A Path Analysis of Psychotic Symptoms among Persons with Schizophrenia using Methamphetamines

Abstract

Knowledge of psychotic symptoms among persons with schizophrenia influenced by methamphetamine use guides the design of nursing innovations to maximize positive patient outcomes. This cross-sectional, descriptive correlation study aimed to explore the relationships among coping, medication use self-efficacy, expressed emotions, stressful life events, social support, and social dysfunction, and to test a model that explained the influences of these factors on psychotic symptoms among persons with schizophrenia using methamphetamines.The stress-vulnerability model for schizophrenia guided this study. A sample of 313 persons with schizophrenia using methamphetamines in psychiatric hospitals and institutes for drug abuse treatment in Thailand was recruited by multi-stage sampling and responded to a Demographic Questionnaire, Brief Psychiatric Rating Scale, Brief COPE, Self-efficacy for Appropriate Medication Use Scale, Expressed Emotional Scale, Stressful Life Events Questionnaire, and Social Dysfunction Scale. A linear structural relationship was used to test the hypothesized path model.The hypothesized model was found to fit the empirical data and explained 54 % of variance in psychotic symptoms (χ2 = 8.28, df = 8, χ2 /df = 1.0, GFI = 0.99, AGFI = 0.96, RMSEA = 0.01). The highest total effect and factors directly affecting psychotic symptoms were emotionally focused coping strategies, medication use self-efficacy, social dysfunction, positively expressed emotions, and stressful life events.The findings recommend that emotionally focused coping strategies, self-efficacy in medication use, social dysfunction, positively expressed emotions, and stressful life events were important factors that influenced psychotic symptoms in patients. Nursing interventions designed to manage these factors are crucial for reducing psychotic symptoms.

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