Factors that influence hospitalization stress in patients with chronic schizophrenia: A cross-sectional study in psychiatric hospitals.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: Patients with chronic schizophrenia become vulnerable to stress when admitted to psychiatric wards, lacking the abilities to independently cope with stress. Therefore, it is crucial to focus on the stress associated with hospitalization. Stress increases when interpersonal functioning is impaired due to schizophrenia symptoms. Social support acts as a protective factor against stress, boosting coping skills and problem-solving abilities.

What the paper adds to existing knowledge: Interpersonal relationships, marital status, having cohabited before hospitalization and hospitalization type were associated with hospitalization stress in patients with chronic schizophrenia. Patients with chronic schizophrenia continue aging (mean 55.73 ± 11.14) within closed psychiatric hospitals due to their long-term hospitalizations (mean 14.24 ± 11.37). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need to use a standardized nursing assessment including interpersonal relationships, family support system and hospitalization type that may affect hospitalization stress in patients with chronic schizophrenia. Mental health nurses should develop tailored interventions to reduce hospitalization stress for long-stay patients with chronic schizophrenia that consider aging, illness duration, and length of hospital stay, as well as psychiatric symptoms. Mental health nurses need to make efforts to help the families of patients with schizophrenia solidify an important support system by participating in treatment plans and intervention programs, checking on the patients' condition, and spending time with them.

Abstract: INTRODUCTION: Patients with chronic schizophrenia in psychiatric hospitals often experience increased stress due to living in closed spaces and frequently lack the coping skills necessary for independent stress management.

Aim: To explore interpersonal relationships, social support and hospitalization stress, and identify the factors associated with hospitalization stress in patients with chronic schizophrenia in psychiatric hospitals.

Method: This cross-sectional study included 135 patients who had been diagnosed with schizophrenia for over 2 years, recruited from two psychiatric hospitals in City B, South Korea through convenience sampling. We conducted descriptive statistics and quantile regression.

Results: Interpersonal relationships, marital status, cohabiting before hospitalization, and voluntary admission were significant factors influencing the hospitalization stress at the 90th percentile.

Discussion: Standardized nursing assessment, active family support, and tailored stress management programs including interpersonal relationships are needed to reduce hospitalization stress in patients with chronic schizophrenia.

Implications for practice: To identify the 90th percentile group for hospitalization stress among patients with chronic schizophrenia, it is essential to consider interpersonal relationships, marital status, pre-hospitalization cohabitation, type of hospitalization, as well as aging and prolonged hospitalization. Mental health nurses should develop and implement family therapy-based interpersonal relationship programs to reduce hospitalization stress in patients with chronic schizophrenia and actively involve families in the process.