Self-stigma, stages of change and psychosocial treatment adherence among Chinese people with schizophrenia: a path analysis
Self-stigma, stages of change and psychosocial treatment adherence among Chinese people with schizophrenia: a path analysis
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DOI：
10.1007/s00127-009-0098-1
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发表时间：
2010-05-01
影响因子：
4.4
通讯作者：
Chan, Fong
中科院分区：
文献类型：
--
作者：
Fung, Kelvin M. T.;Tsang, Hector W. H.;Chan, Fong
精神疾病污名是心理社会治疗依从性差的关键原因之一。这项研究的目的是通过路径分析探索自我污名和坚持之间的联系，洞察力和变革准备被概念化为可能的中介。此外，还测试了精神病理学导致不遵守的直接影响。从香港五个精神科机构招募了105名精神分裂症患者。收集了关于他们污名程度、洞察力、变化阶段、精神病理学和心理社会治疗依从性的数据。路径分析被用来检验两个假设模型，结果支持自我污名对降低心理社会治疗依从性的直接影响，以及其通过自知力和改变的阶段对治疗依从性的间接影响。精神病理学也被发现对破坏坚持有直接影响。这一模型比没有考虑自我污名和心理病态的直接影响的模型具有更好的模型拟合度。综上所述，本研究加深了我们对自我污名影响心理社会治疗坚持的机制的理解。这些发现对如何制定减少自我污名的计划以对抗自我污名及其负面后果提供了直接的启示。
Mental illness stigma is one of the key causes for poor psychosocial treatment adherence. The objective of this study was to explore the link between self-stigmatization and adherence via path analysis with insight and readiness for change conceptualized as the possible mediators. The direct effects of psychopathology causing non-adherence were also tested.One hundred and five participants with schizophrenia were recruited from five psychiatric settings in Hong Kong. Data concerning their level of stigma, insight, stages of change, psychopathology, and psychosocial treatment adherence were collected. Path analysis was used to test two hypothetical models.The findings supported the direct effects of self-stigma on reducing psychosocial treatment adherence, and its indirect influences mediated by insight and stages of change on treatment adherence. Psychopathology was also found to have a direct effect on undermining adherence. This model showed better model fit than the one which did not consider the direct effects of self-stigmatization and psychopathology.To conclude, this study deepened our understanding on the mechanism explaining how self-stigmatization undermines psychosocial treatment adherence. The findings provide direct implications on ways of formulating a self-stigma reduction program to combat self-stigma and its negative consequences.