Effective Strategies for Nurses Empowering Clients With Schizophrenia: Medication Use as a Tool in Recovery

Abstract

Clients with schizophrenia require maintenance treatment with antipsychotic medication and psychosocial therapy to maintain symptom control. Rates of medication adherence or follow-through are low in clients with schizophrenia. This increases the risk of relapse and contributes to poor quality of life. As educators and advisers, psychiatric nurses can collaborate with clients to improve adherence and other outcomes using shared decision-making techniques and tools that engage and empower clients to actively participate in decisions about their treatment. This article outlines effective strategies used by psychiatric nurses to improve outcomes in clients with schizophrenia and uses a case example for demonstrating this strategy in a client with schizophrenia.

The physical health of young people experiencing first‐episode psychosis: Mental health consumers’ experiences

“…As recovery-focused mental health care evolves to encompass physical health, mental health nurses can transform the way in which young people manage their coexisting psychosis and physical health issues to enhance their quality of life and mental well-being (Mahone et al 2016). This facilitates a transition from conventional mental health practices to contemporary evidence-based practices that include the need for regular metabolic monitoring and physical health promotion (Bradshaw & Pedley 2012;Happell et al 2016).…”

“…However, this information is not always provided by health professionals as they believe it may result in the person being nonadherent with taking the medication (Blythe & White 2012;Mahone et al 2016;). However, this information is not always provided by health professionals as they believe it may result in the person being nonadherent with taking the medication (Blythe & White 2012;Mahone et al 2016;).…”

“…Category 3: Lack of education about antipsychotic medications A treatment for first-episode psychosis is often to use antipsychotic medication to reduce the presence of distressing positive symptoms (Mahone et al 2016). However, participants explained that when they commenced taking antipsychotic medications, very little information was provided to them about the medications and the adverse effects that they may experience: 'The doctor keeps pushing us to take medication and didn't tell [me] how bad it [antipsychotic medication] is for our body .…”

“…It is good practice to provide consumers with information about the antipsychotic medications they are prescribed as it facilitates early identification of problems or adverse side effects. However, this information is not always provided by health professionals as they believe it may result in the person being nonadherent with taking the medication (Blythe & White 2012;Mahone et al 2016;). Once they had commenced taking their medication participants began to experience a range of impacts from the medications: 'I think my metabolism has slowed down' (P22); 'The medications have quite a sedative effect and certainly I had less energy.…”

The rationale for shared decision making in mental health care: a systematic review of academic discourse

“…However some authors were critical of this language because they felt it was not synonymous with the values of SDM. For example, because the term 'adherence' implies a rule is being followed (Mahone, Maphis, & Snow, 2016), reinforces the power of the clinician, or does not recognise a decision to stop taking medicine as a rational choice, informed by lived experience (Deegan, 2007). Others noted that 'adherence' is not the primary goal of most shared decision making interventions (Stein et al, 2013) and that non-adherence can indicate a breakdown of the decision making process so may be a positive outcome in cases where the care plan does not meet the goals of the individual (Hegedus & Kozel, Dec 2014;Seale et al, 2006) …”