Self-care and schizophrenia: results of a narrative review of the literature

Author/s Federica Dellafiore, Chiara Catagnano, Ida Vangone, Silvia Casella, Sara Russo, Luca Guardamagna, Irene Baroni, Cristina Arrigoni
Publishing Year 2022 Issue 2022/3 Language Italian
Pages 22 P. 96-117 File size 326 KB
DOI 10.3280/PDS2022-003009
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The treatment of schizophrenic disorders includes multiple interventions that must be inte-grated with each other for the complete management of the patient. Among the interventions of an educational and psychosocial nature we find the improvement of self-care behaviors. From the literature, it is clear that self-care has a positive impact on health and psychosocial out-comes of patients with chronic diseases and its studies is emerging in different realities that deal with patients with schizophrenia, even if the concrete effectiveness of self-care in this pathology remains uncertain and the literature in this regard is fragmented and devoid of an over-all vision. Consequently, this study aims to provide a critical synthesis of the available scien-tific evidence regarding self-care behaviors performed by patients diagnosed with schizophre-nia. Through a review of the literature, the 231 results obtained were examined and 7 articles were selected through the application of the inclusion criteria. Three macro-themes have been identified: (a) the levels of self-care implemented by patients with schizophrenia; (b) the factors influencing this process; (c) educational interventions that have been shown to have an effect and efficacy for developing self-care behaviors. Self-care in the patient suffering from schizophrenia is a fundamental therapeutic tool, however it needs to be deepened with new primary studies, in order to provide a clear vision on the methods of intervention to satisfy the patient’s needs, thus limiting the complications related to the disease and giving these people back a satisfactory quality of life.

Keywords: educational interventions, schizophrenia, self-care, self-management

  1. Abaoğlu H., Mutlu E., Ak S., Aki E. & Anıl Yağcıoğlu A.E. (2020). The Effect of Life Skills Training on Functioning in Schizophrenia: A Randomized Controlled Trial. Journal of Psychiatry, 31(1),48-56.
  2. Anderson C. M., Hogarty G.E. & Reiss D.J. (1980). Family treatment of adult schizophrenipatients: A psycho-educational approach. Schizophrenia Bulletin, 6(3), 490-505.
  3. Arsova S., Bajraktarov S., Barbov, I. & Hadzihamza K. (2014). Patients with schizophreniaand self-care. Open Access Macedonian Journal of Medical Sciences, 2(2), 289-292.
  4. Ausili D., Barbaranelli C., Rossi E., Rebora P., Fabrizi D., Coghi C., Luciani M., Vellone E., Di Mauro S. & Riegel B. (2017). Development and psychometric testing of a theory-based tool to measure self-care in diabetes patients: The Self-Care of Diabetes Inventory. BMC Endocrine Disorders, 17(1), 1-12.
  5. Bäuml J., Froböse T., Kraemer S., Rentrop M. & Pitschel-Walz G. (2006). Psychoeducation: A basic psychotherapeutic intervention for patients with schizophrenia and their families. Schizophrenia Bulletin, 32 (SUPPL. 1).
  6. Bighelli I., Rodolico A., García-Mieres H., Pitschel-Walz G., Hansen W.P., Schneider-Thoma J., Siafis S., Wu H., Wang D., Salanti G., Furukawa T.A., Barbui C. & Leucht S. (2021). Psychosocial and psychological interventions for relapse prevention in schizophrenia: a systematic review and network meta-analysis. The Lancet Psychiatry, 8(11), 969-980. DOI: 10.1016/S2215-0366(21)00243-
  7. Caruso R., Rebora P., Dellafiore F., Fabrizi D., Riegel B., Ausili D. & Di Mauro S. (2019). Clinical and socio-demographic determinants of inadequate self-care in adults with type 1 diabetes mellitus: the leading role of self-care confidence. Acta Diabetologica, 56(2), 151-161.
  8. Chan S.W.C., Li Z., Klainin-Yobas P., Ting S., Chan M.F. & Eu P.W. (2014). Effectiveness of a peer-led self-management programme for people with schizophrenia: Protocol for a randomized controlled trial. Journal of Advanced Nursing, 70(6).
  9. Clark A.P., McDougall G., Riegel B., Joiner-Rogers G., Innerarity S., Meraviglia M., Delville C. & Davila A. (2014). Health status and self-care outcomes after an education-support intervention for people with chronic heart failure. Journal of Cardiovascular Nursing, 30(4), S3-S13. DOI: 10.1097/JCN.000000000000016
  10. Dellafiore F., Arrigoni C., Ghizzardi G., Baroni I., Conte G., Turrini F., Castiello G., Magon A., Pittella F. & Caruso R. (2019). Development and validation of the pressure ulcer management self-efficacy scale for nurses. Ournal of Clinical Nursing, 28(17-18), 3177-3188.
  11. Dickson V.V., Deatrick J.A. & Riegel B. (2008). A typology of heart failure self-care management in non-elders. European Journal of Cardiovascular Nursing, 7(3), 171-181.
  12. DOC Generici (2018). Schizofrenia. -- Retrieved from:
  13. Giberti F. e Rossi R. (2009). Manuale di Psichiatria (pp. 377-399). Padova: Piccin.
  14. Graven L.J. & Grant J.S. (2014). Social support and self-care behaviors in individuals with heart failure: An integrative review. International Journal of Nursing Studies, 51(2), 320-333.
  15. Greenhalgh T., Robert G., MacFarlane F., Bate P., Kyriakidou O. & Peacock R. (2015). Storylines of research in diffusion of innovation: A meta-narrative approach to systematic review. Social Science and Medicine, 61(2), 417-430.
  16. Henriksen M.G. & Parnas J. (2014). Self-disorders and schizophrenia: A phenomenological reappraisal of poor insight and noncompliance. Schizophrenia Bulletin, 40(3), pp. 542-547.
  17. Katakura N., Matsuzawa K., Ishizawa K. & Takayanagi C. (2013). Psychological and physical self-management of people with schizophrenia in community psychiatric rehabilitation settings: A qualitative study. International Journal of Nursing Practice, 19(SUPPL. 2), 24-33.
  18. Khankeh H., Rahgozar M. & Ranjbar M. (2011). The effects of nursing discharge plan (post-discharge education and follow-up) on self-care ability in patients with chronic schizophrenia hospitalized in Razi psychiatric Center. Iranian Journal of Nursing and Midwifery Research, 16(2).
  19. Lommi M., Matarese M., Alvaro R., Piredda M. & De Marinis M.G. (2015). The evolution of the concept of self-care in the healthcare system: a narrative literature review. Professioni Infermieristiche, 68(2), 155-166.
  20. Matarese M., Clari M., De Marinis M.G., Barbaranelli C., Ivziku D., Piredda M. & Riegel B. (2020). The Self-Care in Chronic Obstructive Pulmonary Disease Inventory: Development and Psychometric Evaluation. Evaluation and the Health Professions, 43(1), 50-62. DOI: 10.1177/016327871985666
  21. Morera-Fumero A.L. & Abreu-Gonzalez P. (2013). Role of melatonin in schizophrenia. International Journal of Molecular Sciences, 14(5), 9037-9050.
  22. Moser D.K. & Watkins J.F. (2008). Conceptualizing Self-care in Heart Failure:A Life Course Model of Patient Characteristics. Journal of Cardiovascular Nursing, 23(3), 205-218.
  23. Mueser K.T. & McGurk S R. (2004). Schizophrenia. Lancet, 363(9426), 2063-2072. DOI: 10.1016/S0140-6736(04)16458-
  24. Page M.J., McKenzie J.E., Bossuyt P.M., Boutron I., Hoffmann T.C., Mulrow C.D., Shamseer L., Tetzlaff J.M., Akl E.A., Brennan S.E., Chou R., Glanville J., Grimshaw J.M., Hróbjartsson A., Lalu M.M., Li T., Loder E.W., Mayo-Wilson E., McDonald S., McGuinness L.A., Stewart L.A., Thomas J., Tricco A.C., Welch V.A., Whiting P. & Moher D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. The BMJ, 372, 71.
  25. Riegel B., Barbaranelli C., Sethares K.A., Daus M., Moser D.K., Miller J.L., Haedtke C.A., Feinberg J.L., Lee S., Stromberg A. & Jaarsma T. (2018). Development and initial testing of the self-care of chronic illness inventory. Journal of Advanced Nursing, 74(10), 2465-2476.
  26. Riegel B., Jaarsma T., Lee C.S. & Strömberg A. (2019). Integrating symptoms into the middle-range theory of self-care of chronic illness. Advances in Nursing Science, 42(3), 206-215. DOI: 10.1097/ANS.000000000000023
  27. Riegel B., Jaarsma T. & Strömberg A. (2012). A middle-range theory of self-care of chronic illness. Advances in Nursing Science, 35(3), 194-204.
  28. Riegel B., Lee C.S., Dickson V.V. & Carlson B. (2009a). An update on the self-care of heart failure index. Journal of Cardiovascular Nursing, 24(6), 485-497.
  29. Riegel B., Moser D.K., Anker S.D., Appel L. J., Dunbar S.B., Grady K.L., Gurvitz M.Z., Havranek E.P., Lee C.S., Lindenfeld J., Peterson P.N., Pressler S.J., Schocken D.D., Whellan D.J., American Heart Association Council on Cardiovascular Nursing, American Heart Association Council on Cardiovascular Nursing, American Heart Association Council on Clinical Cardiology, American Heart Association Council on Nutrition, Physical Activity & Metabolism and American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research. (2009b). State of the science: Promoting self-care in persons with heart failure: A scientific statement from the american heart association. Circulation, 120(12), 1141-1163. DOI: 10.1161/CIRCULATIONAHA.109.19262
  30. Riegel B., Westland H., Iovino P., Barelds I., Bruins Slot J., Stawnychy M.A., Osokpo O., Tarbi E., Trappenburg J.C.A., Vellone E., Strömberg A. & Jaarsma T. (2021). Characteristics of self-care interventions for patients with a chronic condition: A scoping review. International Journal of Nursing Studies, 116.
  31. Tamminga C. (2020). Schizophrenia. -- Retrieved from:
  32. Taş S. (2017). Early period self-care ability and care requirements of schizophrenia patients after discharge. Journal of Psychiatric Nursing, 9(1).
  33. Van Schie D., Castelein S., Van der Bijl J., Meijburg R., Stringer B. & Van Meijel B. (2016). Systematic review of self-management in patients with schizophrenia: psychometric assessment of tools, levels of self-management and associated factors. Journal of Advanced Nursing, 72(11).
  34. Vaughan Dickson V., Lee C.S., Yehle K.S., Mola A., Faulkner K.M. & Riegel B. (2017). Psychometric Testing of the Self-Care of Coronary Heart Disease Inventory (SC-CHDI). Research in Nursing and Health, 40(1), 15-22.
  35. Vellone E., Fida R., D’Agostino F., Mottola A., Juarez-Vela R., Alvaro R. & Riegel B. (2015). Self-care confidence may be the key: A cross-sectional study on the association between cognition and self-care behaviors in adults with heart failure. International Journal of Nursing Studies, 52(11), 1705-1713.
  36. World Health Organization (2021). WHO Guideline on self-care interventions for health and well-being. -- Retrieved from:
  37. Yu D. S.F., De Maria M., Barbaranelli C., Vellone E., Matarese M., Ausili D., Rejane R.S.E., Osokpo O.H. & Riegel B. (2021). Cross-cultural applicability of the Self-Care Self-Efficacy Scale in a multi-national study. Journal of Advanced Nursing, 77(2), 681-692.
  38. Zou H., Li Z., Arthur D. & Wang H. (2014). Self-management in Chinese people with schizophrenia and their caregivers: A qualitative study on facilitators and barriers. International Journal of Mental Health Nursing, 23(4), 355-363.
  39. Zou H., Li Z., Nolan M.T., Arthur D., Wang H. & Hu L. (2013). Self-management education interventions for persons with schizophrenia: A meta-analysis. International Journal of Mental Health Nursing, 22(3).

Federica Dellafiore, Chiara Catagnano, Ida Vangone, Silvia Casella, Sara Russo, Luca Guardamagna, Irene Baroni, Cristina Arrigoni, Self-care e schizofrenia: risultati di una revisione narrativa della letteratura in "PSICOLOGIA DELLA SALUTE" 3/2022, pp 96-117, DOI: 10.3280/PDS2022-003009