Empowerment among treatment-engaged individuals living with schizophrenia in Tanzania.

Abstract

Purpose: As low-resource settings move to address the treatment and social service gap for people living with schizophrenia (PLWS), person-centered and recovery-oriented interventions should monitor impacts on empowerment. This study explores empowerment and associated factors among PLWS in Tanzania.

Methods: This study uses endline data from the Culturally Adapted Family Psychoeducation for Adults with Psychotic Disorders in Tanzania (KUPAA) pilot trial. Participants included 66 dyads of PLWS and caregivers recruited from two tertiary-level hospitals. The main outcome variable of interest was empowerment (Rogers 28-item Empowerment Scale), and the main exposure variable was Participation in Society (Domain 6 of the WHO Disability Assessment Schedule, WHODAS 2.0). Key psychosocial correlates of interest included hopefulness, general self-efficacy, internalized stigma, and family functioning. Bivariate and multivariable analyses were used to explore variable relationships.

Results: There were 21 women and 40 men with a mean age of 32 years. Bivariate analyses revealed greater participation in society (p < 0.0003) was correlated with greater empowerment, higher hopefulness (p < 0.0001) and higher self-efficacy (p < 0.0001). Lower empowerment was correlated with higher self-stigma (p < 0.0001) and worse family functioning (p < .001). Multivariable models indicated more participation in society was associated with higher empowerment, but when hope, self-efficacy, internalized stigma, and/or family functioning were added to the models, those factors were more strongly correlated with empowerment than participation in society.

Conclusion: Empowerment is increasingly being recognized as an important outcome of psychosocial interventions. Understanding empowerment and its possible effects on recovery-centered outcomes is important when thinking of future interventions for PLWS in low-resource settings. Future recovery-oriented interventions and research should both consider including empowerment measurement among PLWS and incorporate their lived experiences in psychosocial treatment programming.