Mastery in patients with schizophrenia living in the community: relationship to sociodemographic and clinical characteristics, needs for care and support, and social network

Abstract

In line with user involvement and empowerment in individuals who suffer from a severe mental illness, the sense of mastery is important. Few studies have investigated factors that contribute to mastery in individuals with schizophrenia. The aims of the present 18-month follow-up study were to investigate associations between mastery and clinical and sociodemographic factors, needs for care and support and social network, and to investigate whether changes in mastery were related to changes with regard to these aspects in a group of patients (n = 120) with schizophrenia living in the community. Structural interviews were performed at baseline and after 18 months. Pearlin's mastery scale, the Camberwell Assessment of Needs (CAN), the Interview Schedule for Social Interaction (ISSI), and the Brief Psychiatric Rating Scale (BPRS) were used on both interview occasions. A stepwise regression analysis showed a negative relationship between psychopathology, especially affective and negative symptoms, and mastery. Stronger mastery was associated with younger age and less severe basic needs. In total psychopathology, age and basic needs explained 50.7% of the variance in mastery. Changes in mastery were positively correlated to changes in access to social contact but negatively correlated to changes in affective symptoms. In order to target mastery in individuals with schizophrenia, the community-based nursing services need to develop, implement, and evaluate interventions that are effective for psychiatric symptoms, social skills performance, and needs for care and support in areas of living, nutrition, and daytime activities.

Psychiatric rehabilitation in community-based day centres: Motivation and satisfaction

“…The participation rate, which was approximately 50%, was comparable to that of other similar samples (26,45). Because of the frailty and vulnerability of the target group it is difficult to attain participation rates above 50-60% in studies that go beyond clinical routines.…”

“…Because of the frailty and vulnerability of the target group it is difficult to attain participation rates above 50-60% in studies that go beyond clinical routines. Analyses of attrition in a similar sample have indicated that the non-participants were somewhat more likely to be females and to be marginally younger, but not to differ from the participants regarding diagnosis (45). It is still likely that the most frail and vulnerable attendees chose not to participate in the study, which limits the external validity of the study.…”

Factors influencing subjective perceptions of everyday occupations: Comparing day centre attendees with non-attendees

“…Self-mastery has also been emphasized as a factor of importance for health-related aspects (22), empowerment and recovery (24) and a high activity level (35) among people with PD. This prominent role of self-mastery makes it a key factor in achieving positive subjective experiences from participation in everyday occupations.…”

“…Regarding people with PD, self-mastery has been shown to be of importance to healthrelated factors such as sense of coherence (22), hope (23), empowerment and recovery (24), well-being and quality of life (25), and meaning (11).…”

Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services

“…Furthermore, there was a considerable loss of study participants over the follow-up period, which is standard in studies of people with severe mental health conditions (Argentzell et al, 2012;Bengtsson-Tops, 2004). This may jeopardize representativity and both internal and external validity.…”