Effects of an Interpersonal Communication Skills Training Program on Medication Adherence of Schizophrenic Patients

Suranaree University of Technology40 enrolled

Overview

This quasi-experimental two-group pretest-posttest study examined the effects of an interpersonal communication skills training program on medication adherence in patients with schizophrenia, measured at pre-intervention, post-intervention, and one-month follow-up. Research Hypotheses 1. The experimental group receiving the interpersonal communication skills training program will show higher mean treatment adherence scores post-intervention and at one-month follow-up compared to baseline. 2. The experimental group will show higher mean treatment adherence scores post-intervention and at one-month follow-up than the control group receiving routine nursing care.

Intervention : Interpersonal Communication Skills Training Program This program was developed based on DeVito's communication theory and integrated with the positive reinforcement-based interpersonal communication training developed by Thiengwiriyakul et al.(11) The program comprises six sessions: 1) Positive Communication 2) Equal Communication 3) Empathic Communication 4) Supportive Communication 5) Open Communication and 6) Relationship-Building Communication. The intervention was conducted three times per week, 60 minutes per session, over a two-week period. Usual Care : Usual care is defined as the provision of standard psychiatric nursing interventions consistent with usual clinical practice.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Schizophrenia; Psychosis

Interventions

Interpersonal Communication Skills Training ProgramBEHAVIORAL

This program was developed based on DeVito's communication theory and integrated with the positive reinforcement-based interpersonal communication training developed by Thiengwiriyakul et al.(11) This program was evaluated by a panel of three experts-a psychiatrist, a psychiatric nurse, and a psychiatric nursing academic-who assessed content relevance, appropriateness, and language clarity. After revisions based on their feedback, the program achieved a Content Validity Index (CVI) of 0.93, exceeding the acceptable threshold.

Usual careBEHAVIORAL

Received routine psychiatric nursing care

Eligibility

Sex: MALEMin age: 20 YearsMax age: 59 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Male patients aged 20-59 with an ICD-10 schizophrenia diagnosis(F20.0-F20.9). 2. History of psychiatric readmission due to medication non-adherence 3. Mild psychiatric symptoms(Thai BPRS score ≤ 36). 4. Poor interpersonal communication skills(score ≤ 1.50 on Thiengviriya et al.'s assessment tool 5. Low to moderate medication adherence(score ≤ 42 on Uthaiphan \& Daengdomyut's scale 6. Able to read, write, speak, and without hearing/visual impairments. 7. Had a primary caregiver post-discharge. 8. Provided informed consent voluntarily. Exclusion Criteria: Patients with other psychiatric comorbidities(e.g., depression, bipolar disorder, anxiety, or substance-induced psychosis)

Outcomes

Primary Outcomes

Medication Adherence Behavior

Treatment adherence refers to the extent to which patients with schizophrenia follow their prescribed medication regimen, assessed using the 16-item Treatment Adherence Behavior Assessment Scale (Uthaipan \& Daengdomyut, 2013) It has been validated for content with a content validity index (CVI) of 0.88 and demonstrates good reliability with a Cronbach's alpha of 0.85. It consists of 16 items rated on a 4-point Likert scale (Always, Often, Occasionally, Never), divided into two parts: 1) Items 1-8: behaviors related to medication adherence. 2) Items 9-16: abilities to recognize and manage side effects. Seven items are negatively worded (Items 1, 2, 3, 7, 8, 12, 15), and nine items are positively worded (Items 4, 5, 6, 9, 10, 11, 13, 14, 16). The scoring is interpreted as follows: 1) ≤ 21 points: Low adherence 2) 21-42 points: Moderate adherence 3) ≥ 43 points: High adherence

Time frame: Before the intervention, Immediately after the intervention , 1 month follow-up