A Causal model of personal recovery among persons with schizophrenia

Abstract

Personal recovery is a primary goal for people with schizophrenia. Few studies have explored the factors affecting personal recovery in schizophrenia patients, and no causal studies have been conducted in Thailand. This research uses a cross-sectional approach and Structural Equation Modeling (SEM) to construct and analyze a proposed model of personal recovery. The study enrolled 315 schizophrenia patients, who participated voluntarily, from outpatient departments of specialized psychiatric hospitals across five locations in Thailand. Selection criteria included the absence of intellectual disability or other co-morbid diagnoses. Data collection involved eight tools: 1) a demographic data form, 2) a questionnaire about the process of recovery, 3) the Thai version of the Rosenberg self-esteem scale, 4) the Thai version of the hospital anxiety and depression scale, 5) the Beck cognitive insight scale, 6) the client-rated coping self-efficacy scale, 7) the multidimensional scale of perceived social support, and 8) the Thai version of the personal and social performance scale. These tools underwent validation tests, and data analysis employed descriptive statistics, Pearson correlation, and structural equation model analysis. The overall personal recovery score among the sample was moderate. Self-esteem, negative emotions, cognitive insight, coping self-efficacy, and social support were found to directly and indirectly influence personal recovery. Negative emotion acted as a mediator between primary variables and personal recovery, with self-esteem emerging as the most significant predictor. However, social functioning did not influence personal recovery. These findings provide essential insights for developing tailored nursing interventions to support personal recovery among persons with schizophrenia. Future research may explore additional variables like resilience, empowerment, and social inclusion to gain a deeper understanding of this matter.