About 30% to 50% of people with schizophrenia experience lack of insight, meaning they may not acknowledge their illness or the need for treatment. Researchers have developed valid tools for measuring insight. Accordingly, a great deal of descriptive and correlational research has been done on insight, treatment adherence, symptom severity, and other associated variables. Several possible etiologic models and treatment modalities for lack of insight have been proposed. Possible brain dysfunctions causing lack of insight are being investigated. Cognitive-behavioral therapy and motivational interviewing have been successful in teaching patients to cope with the symptoms and make changes in health-related behaviors. Ultimately, people with schizophrenia need to know how to ask for help with coping with their symptoms.
This qualitative research report presents an illustration of Mishel's (1990) reconceptualization of uncertainty in illness theory applied to persons with schizophrenia. The researcher interviewed 6 persons with schizophrenia and 5 family members. The informants reported being uncertain about whether their medicine would keep working, whether they would be able to provide for their children, whether they could stay on their medicine, whether their symptoms would improve, when the next relapse would be, and even whether they would survive. They appeared to be experiencing differing degrees of uncertainty and a variety of manifestations of probabilistic thinking. For some, uncertainty provided the opportunity for hope. For others, the uncertainty was perceived as a danger. For all of them, their view of life had changed.
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