Risk and protective factors for relapse among Individuals with Schizophrenia: A Qualitative Study in Dar es Salaam, Tanzania

Abstract

BackgroundRelapse in people with schizophrenia is a major challenge for mental health service providers in Tanzania and other countries. Approximately 10% of people with schizophrenia are re-admitted due to relapse at Muhimbili National Hospital (MNH) Psychiatric Unit each month. Relapse brings about negative effects and it results in a huge burden to patients, their families, the mental health sector and the country’s economy. So far no study has been done to address relapse in Tanzania. The purpose of the study was to explore perspectives on risk and protective factors influencing relapse of people with schizophrenia and their caregivers attending Muhimbili National Hospital Psychiatric Out-patient Department, Dar es Salaam, Tanzania.MethodsA qualitative study was conducted, involving in-depth interviews of seven people with schizophrenia who are out-patients and their seven family caregivers at MNH. Purposive sampling procedure was used to select participants for the study. Audio recorded in-depth interviews in Swahili language were conducted with all study participants. The recorded information was transcribed and analyzed using NVivo 9 computer assisted qualitative data analysis software.ResultsPersonal risk and protective factors for relapse, environmental risk and protective factors for relapse and suggestions to reduce relapse were the main themes that emerged from this study. People with schizophrenia and their caregivers (all of whom were relatives) perceived non adherence to antipsychotic medication as a leading risk factor of relapse; other risks included poor family support, stressful life events and substance use. Family support, adherence to antipsychotic medication, employment and religion were viewed as protective factors. Participants suggested strengthening mental health psycho-education sessions and community home visits conducted by mental health nurses to help reduce relapse. Other suggestions included strengthening the nurse-patient therapeutic relationship in provision of mental health care.ConclusionsThis study calls for improvement in mental health care service delivery to individuals with schizophrenia. Establishing a curricular in mental health nursing that aims to produce competent mental health nurse force would improve nursing practice in mental health care service delivery.

Family Support and Adherence to Treatment in Patients Diagnosed with Schizophrenia in Tabasco, Mexico: A Case- Series Study

“…We observed a good adherence to treatment plus good family support which provide better outcome and prognosis. This is in agreement with other reports in the literature that have demonstrated that a combination of family support and knowledge of the disease help families and persons with schizophrenia to lessen the relapse frequency and improve compliance with the treatment [31,32].…”

Pencegahan Kekambuhan Klien Skizofrenia Berbasis Mobile Apps dan Mobile Web: Systematic Review

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Faktor Caregiver dan Kekambuhan Klien Skizofrenia

“…Sariah (2014) menyimpulkan bahwa salah satu penyebab kambuhnya penyakit skizofrenia disebabkan oleh peristiwa kehidupan keluarga yang penuh dengan tekanan (stres).…”