Improving Insight in Patients Diagnosed With Schizophrenia
Condition: Schizophrenia
MeSH terms: Schizophrenia
Study type: Interventional

Summary: 
      Background:

      Rehospitalisation and discontinued treatment are common among patients with schizophrenia and
      is often associated with lack of insight into the illness. Improving patients' insight has
      been attempted through psychoeducation and standard treatment but without any considerable
      change. A newly developed method, Guided Self-Determination (GSD), originally developed and
      proved effective in difficult diabetes care has been adjusted to patients with schizophrenia.
      A qualitative evaluation of GSD has shown a positive influence on patients' insight into the
      illness.

      Aim and hypotheses: The aim of the study is to evaluate the effects of the method GSD in the
      care of patients with schizophrenia compared to treatment as usual. The following hypotheses
      will be tested:

      The method GSD will improve: Cognitive and clinical insight in patients, various domains of
      recovery, patients' self-esteem, psychopathology and social functioning.

      Material and method:

      The study design is a randomised controlled trial. The participants are diagnosed with
      schizophrenia and schizoaffective disorder, receiving treatment in 3 Assertive Outreach Teams
      and 3 Psychosis Teams in Region North. Participants complete four self-rating questionnaires,
      a demographic data sheet, an interview concerning psychopathology and an assessment of social
      functioning at baseline, and after 3, 6, and 12 month. All assessments will be conducted by
      the investigator, except for the assessment of social functioning, that will be measures by
      community nurses. Intervention with the method GSD will also be conducted by the community
      nurses but under supervision from the investigator. Fifty patients are randomly assigned to
      immediate receipt of individual training with the method GSD (intervention group) and 50 to a
      12-month waiting list for individual training with the method GSD (control group).

      Perspectives:

      In mental health nursing practice in Denmark there is no tradition for empirical research as
      the basis of psychiatric nursing - unverified theories or general empirical consensus of good
      clinical practice are often the foundation of psychiatric nursing. If the method GSD proves
      effective in the care of patients with schizophrenia, this study contributes to an evidence
      based nursing intervention, which is ready for further research on implementation in mental
      health nursing practice.
    


Intervention name(s): Guided Self-Determination GSD
Intervention type(s): Behavioral
Intervention description(s): The method GSD consists of 21 worksheets designed to guide patient and mental health professionals through autonomy-supportive problem solving. The worksheets are filled in by the patient before and between conversations with their community nurse over 10 sessions, approximately 1 hour a session.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Guided Self-Determination; Improving insight; Autonomy-supportive problem solving intervention; Evaluate the effects of the method Guided Self-Determination; Improving insight in patients diagnosed with schizophrenia