Assessment of self-care capacity, self-management, and disease adherence in patients with psychosis and chronic illnesses

Individuals diagnosed with psychosis may experience difficulties in managing their chronic diseases due to cognitive and emotional challenges. Therefore, evaluating the self-care agency, self-management, and adaptation to illness of these patients is crucial for understanding their capacity to maintain their health. This study aimed to assess the level of chronic disease management among patients diagnosed with psychotic disorders. Method: This cross-sectional and descriptive study was conducted with a total of 70 female inpatients in the women's ward of a regional psychiatric hospital. All participants had been followed up for at least one year and had at least one chronic disease in addition to a psychosis diagnosis. Data were collected using the Patient Information Form, Positive and Negative Syndrome Scale (PANSS), Self-Care Agency Scale, and Chronic Disease Self-Management Scale. Results: Among the participants, 64.3% were over 40 years old, married, housewives, and had a secondary education level or higher. None reported alcohol use, but 58.6% were smokers. Additionally, 65.7% were diagnosed with non-organic psychosis, had chronic diseases for more than six years, and had comorbidities such as diabetes mellitus (31.4%), thyroid disorders (45.7%), and hypertension (17.2%). A negative correlation was found between total scores on the PANSS and the Self-Care Agency Scale (r = -0.61, p < 0.01). Furthermore, strong positive correlations were observed between the total score of the Self-Care Agency Scale and subdimensions of the Chronic Disease Self-Management Scale, including self-stigma, coping with stigma, treatment adherence, and healthcare efficacy (p < 0.01). Conclusion: The findings indicate that severe psychotic symptoms negatively impact patients' self-care abilities and that stigma reduces treatment adherence. In this context, expanding nursing interventions, psychosocial support programs, psychoeducation programs for patients and families, increasing awareness training against stigma, and developing individualized treatment plans for patients are recommended.