The Effect of Salutogenic-based Interviewing on Subjective Recovery and Quality of Life in Schizophrenia

Overview

Schizophrenia is an inherited, complex, multidimensional syndrome with varying degrees of psychotic, negative, cognitive, mood and motor symptoms. Schizophrenia is a serious public health problem that causes significant losses in the lives of individuals due to both its occurrence at a young age and its prevalence. Ranked by the World Health Organization as one of the top ten diseases contributing to the global burden of disease, it is among the most disabling and economically disastrous medical disorders. The boundaries of schizophrenia remain unclear, indicating a lack of categorical cohesion and the need to reconceptualize it as a broader, multidimensional and/or spectrum construct. With the discovery of antipsychotic drugs, the symptoms of the disease were alleviated, the level of severity decreased and the length of hospitalization was shortened. However, this led to repeated hospitalizations of patients with chronic course and a revolving door effect occurred. Drug treatment has a limited effect on readjustment to society, improving social relations and increasing self-care activities in individuals with chronic mental illness. Therefore, it is important to support drug treatment with social support programs and various psychosocial approaches. In the past, pathogenic approaches focusing on problems and risk factors have been adopted to promote and maintain health. The salutogenic model developed by medical sociologist Aaron Antonovsky (1987) focuses on the causes of health rather than the factors that cause disease. This model is concerned with the relationship between how people approach stressful situations (such as mental and chronic health conditions and their consequences) and their individual ability to self-manage and cope with these situations. The model is a medical approach that focuses on the causes of health rather than the factors that cause disease. This study was planned to evaluate the effect of salutogenic approach-based interviewing on subjective recovery and quality of life in individuals diagnosed with schizophrenia.

Salutogenesis theory focuses on what contributes to the development of good health and contrasts with pathogenesis explaining disease. The most important question for the salutogenic orientation is how a person identifies and utilizes different resources and thus how health promotion can be supported. It focuses on the creation and maintenance of good health rather than looking for the cause of specific diseases. This is in contrast to the traditional pathogenic model, which focuses on risk factors that play a role in disease occurrence. The similarity between the core principle of the salutogenic model and the professional purpose of psychiatric nursing is striking. Psychiatric nursing supports the protection and promotion of community mental health, the rehabilitation of disorders and the regaining of the ability to cope with the experiences of suffering and to find meaning in life. Therefore, the model is suitable for many practice areas of psychiatric nurses. The increasing number of people living with mental health problems in society for many years focuses on the need for recovery from a coping and mental health promotion perspective. The value of salutogenic theory is that it emphasizes coping and health promotion. Although there are numerous empirical applications of salutogenic theory in the field of public health, reviews of salutogenic-based interventions and their impact on population health are limited. Through the salutogenic method, examining deep challenges can provide opportunities to understand how individuals cope during crises and suggest methods to improve the health of the general population. As nursing education and intervention, it is important in terms of emphasizing the need for health promotion and ultimately promoting normal physical and psychological health. The motto of the Mental Health Action Plan for 2021-2023 is stated as "Implementing an integrated community-based mental health service model in mental health services, monitoring, protecting and improving the mental health of individuals". Subjective recovery is a personally perceived improvement that includes other factors beyond clinical recovery. These factors focus on areas of personal development such as empowerment, having a sense of hope, having confidence in the future, redefining oneself, overcoming stigmatization, establishing supportive relationships, taking responsibility, giving meaning to life and leading a fulfilling life. Subjective well-being and quality of life are increasingly recognized as important treatment outcomes in patients with schizophrenia. Schizophrenia, which usually lasts a lifetime, is a disorder that causes significant problems in quality of life and functioning. Factors such as physical health, adaptability, well-being, economic status and social interaction are among the components of quality of life. Therefore, this study was planned to evaluate the effect of salutogenic approach-based interviewing on subjective recovery and quality of life in individuals diagnosed with schizophrenia.