School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
Int J Ment Health Nurs. 2023 Aug;32(4):1008-1024. doi: 10.1111/inm.13123. Epub 2023 Feb 14.
Medication adherence and recovery rates are <50% among persons with schizophrenia; therefore, this health concern needs attention. Empowerment is a vital element for behavioural change, but previous studies have presented different results and lack specific connotations about empowerment. Therefore, this study systematically reviewed and meta-analysed the effects of empowerment-based illness management on the medication adherence and recovery of persons with schizophrenia. The databases searched included the PROSPERO registration network, Cochrane Library, PubMed, Embase, CINAHL, PsycAricle, and Airiti Library. The research steps were based on PRISMA. RoB 2.0 was used for article quality evaluation, the effect size was calculated using RevMan software, and the random-effect model and standardized mean differences (SMD) were established. Eight randomized controlled trials (RCTs) involving 859 participants were used to investigate the effect of empowerment on medication adherence. The trials involved the use of effective strategies as inducing medication motivation, promoting self-medication management, and providing support resources. A moderate effect was observed (SMD = 0.58, 95% CI 0.18-0.99). Ten RCTs involving 1473 participants were used to investigate the effect of empowerment on recovery. These trials involved the use of such effective strategies as using self-strength, connecting external forces, understanding personal needs, and overcoming self-stigma. A moderate effect was observed (SMD = 0.55, 95% CI 0.10-0.99). Empowerment in illness management can effectively promote the medication adherence and recovery of persons with schizophrenia. In the future, nurses can use self-strength care to promote medication motivation and connect internal and external forces to assist a person's medication adherence and recovery.
精神分裂症患者的药物依从率和康复率<50%；因此，这一健康问题值得关注。赋权是行为改变的重要因素，但以前的研究结果不同，缺乏赋权的具体内涵。因此，本研究系统地综述和荟萃分析了基于赋权的疾病管理对精神分裂症患者药物依从性和康复的影响。检索的数据库包括 PROSPERO 注册网络、 Cochrane 图书馆、PubMed、Embase、CINAHL、PsycAricle 和 Airiti 图书馆。研究步骤基于 PRISMA。使用 RoB 2.0 对文章质量进行评估，使用 RevMan 软件计算效应量，并建立随机效应模型和标准化均数差（SMD）。八项随机对照试验（RCT）共纳入 859 名参与者，用于研究赋权对药物依从性的影响。这些试验采用了有效的策略，如激发药物动机、促进自我药物管理和提供支持资源。观察到中度效应（SMD=0.58，95%CI 0.18-0.99）。十项 RCT 共纳入 1473 名参与者，用于研究赋权对康复的影响。这些试验采用了有效的策略，如利用自身优势、联系外部力量、了解个人需求和克服自我污名化。观察到中度效应（SMD=0.55，95%CI 0.10-0.99）。疾病管理中的赋权可以有效促进精神分裂症患者的药物依从性和康复。在未来，护士可以使用自强护理来促进药物动机，联系内部和外部力量，以帮助患者坚持服药和康复。
