Systematic review of self-management in patients with schizophrenia: psychometric assessment of tools, levels of self-management and associated factors

AIMS: The aim of this study was to provide an overview of existing knowledge about self-management assessment tools used in patients with schizophrenia, and levels of self-management and associated factors in these patients. BACKGROUND: Self-management empowers patients with chronic conditions to manage their illness and psychosocial consequences. With respect to patients with schizophrenia, knowledge concerning self-management is scarce. A systematic review of existing literature focusing on self-management in these patients may contribute to further research programming and practice development. DESIGN: A systematic review of the literature. DATA SOURCES: A systematic literature search was conducted in March 2015 in Medline, Embase, PsycINFO and CINAHL. REVIEW METHODS: Twelve articles were included. Data were extracted and categorized following the objectives of this review: (1) self-management assessment tools and their psychometric properties; (2) level of self-management; and (3) factors associated with self-management in patients with schizophrenia. RESULTS: The PIH scale, the PAM-MH and the IMR scale were used to assess self-management. The overall psychometric quality of these instruments showed to be fair to poor. The level of self-management in patients with schizophrenia is comparable with other mental health conditions, higher than general population and lower than patients with physical health conditions. Several factors (e.g. sense of coherence, recovery and hope) were found to be associated. CONCLUSION: Further efforts are needed to increase the methodological quality of psychometric research on self-management assessment tools. More insight in the level of self-management and associated factors may enhance the development of future interventions