CONCEPT ANALYSIS OF “ COMING TO TERMS ” WITH  THE  ILLNESS OF THE PERSON WITH  SCHIZOPHRENIA

Abstract

Purpose: To define the concept of “coming to terms” with schizophrenia

Methods: Rodgers’ (2000) concept analysis approach was used. Data was collected by searching six databases, including the Japan Medical Abstracts Society. The search keywords “coming to terms” and related keywords “acceptance/schizophrenia” were used. The English literature was searched using the keywords “identity adaptation schizophrenia.” Only original works with abstracts were retrieved, which included 20 Japanese and two English manuscripts. Antecedents, attributes, and conclusions were extracted from each document and categorized as separate items.

Results: Six categories of attributes were extracted: “living with the illness,” “positive recognition of oneself,” “the manner of interaction between oneself and one’s family or other people,” “the acquisition of a new sense of values,” “the reinforcement of self-monitoring,” and “living freely and naturally.” Antecedent factors were broadly divided into two categories, namely, individual and environmental causal factors, and each category was further divided into four subcategories. The individual factors were divided into “illness-related distress”; “illness-related negative experiences”; “sense of negativity toward activities of daily living and “coping response”; and “new questions arising from knowledge of schizophrenia.” The environmental factors were divided into “medical treatment,” “family support,” “interpersonal relations,” and “institutional/social resources.” Six categories of consequences were extracted: “establishing a pattern of living,” “acquiring the confidence to interact with others,” “discovering one’s new role in society,” “self-fulfillment/determination,” “expectations regarding medical treatment,” and “rediscovering oneself.

Conclusion: The concept of “coming to terms” in schizophrenia was defined as “living freely and naturally.” However, those with schizophrenia struggled with illness-related experiences stemming from prejudice. Such experiences amidst an illness-based loss of self-confidence fueled a continual perception that people with schizophrenia were different from who they were prior to their illness, and thus, the definition of “living freely and naturally” was chosen.