Department of Nursing Education, School of Therapeutic Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa.
Department of Nursing Science, Faculty of Basic Medical Sciences, Obafemi Awolowo University, Ile-Ife, Osun-state, Nigeria.
Health Expect. 2021 Apr;24(2):198-208. doi: 10.1111/hex.13139. Epub 2021 Jan 11.
Schizophrenia, the most chronic and stigmatized form of mental illness, can be described as a brain disorder that affects an individual's cognition. Individuals with schizophrenia exhibit socially unacceptable symptoms that affect their psychosocial lives. They suffer from reduced productivity due to the debilitating effect of the illness, and the negative symptoms impede their employability; such symptoms and effects aggravate the stigma around mental illness. However, when rehabilitation is successfully achieved, so is productivity, and this decreases the associated stigma. Thus, this study describes the rehabilitation experiences and productivity of individuals with schizophrenia in South-West Nigeria.
A descriptive qualitative approach with semi-structured interviews was used to gather information from mental health service users. The discharged users in this study received in-hospital or outpatient rehabilitation care at four outpatient units within two specialist mental health-care facilities in South-West Nigeria. These facilities offer vocational training and rehabilitation services for individuals with schizophrenia. Twenty-nine mental health service users were interviewed. The data from the interviews were independently analysed by two researchers through a content analysis approach using NVIVO version 11. The researchers compared the results of the analysis and reached an agreement on the conclusion.
The rehabilitation services availed by patients in the research setting are of three types. Some attend occupational rehabilitation to learn a trade; they depend on professionals for the choice of skill but at a cost that is not affordable to many. Some stay in rehabilitation units linked to the hospital, rendering their services at a cost, and their living expenses and skill acquisition processes are based on the remuneration they get from the services rendered to the institution. Others depend on their family members' efforts to afford rehabilitation services but set up on job by family or employed in family business. The mental health service users in this study who offered their services to the institutions were able to make informed decisions and showed better performance with their chosen occupation than those who depended on their family or health professionals for the choice of rehabilitation service or vocational career. Therefore, this study concludes that prioritizing mental health facility users' preferences in terms of productive activities (sales, services, vocation) or rehabilitation goals should be encouraged.
精神分裂症是最慢性和最具污名化的精神疾病形式，可以被描述为一种影响个体认知的大脑障碍。患有精神分裂症的个体表现出不受社会接受的症状，影响他们的社会生活。由于疾病的衰弱效应，他们的生产力下降，而负面症状则阻碍了他们的就业能力；这些症状和影响加剧了围绕精神疾病的污名。然而，当康复成功实现时，生产力也会提高，从而减少相关的污名。因此，本研究描述了在尼日利亚西南部，精神分裂症患者的康复体验和生产力。
采用描述性定性方法和半结构化访谈，从精神卫生服务使用者那里收集信息。本研究中的出院使用者在尼日利亚西南部的两家专门精神保健机构的四个门诊单位接受住院或门诊康复护理。这些设施为精神分裂症患者提供职业培训和康复服务。对 29 名精神卫生服务使用者进行了访谈。访谈数据由两位研究人员通过使用 NVIVO 版本 11 的内容分析方法进行独立分析。研究人员比较了分析结果，并就结论达成一致。
研究设定中患者可获得的康复服务有三种类型。一些人参加职业康复以学习一门手艺；他们依赖专业人员选择技能，但费用对于许多人来说是负担不起的。一些人留在与医院相关的康复单位，以成本提供服务，他们的生活费用和技能获取过程取决于他们向机构提供服务所获得的报酬。其他人则依赖家庭成员的努力来负担康复服务，但通过家庭或受雇于家族企业来创业。本研究中的精神卫生服务使用者在向机构提供服务时能够做出明智的决策，并在选择职业方面表现出更好的绩效，而不是依赖家庭或卫生专业人员选择康复服务或职业。因此，本研究得出结论，应该鼓励优先考虑精神卫生机构使用者在生产性活动（销售、服务、职业）或康复目标方面的偏好。
