Medication Adherence in Home Patients with Schizophrenia: A Care Scheme Developed in Community in Yala Province
Keywords:
Schizophrenia Patients, Medication Adherence, Care Scheme, YalaAbstract
This action research aimed to: 1) study medication adherence in home patients with schizophrenia, and 2) assess the effectiveness of a new care scheme regarding medication adherence in those patients. Sample was 24 patients with schizophrenia, living in a community of Yala province. The research methodology consisted of 3 steps: 1) conducting a survey about the medication adherence of patients at home with schizophrenia, 2) the development of a care scheme regarding medication adherence, based on the participatory treatment criteria (the Orlando Nursing Process Theory, 1961), and a literature review; and 3) an evaluation of the medication adherence in patients with schizophrenia before and after using the care scheme. The research instruments were: 1) the care scheme that was validated by 3 experts, yielding a content validity (IOC) of .80, 2) a questionnaire regarding medication adherence that was tested using Cronbach’s alpha coefficient, yielding a value of .75, and 3) a family and caregiver interview form that was examined by 3 experts, yielding a content validity (IOC) of .67 – 1.00. Data were analyzed using frequency, percentage, mean, standard deviation, and paired t-test.
The research found that:
1. Schizophrenia patients at home had medication adherence at a low, moderate, and good level (70.83%, 25.00 %, and 4.16%, respectively). Their abilities to observe and manage symptoms from the side effects were at a moderate, low, and good level (58.3-%, 37.5จ%, and 4.16%, respectively).
2. The patterns of care given to the patients for higher medication adherence were: 1) building relationship, 2) stating the importance and necessity of medication, 3) counseling, 4) promoting self-esteem in caregivers and patients, 5) providing information about social support, 6) promoting volunteer spirit, 7) a good coordination with relevant parties to help patients and caregivers, and 8) referral for treatment.
3. After using the care scheme, mean score for medication adherence was higher than before with statistical significance (t=19.64, p<.001).
The developed care scheme can be used for schizophrenia patients at home who lack of medication adherence, following the treatment criteria.
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