Study Of Self-management Subgroup Classified Intervention Construction For The Patients With Schizophrenia

Background:Schizophrenia is characterized by chronic,high recurrence rate and high disability rate.Antipsychotics are insufficient to improve negative symptoms,social function and cognitive function in patients with schizophrenia.Disease self-management is the way to reduce relapse,control symptoms and promote recovery.Many selfmanagement interventions for patients with schizophrenia were general,leading to some patients not achieving the expected benefits after receiving self-management interventions.Several studies identified subgroups based on the self-management of patients with schizophrenia using different classification indicators,but there was still a lack of selfmanagement classification intervention programs for patients with schizophrenia.Aims:To clarify a self-management classification for patients with schizophrenia and develop subgroup classified intervention programs.Methods:The research on the classification of self-management and self-management intervention in patients with schizophrenia were systematically reviewed.Interviews were conducted for survey research to identify the problems and needs of patients with schizophrenia and caregivers in the course of disease management,their preferences for self-management interventions,and to clarify healthcare professionals’ suggestions for self-management interventions as well as the barriers and facilitators to implementing related interventions.Based on the above studies,the self-management classification of patients with schizophrenia and subgroup classified intervention programs were formed preliminarily.Above contents were revised and improved through the Delphi method.Results:21 articles on the self-management classification of patients with schizophrenia and 26 articles on the self-management intervention of patients with schizophrenia were included.12 patients with schizophrenia,7 caregivers and 10 healthcare professionals were selected for offline and online interviews.After preliminarily identifying selfmanagement classification and constructing subgroup classified intervention programs for patients with schizophrenia,16 experts were invited to conduct two rounds of the Delphi method.Finally,five self-management subgroups of patients with schizophrenia,namely high-functioning type,slump type,passive type,arrogant type,and low-literacy type,were identified.The material library of self-management intervention programs for patients with schizophrenia was established,including five intervention modules:self-compensation,self-learning,self-reconstruction,self-improvement and cooperative care.Five sets of selfmanagement intervention programs for the high-functioning type,slump type,passive type,arrogant type,and low-literacy type were developed respectively.Conclusions:Based on the cognitive-psychological model of self-management behavior in patients with schizophrenia,self-management can be classified into five subgroups:high-functioning type,slump type,passive type,arrogant type,and low-literacy type.Based on the characteristics of the subgroups,targeted intervention programs for each subgroup were constructed from five intervention modules of self-compensation,selflearning,self-reconstruction,self-improvement,and collaborative care which are highly expected to be important references for the classification management of patients with schizophrenia in the future.