TitlePatients' perception of family involvement and its relationship to medication adherence for persons with schizophrenia and schizoaffective disorders
NameEdelman, Elaine M. (author), Mayers, Raymond Sanchez (chair), Akincigil, Ayse (internal member), Peterson, N. Andrew (internal member), Boyer, Carol (outside member), Rutgers University, Graduate School - New Brunswick,
Families of the mentally ill
DescriptionIt has been a consistent finding in the literature on patients with schizophrenia that poor medication adherence precipitates relapse of psychiatric symptoms. One of the most consistent findings in the research is that patients diagnosed with schizophrenic disorders who have close ties to family members that are critical of them tend to have much higher rates of relapse. The question of how affectionate and/or supportive family relationships impact psychiatric stability remains. This dissertation examined the connection between perception of family relationships and medication adherence among patients with schizophrenia. Utilizing the Rutgers Hospital and Community Survey, this study looked at the follow up surveys of 182 patients who were on oral anti-psychotic medications and who reported at least one family relationship. Data were analyzed using the patients' responses to questions about how they perceive their family relationships as well as their responses about their medication adherence in the previous two weeks and the previous three months. Chi-square and logistic regression were performed, while controlling for age, race, education, gender, Brief Psychiatric Rating Scale scores, Global Assessment Scale scores, side effects, substance abuse, therapeutic alliance, housing status, and objective family involvement scores (which measured the family's involvement behaviors while the patient had been hospitalized). The main hypothesis, that patients who perceive their families to be affectionate and/or high in instrumental support would have higher rates of adherence, was not supported. An objective measure of family involvement (which measured family behaviors such as visitation and participation in treatment when the patient was in the hospital) also did not correlate with medication adherence. This analysis did find that having a substance abuse diagnosis was a predictor of poor medication adherence and that a positive therapeutic alliance, when measured at the three month follow up, was a predictor of medication adherence. Limitations of this follow up treatment study include questionable validity and reliability of self report on both family relationships and medication adherence, loss of statistical power as variables were added into the regression, and possible memory problems related to the diagnosis of schizophrenia since both the illness and possibly the medication regimen may impact memory. However, it is possible, since the objective family involvement score also did not yield a relationship to medication adherence, that positive family relationships do not translate into medication taking behavior.
NoteIncludes bibliographical references
Noteby Elaine M. Edelman
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.