Symptom monitoring in schizophrenia: Potential for enhancing self-care

doi:10.1016/0883-9417(92)90084-V

Archives of Psychiatric Nursing

Volume 6, Issue 6, December 1992, Pages 324-330

https://doi.org/10.1016/0883-9417(92)90084-V Get rights and content

Abstract

In this study a symptom self-regulation model was used as a framework to examine the characteristics and stability of indicators of illness identified by individuals with schizophrenia. Subjects were interviewed to determine if they could identify indicators of illness and describe characteristics of their primary indicator. Primary indicators of illness from 51 subjects were categorized as anxiety-based, depressive, or psychotic. Subjects who identified psychotic indicators were more confident that their indicator occurred when they were getting ill than subjects with anxiety-based or depressive indicators, and subjects who identified psychotic and depressive indicators reported that their indicators were more troublesome than those identifying anxiety-based indicators. Anxiety-based indicators were reported by subjects to occur more frequently than indicators from the other two categories. Findings from a follow-up interview of 28 subjects 1 year later showed that approximately half reported either the same primary indicator of illness or identified an indicator in the same category (anxiety-based, depressive, or psychotic) as they had 1 year previously. The implications of the findings for enhancing self-care through monitoring symptoms are discussed.

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Cited by (22)

Self-Management Among Chinese People With Schizophrenia and Their Caregivers: A Qualitative Study
2013, Archives of Psychiatric Nursing
Citation Excerpt :
It is worth noting that many patients expressed reluctance to participate in symptom management because they thought that they did not have the capacity to do this. This was in contrast with evidence suggesting that individuals with schizophrenia have the capacity to recognize personal symptoms or changes associated with relapse (Baker, 1995; Birchwood et al., 1989; Hamera, Peterson, Handley, Plumlee, & Frank-Ragan, 1991; Hamera, Peterson, Young, & Schaumloffel, 1992). Our study revealed that the most commonly used strategy to deal with persistent symptoms by Chinese patients was ignoring them.
This study explores the practice of self-management in Chinese people with schizophrenia and their caregivers. Twenty-one patients and 14 caregivers were interviewed. Four themes were identified, reflecting the practice of self-management from both the patients' and caregivers' perspective: managing medication, monitoring and dealing with symptoms, maintaining social relations, and seeking health information and maintaining medical appointments. In general, self-management practices among Chinese people with schizophrenia were not optimal. This study highlights the importance of developing and implementing family-based self-management programs for Chinese people with schizophrenia and their family in order to enhance their self-management abilities and improve care outcomes.
Mediating Role of Illness Representation Among Social Support, Therapeutic Alliance, Experience of Medication Side Effects, and Medication Adherence in Persons With Schizophrenia
2011, Archives of Psychiatric Nursing
Citation Excerpt :
However, some studies support the idea that this population maintains the ability to identify symptoms and illness representations. Hamera, Peterson, Young, and Schaumloffel (1992) studied 51 individuals with schizophrenia, and found that participants identified their illness representation as anxiety, depression, or psychosis. Among these, auditory hallucination and anxiety symptoms were reported most frequently as primary indicators of illness.
The purpose of this cross-sectional research study was to examine factors affecting medication adherence in Thai individuals with schizophrenia. The Common-Sense Model of Illness Representation was used to guide the study. Two hundred twenty-five subjects met the inclusion criteria and were interviewed. Variables of interest focused on experience of medication side effects, therapeutic alliance, social support, illness representation, and behavior change with medication adherence. Results indicated that therapeutic alliance and the experience of medication side effects enhanced illness representation, which in turn led to an intention to change adherence behavior. Social support did not alter illness representation or adherence behavior. Because illness representation positively influenced patients' intention to change adherence behavior, mental health nurses should promote patients' perception about their illness to enhance medication adherence.
Symptomatology and medication monitoring for public mental health consumers: A cultural perspective
2001, Journal of the American Psychiatric Nurses Association
Background: With the increased focus and impetus on pharmacological interventions, psychiatric mental health nurses have become concerned about consumers' ability to understand and monitor their symptoms and medications. Objective: The purpose of this study was to examine the relationship among cultural factors, stressors, moderators, medication monitoring, and psychiatric symptoms in consumers with severe mental disorders. Study Design: This study is a cross-sectional analysis of data from a longitudinal research project conducted in Ohio. The sample was comprised of 199 consumers receiving community-based services within the public mental health system. Results: Age, gender, and race were associated with indicators of medication monitoring. The model explained 51% of the variance in depression, 35% in anxiety, and 43% in psychoticism. Conclusion: Consumers' culture is an important facet in the manifestation of psychiatric symptoms and the ability to monitor medications. (J Am Psychiatr Nurses Assoc [2001]. 7, 115-124.)
Symptom self-management and relapse in schizophrenia
2000, Archives of Psychiatric Nursing
The purpose of this descriptive study was to examine the relationships among 4 variables that are hypothesized to be associated with relapse in schizophrenia; insight, symptom recognition, symptom self-management, and perceived effectiveness of symptom self-management. The theoretical framework was derived from self-management theory and the vulnerability-stress model of schizophrenia. Pearson's correlation coefficients for the variables in the model detected 2 significant relationships; between symptom recognition and symptom self-management and between symptom self-management and perceived effectiveness of symptom self-management. Insight was not found to be significantly related to the other variables. Results of the study indicate that individuals with schizophrenia do recognize symptoms associated with relapse and use a wide range of management methods, regardless of the degree of insight present.
A nursing practice paradigm for depressed rural women: The women's affective illness treatment program
1997, Archives of Psychiatric Nursing
Major depressive disorder (MDD) results from a complex interplay of biological, psychological, and social factors that act as historical and contemporary antecedents. To promote and maintain recovery from depression women with MDD must understand their depression risk, act to reduce symptoms, and maintain a lifetime program of relapse prevention. This requires self-care skills including self-assessment, stress response reduction, and health behavior modification. The Women's Affective Illness Treatment Program (WAIT) is a skill-based depression recovery program that addresses the complex cause of major depressive disorder in women. WAIT is based on the Nursing Practice Paradigm described in a previously published article.
Striving for stability with bipolar disorder despite barriers
1995, Archives of Psychiatric Nursing
A conceptual model was developed during interviews with 33 participants that depicts the processes of information search and self-management of hospitalized people with bipolar disorder. Grounded theory methodology guided data collection and analysis. Barriers were reported as encountered throughout the processes; denial of the disorder was the most prevalent obstacle. Critical areas of intervention are helping the person accept the disorder and achieving the basis to be motivated for self-management. Recommendations are for relapse reduction programs to be structured on the awareness that relapse is most likely to occur when barriers are encountered, and that people with the disorder perceive barriers to be everywhere.

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^☆: Supported by Grant No. SRG 5R21NR01507-02, Principal Investigator, Roma Lee Taunton, Project Director, Kathryn Peterson from the Center for Nursing Research, US Department of Health and Human Services.

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Symptom monitoring in schizophrenia: Potential for enhancing self-care☆

Abstract

Archives of Psychiatric Nursing

Predicting relapse in schizophrenia: The development and implementation of an early sign monitoring system using patients and families as observers, a preliminary investigation

Psychological Medicine

The role of social relationships in the recovery from psychotic disorders

American Journal of Psychiatry

Attention and self-regulation: A control-theory approach to human behavior

Stages of onset of schizophrenic psychosis

American Journal of Psychiatry

Feasibility of daily monitoring symptoms and substance use in individuals with schizophrenia

Self-regulation in individuals with Type II diabetes

Nursing Research

Self-regulation and functioning schizophrenia

Hospital and Community Psychiatry

Prospective study of prodromal symptoms in schizophrenic relapse

American Journal of Psychiatry

Relapse in schizophrenia

American Journal of Psychiatry