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

Abstract

Background: Schizophrenia is a debilitating psychotic disorder that affects patients' personality, career-related and social functioning. Patients stop medications after discharge or inpatient care, when they feel relatively recovered. Most patients do not know that they are sick and they need medication for recovery due to lack of information and cognitive impairment, which makes them incompetent for self-care. A well designed discharge plan with disease management, prevention cares and education along with follow-up can significantly improve patients and decrease the health care costs; because it helps them take care of themselves and maintain a certain level of health. This study aimed to determine the effect of discharge, education and follow-up program on self-care abilities of patients with chronic schizophrenia.

Methods: This was a quasi-experimental study, using a hospital based accessible sampling method. Participants included 60 schizophrenic patients who were randomly divided into two groups of intervention and control (30 patients in each group). After their symptoms were relatively controlled, the intervention group received a service of post-discharge program and home-care for 6 months. Data were collected before, and one month after education up to 6 month after discharge, using a demographic data questionnaire and a researcher-made questionnaire for self-care. Validity and reliability of instruments were approved by content validity and test-retest, respectively. Also, ethical approval for this study was obtained from the University of Social Welfare and Rehabilitation Science.

Results: There was a significant difference between the self-care abilities after intervention (from month 1 to month 6) in the intervention group compared with the controls. It means that conducting a discharge plan, education and follow-up increased the self-care abilities of the participants in the intervention group compared with themselves and control group members.

Conclusions: Educating patients and their families and follow-up cares after discharge along with medications led to independency, self-care improvement and cognitive and social functioning of schizophrenic patients.

Keywords: Discharge planning; schizophrenia; self-care.