Van Husen Madeline Jin, Kaaya Sylvia, Swai Praxeda, Lawala Paul Sarea, Thadei Beatrice, Minja Anna, Headley Jennifer, Egger Joseph R, Baumgartner Joy Noel
School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Psychiatry and Mental Health, School of Clinical Medicine, Muhimbili National Hospital, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
BMC Psychiatry. 2025 Apr 28;25(1):422. doi: 10.1186/s12888-025-06700-y.
As low-resource settings move to address the treatment and social service gap for people living with schizophrenia (PLWS), person-centered and recovery-oriented interventions should monitor impacts on empowerment. This study explores empowerment and associated factors among PLWS in Tanzania.
This study uses endline data from the Culturally Adapted Family Psychoeducation for Adults with Psychotic Disorders in Tanzania (KUPAA) pilot trial. Participants included 66 dyads of PLWS and caregivers recruited from two tertiary-level hospitals. The main outcome variable of interest was empowerment (Rogers 28-item Empowerment Scale), and the main exposure variable was Participation in Society (Domain 6 of the WHO Disability Assessment Schedule, WHODAS 2.0). Key psychosocial correlates of interest included hopefulness, general self-efficacy, internalized stigma, and family functioning. Bivariate and multivariable analyses were used to explore variable relationships.
There were 21 women and 40 men with a mean age of 32 years. Bivariate analyses revealed greater participation in society (p < 0.0003) was correlated with greater empowerment, higher hopefulness (p < 0.0001) and higher self-efficacy (p < 0.0001). Lower empowerment was correlated with higher self-stigma (p < 0.0001) and worse family functioning (p < .001). Multivariable models indicated more participation in society was associated with higher empowerment, but when hope, self-efficacy, internalized stigma, and/or family functioning were added to the models, those factors were more strongly correlated with empowerment than participation in society.
Empowerment is increasingly being recognized as an important outcome of psychosocial interventions. Understanding empowerment and its possible effects on recovery-centered outcomes is important when thinking of future interventions for PLWS in low-resource settings. Future recovery-oriented interventions and research should both consider including empowerment measurement among PLWS and incorporate their lived experiences in psychosocial treatment programming.
随着资源匮乏地区着手解决精神分裂症患者的治疗和社会服务差距问题，以患者为中心和以康复为导向的干预措施应监测对赋权的影响。本研究探讨了坦桑尼亚精神分裂症患者的赋权情况及相关因素。
本研究使用了坦桑尼亚针对成人精神病患者的文化适应性家庭心理教育（KUPAA）试点试验的终期数据。参与者包括从两家三级医院招募的66对精神分裂症患者及其照料者。主要关注的结果变量是赋权（罗杰斯28项赋权量表），主要暴露变量是社会参与（世界卫生组织残疾评定量表2.0的第6领域）。感兴趣的关键心理社会相关因素包括希望、一般自我效能感、内化耻辱感和家庭功能。采用双变量和多变量分析来探讨变量之间的关系。
有21名女性和40名男性，平均年龄为32岁。双变量分析显示，更多的社会参与（p < 0.0003）与更高的赋权、更高的希望（p < 0.0001）和更高的自我效能感（p < 0.0001）相关。较低的赋权与更高的自我耻辱感（p < 0.0001）和更差的家庭功能（p < 0.001）相关。多变量模型表明，更多的社会参与与更高的赋权相关，但当将希望、自我效能感、内化耻辱感和/或家庭功能纳入模型时，这些因素与赋权的相关性比社会参与更强。
赋权日益被视为心理社会干预的重要结果。在考虑资源匮乏地区精神分裂症患者未来的干预措施时，了解赋权及其对以康复为中心的结果可能产生的影响非常重要。未来以康复为导向的干预措施和研究都应考虑在精神分裂症患者中纳入赋权测量，并将他们的生活经历纳入心理社会治疗方案中。
