Structure of Illness Insight in Patients with Schizophrenia

Abstract

The objective of this study was to elucidate the factors affecting schizophrenia patients' awareness of their illness, so that nursing interventions can be devised to enhance levels of insight in these patients.
We investigated the following in participants with schizophrenia: the Japanese version of the Schedule for Assessment of Insight (SAI-J), drug-taking attitude, health locus of control (HLC), knowledge of disease/medication, experience in relation to disease/medication, psychotic symptoms, type of treatment, the attending physician's explanation of informed consent, and self-efficacy. Additionally, we conducted semi-structured interviews. Information on such factors as the participants' awareness of their disease, drug-related experiences, emotions, and state of acceptance were extracted from an analysis of the interview results. Covariance structure analysis was used to examine the total scores of the individual scales and categories so as - to construct a path model for illness insight. The "objective standpoint of the disease experience" influenced the SAI-J and drug-related experience scores, leading to the emergence of feelings regarding medication. This affected the total scores on the drug-taking attitude scale.
Our findings indicated that nursing intervention that improves insight should be able to help patients to take an objective standpoint of their disease experience and to express their medication-related experiences.