Intervention
schizophrenia, schizophrenia disease
DISEASE
The present study provided interventions for improving the health status of the caregivers of individuals with schizophrenia based on the Carative factors of Watson’s human caring theory.To develop the health promotion program, initially, a literature review was conducted regarding the experiences, viewpoints, tendencies, needs of caregivers of individuals with schizophrenia and the related interventions, and a list of health needs and strategies to meet that needs was created. The identified needs of caregivers of persons with schizophrenia included psychological, physical, and social needs, lack of knowledge, and the need to know about disease management. The strategies to meet the caregiver's needs were counseling, stress management, problem-solving, decision-making, time management, coping skills, self-care, communication skills, promotion of family coexistence, and management of schizophrenia disease [The first author, a nursing instructor with experience in mental health nursing, carried out the intervention. This nursing instructor was familiar with Watson’s theory and had completed an immersive four-week Massive Open Online Course [The intervention was provided individually with face-to-face interviews, consultation, training, and practice for each participant through five 90–120-min sessions with 10–14-day intervals. In each intervention session, the participants were asked questions to identify their needs, inspire motivation, and create a caring teaching–learning atmosphere, which is Caring Science principles. Then, the participants received individualized education regarding personal conditions, needs, tendencies, and preferences. They were also provided with educational pamphlets, homework assignments, and worksheets to complete during the intervention sessions. The weekly exercises included mindfulness and self-awareness exercises, journaling about daily activities, applying problem-solving exercises, time management training, stress management, communication with others, kindness towards oneself and others, basic yoga asana, and self-care. At the beginning of each session, assignments were reviewed, and clarification with further teaching was provided if necessary. To ascertain the participants’ performance on their homework, online or phone contacts were also made for 30–60 min. After the intervention, phone follow-ups with the participants were continued for four weeks. In addition, the participants could contact the researcher with questions via phone or WhatsApp. If the participants needed diagnostic and therapeutic measures due to physical or mental problems, they were referred to the physician and the psychologist who collaborated with the researcher.The control group participants were provided with the usual care protocols, which consisted of brief oral training about schizophrenia and taking care of patients provided by a physician, psychologist, or nurse during periodical inpatient visits in the clinics. After the study, however, the control group participants were provided a consultation session by the researcher. They were also given educational content, including video clips, audio files, and pamphlets. The CONSORT flow diagram of the study is depicted in Fig. Flow chart of the study participants