The Influences of Drug Attitudes Between Side Effects and Quality of Life in Schizophrenia Patients

Friday, 26 July 2019: 3:20 PM

Chiu-Yueh Yang, PhD, RN
School of Nursing, National Yang-Ming University, Taipei, Taiwan
Shih-Pi Lin, PhD, RN, MSN
Department of Nursing, National Defense Medical Center, Taipei City 11490,, Taiwan
San-Yuan Huang, PhD
Psychiatric department, National Defense Medical Center, Taipei City 11490,, Taiwan

Purpose: Past studies had shown that the quality of life of patients with schizophrenia is lower than other common mental disorders. Although studies had investigated the factors and mechanisms of quality of life, most of them were cross-sectional or focused on direct effects without clarifying the relationships between variables. Therefore, the present study analyzed data that were collected 6 months apart to determine the roles that drug attitude play in the relationships between schizophrenia side effects and quality of life. The objectives of this study are: 1. To examine changes in drug attitude, side effects, and quality of life over 6 months in patients with schizophrenia; 2. to examine the mediating effect of drug attitude on the relationships between side effects and quality of life.

Methods: The present study was a longitudinal study that employed convenience sampling to collect data, with data collection performed twice, 6 months apart. The participants, who were patients with chronic schizophrenia, were recruited from the psychiatric wards, day-care ward, and outpatient department of a regional teaching hospital in Northern Taiwan after the approval of the hospital’s institutional review board was acquired. In total, 216 valid questionnaire responses were retrieved, covering the period from November 2016 to November 2017. The questionnaire consisted of demographic data, the Positive and Negative Syndrome Scale (PANSS), the Health, Personality, and Habit Scale (HPH), the Drug Attitude Inventory (DAI), the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the Heart Rate Variability (HRV). SPSS 18 for Windows was employed, with descriptive statistics, independent-sample t-tests, paired t-tests, Pearson product-moment correlation, and multiple hierarchical regression were performed.

Results:

  1. The results indicated that the patients with schizophrenia had more positive drug attitudes, reduced side effects, and improved quality of life after 6 months.
  2. PANSS ≤ 60 points at baseline, the drug attitude exhibited a partial mediating effect on the relationships between side effects and the psychological and the environmental domains of quality of life in patients with schizophrenia. PANSS score between 61 to 90 and ≥ 91 points, the drug attitude had no mediating effect on the relationships between side effects and quality of life in patients with schizophrenia at both periods.

Conclusion:

  1. After 6 months, the drug attitudes, side effects, and quality of life have been changed in patients with chronic schizophrenia.
  2. Drug attitudes lessens the impact of side effects on the psychological and the environmental domains of quality of life in patients with chronic schizophrenia.
  3. Suggest that nursing care should be provided to improve drug attitude, side effects, and then to increase quality of life in patients with chronic schizophrenia
  4. For patients with stable symptom (PANSS ≤ 60), suggest that nursing care improve patients’ drug attitudes to lessen the impact of side effects on the psychological and the environmental domains of quality of life.
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