Mediating Effect of Psychological Flexibility on Quality of Life in Inpatients with Schizophrenia

Hyun Sook Park; Jae Woon Lee

doi:10.12934/jkpmhn.2018.27.3.284

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Park and Lee: Mediating Effect of Psychological Flexibility on Quality of Life in Inpatients with Schizophrenia

Original Article

J Korean Acad Psychiatr Ment Health Nurs 2018;27(3):284-292.

Published online: 17 September 2018

DOI: https://doi.org/10.12934/jkpmhn.2018.27.3.284

Mediating Effect of Psychological Flexibility on Quality of Life in Inpatients with Schizophrenia

Hyun Sook Park¹, Jae Woon Lee²

¹Professor, College of Nursing ․ The Research Institute of Nursing Science, Daegu Catholic University, Daegu, Korea

²Doctoral Course Student, College of Nursing, Graduate School, Daegu Catholic University, Daegu, Korea

Corresponding author: Lee, Jae Woon https://orcid.org/0000-0002-9648-7233 College of Nursing, Catholic University of Daegu, 33 Duyugongwon-ro, 17-gil, Nam-gu, Daegu 42472, Korea. Tel: +82-53-650-4827, Fax: +82-53-650-4392, E-mail: jungnamguy@hanmail.net

Received 29 July 201827 August 2018 Accepted 4 September 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

This study was conducted to explore psychological flexibility's mediating effect on the relationship between symptoms, social functioning and quality of life among inpatients with schizophrenia.

Methods

Participants were 190 inpatients with schizophrenia from five mental hospitals in three areas. Data were collected from self-report questionnaires administered from June to July 2018. Data were analyzed using Pearson's correlation coefficients and the Baron and Kenny method with IBM SPSS 22.0.

Results

Quality of life showed a positive correlation with psychological flexibility (r=.52, p<.001), but a negative correlation with symptoms (r=-.39, p<.001) and social functioning (r=-.42, p<.001). Psychological flexibility had a full mediating effect on the relationship between symptoms and quality of life. Psychological flexibility also showed partial mediating effects on social functioning and quality of life.

Conclusion

The results suggest that psychological flexibility plays an important role in the quality of life of inpatients with schizophrenia. Therefore, mental health practitioners should focus on interventions to improve their social functioning and psychological flexibility to improve their quality of life.

Keywords: Hospitalization, Mental health, Psychopathology, Quality of life, Schizophrenia

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Table 1.

General Characteristics of the Subjects (N=190)

Characteristics	Categories	n (%) or M±SD	Range
Gender	Male	97 (51.1)
Gender	Female	93 (48.9)
Age (year)	＜30	10 (5.3)
	30~39	36 (18.9)
	40~49	52 (27.4)
	50~59	70 (36.8)
	≥60	22 (11.6)
		47.26±10.45	20~65
Marital status	Unmarried	114 (60.0)
	Married	36 (18.9)
	Divorce	35 (18.5)
	Bereavement	5 (2.6)
Education	Elementary school	13 (6.9)
	Middle school	24 (12.6)
	High school	111 (58.4)
	≤College	42 (22.1)
Religion	Yes	141 (74.2)
Religion	No	49 (25.8)
Monthly family income (10,000 won)	＜100	96 (50.5)
	100~149	33 (17.4)
	150~199	29 (15.3)
	≥200	32 (16.8)
Frequency of hospitalizations	1~4	80 (42.1)
	5~9	64 (33.7)
	≥10	46 (24.2)
		6.24±4.21	1~20
First admission (year)		31.79±10.12	14~57

Table 2.

Degrees of Symptoms, Social Functions, Psychological Flexibility, and Quality of Life for Subjects (N=190)

Variables	M±SD	Range
Symptoms	32.48±11.83	16.00~66.00
Social functions	34.38±10.68	16.00~61.00
Psychological flexibility	45.91±9.23	22.00~65.00
Quality of life	18.34±8.91	0.00~36.00

Table 3.

Correlations among Symptoms, Social Functions, Psychological Flexibility, and Quality of Life for Subjects (N=190)

Variables	Symptoms	Social functions	Psychological flexibility	Quality of life
Variables	r (p)	r (p)	r (p)	r (p)
Symptoms	1
Social functions	.63 (＜.001)	1
Psychological flexibility	-.56 (＜.001)	-.57 (＜.001)	1
Quality of life	-.39 (＜.001)	-.42 (＜.001)	.52 (＜.001)	1

Table 4.

Mediating Effect of Psychological Flexibility on the Relationship between Symptoms and Quality of Life of Subjects (N=190)

Steps	Independent variables	Dependent variables	B	SE	β	t (p)	R²	F (p)	Sobel test
Steps	Independent variables	Dependent variables	B	SE	β	t (p)	R²	F (p)	z	p
1	Symptoms	Psychological	-0.44	.05	-.57	-9.40 (＜.001)	.32	88.39 （＜.001)
		flexibility
2	Symptoms	Quality of life	-0.29	.05	-.39	-5.82 (＜.001)	.15	33.88 （＜.001)
3	Symptoms	Quality of life	-0.10	.06	-.14	-1.80 (.073)	.29	38.63 （＜.001)	-5.09	＜.001
	Psychological flexibility		0.44	.07	.45	6.10 (＜.001)

Table 5.

Mediating Effect of Psychological Flexibility between Social Functions and Quality of Life (N=190)

Steps	Independent variables	Dependent variables	B	SE	β	t (p)	R²	F (p)	Sobel test
Steps	Independent variables	Dependent variables	B	SE	β	t (p)	R²	F (p)	z	p
1	Social functions flexibility	Psychological	-0.49	.05	-.57	-9.56 (＜.001)	.33	91.38 （＜.001)
2	Social functions	Quality of life	-0.36	.06	-.43	-6.45 (＜.001)	.18	41.63 （＜.001)
3	Social functions	Quality of life	-0.15	.06	-.18	-2.46 (.015)	.30	40.57 （＜.001)	-4.88	＜.001
3	Psychological flexibility		0.41	.07	.43	5.70 (＜.001)

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