 (15.0)	15 (41.7)	4.19	.072
Disability registration	No	38 (67.9)	17 (85.0)	21 (58.3)
Problem solving ability^†		104.34±18.33	104.60±23.74	104.19±14.90	0.08	.938
Quality of life^†		73.29±16.22	72.35±18.37	73.81±15.15	-0.32	.751
Mental health literacy
Recognition of schizophrenia	Have	14 (25.0)	7 (35.0)	7 (19.4)	1.66	.198
Recognition of schizophrenia	Have not	42 (75.0)	13 (65.0)	29 (80.6)
Knowledge and beliefs about causes^†	Biological	2.38±0.12	2.12±0.83	2.53±0.86	-1.73	.090
Knowledge and beliefs about causes^†	Individual	3.27±0.13	3.30±1.07	3.28±0.89	0.15	.879
	Social and environmental	2.85±0.10	2.76±0.84	2.90±0.70	-0.67	.507
Knowledge and beliefs about self-help^†	Family and friends	3.98±0.79	3.70±0.95	4.14±0.65	-1.84	.076
	Other professional	3.51±0.56	3.33±0.45	3.62±0.60	-1.92	.060
	Psychiatrist	4.05±0.62	4.16±0.49	3.99±0.68	0.98	.332
	Self-help	2.54±1.19	2.41±0.94	2.67±1.24	-0.76	.290
Knowledge and beliefs about professional help^†	Other medication	3.17±0.65	3.13±0.46	3.19±0.73	-0.34	.737
	Psychotherapy	3.46±0.68	3.43±0.56	3.48±0.74	-0.29	.772
	Lifestyle change	3.30±0.45	3.29±0.42	3.30±0.47	-0.06	.956
	Health information	3.96±0.72	4.03±0.64	3.92±0.77	0.54	.595
Stigma for receiving psychiatric treatment^†		2.80±0.84	2.88±0.72	2.76±0.91	0.51	.615

Exp.=Experimental group; Cont.=Control group;

^† Fisher's exact test.

Table 3.

Effect of Empowerment Programme on Problem Solving Ability, Quality of Life, and Mental Health Literacy (N=56)

Variables	Categories	Group	Pretest	Posttest	F or x2	p
Variables	Categories	Group	M±SD	M±SD	F or x2	p
Problem solving ability^†		Exp.	104.60±23.74	109.30±17.82	2.83	.098
Problem solving ability^†		Cont.	104.19±14.90	102.83±13.84
Quality of life^†		Exp. Cont.	72.35±18.37 73.81±15.15	76.95±19.99 70.72±13.51	4.38	.041
Mental health literacy
Recognition of schizophrenia	Have	Exp.	7 (35.0)	12 (60.0)	7.99	.005
	Have not		13 (65.0)	8 (40.0)
	Have	Cont.	7 (19.4)	8 (22.2)
	Have not		29 (80.6)	28 (77.8)
Knowledge and beliefs about causes^†	Biological	Exp.	2.12±0.83	2.77±0.57	4.87	.032
		Cont.	2.53±0.86	2.71±0.87
	Individual	Exp.	3.30±1.07	3.28±0.85	0.29	.593
		Cont.	3.26±0.89	3.10±1.05
	Social and	Exp.	2.76±0.84	2.86±0.78	0.23	.633
	environmental	Cont.	2.90±0.70	3.01±0.87
Knowledge and beliefs about self-help^†	Family and friends	Exp.	3.70±0.95	4.08±0.82	3.35	.073
		Cont.	4.14±0.65	4.01±0.73
	Other professional	Exp.	3.33±0.45	3.50±0.65	0.78	.383
		Cont.	3.62±0.60	3.57±0.89
	Psychiatrist	Exp.	4.16±0.49	4.30±0.46	0.04	.847
		Cont.	3.99±0.68	4.00±0.84
	Self-help	Exp.	2.41±0.94	2.54±0.94	0.11	.746
		Cont.	2.67±1.24	2.78±1.29
Knowledge and beliefs about professional help^†	Other medication	Exp.	3.13±0.46	3.28±0.77	0.82	.369
		Cont.	3.19±0.73	3.17±0.72
	Psychotherapy	Exp.	3.43±0.56	3.79±0.62	2.03	.160
		Cont.	3.48±0.74	3.47±0.62
	Change lifestyle	Exp.	3.29±0.42	3.25±0.51	0.16	.690
		Cont.	3.30±0.47	3.41±0.65
	Health information	Exp.	4.03±0.64	4.03±0.53	0.05	.824
		Cont.	3.92±0.77	3.92±0.82
Stigma for receiving psychiatric treatment^†		Exp.	2.88±0.72	2.84±0.91	0.16	.691
Stigma for receiving psychiatric treatment^†		Cont.	2.76±0.91	2.68±0.76

Exp.=Experimental group; Cont.=Control group;

^† Covariate: gender.

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