The Role of Insight into Illness as a Mediator and Moderator Between Psychotic Symptoms and Self-care Ability in Chronic Schizophrenia

IF 2.9 3区医学 Q2 NURSING

Asian Nursing Research Pub Date : 2026-02-01 Epub Date: 2025-11-03 DOI:10.1016/j.anr.2025.10.004

Hsu-Chi Chao , Su-Chen Lo , Jason W. Beckstead , Chiu-Yueh Yang

{"title":"The Role of Insight into Illness as a Mediator and Moderator Between Psychotic Symptoms and Self-care Ability in Chronic Schizophrenia","authors":"Hsu-Chi Chao , Su-Chen Lo , Jason W. Beckstead , Chiu-Yueh Yang","doi":"10.1016/j.anr.2025.10.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to explore how insight into illness mediates and moderates the relationship between psychotic symptoms and self-care ability in patients with chronic schizophrenia.</div></div><div><h3>Methods</h3><div>A cross-sectional convenience sampling method was used, and 203 participants were recruited from seven rehabilitation units in northern Taiwan between April and December 2020. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale, insight into illness was assessed with the Schedule for Assessment of Insight in Psychosis, and self-care ability was evaluated using the Self-Care Ability Assessment Scale. Mediation and moderation analyses were conducted using models 4 and 1 of the PROCESS Macro in SPSS, controlling for demographic variables.</div></div><div><h3>Results</h3><div>Insight into illness emerged as both a mediator and a moderator in the relationship between psychotic symptoms and self-care ability. Specifically, insight into illness mediated the relationship by partially alleviating the adverse effects of psychotic symptoms on self-care ability. Furthermore, insight into illness acted as a moderator, with greater insight significantly reducing the impact of psychotic symptoms on an individual’s capacity for self-care.</div></div><div><h3>Conclusion</h3><div>Improving insight into illness is vital to help patients with chronic schizophrenia manage psychotic symptoms and improve self-care. Mental health nurses should prioritize interventions aimed at improving insight, which may significantly improve self-care and overall quality of life.</div></div>","PeriodicalId":55450,"journal":{"name":"Asian Nursing Research","volume":"20 1","pages":"Pages 76-83"},"PeriodicalIF":2.9000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asian Nursing Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1976131725001252","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/11/3 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

The aim of this study was to explore how insight into illness mediates and moderates the relationship between psychotic symptoms and self-care ability in patients with chronic schizophrenia.

Methods

A cross-sectional convenience sampling method was used, and 203 participants were recruited from seven rehabilitation units in northern Taiwan between April and December 2020. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale, insight into illness was assessed with the Schedule for Assessment of Insight in Psychosis, and self-care ability was evaluated using the Self-Care Ability Assessment Scale. Mediation and moderation analyses were conducted using models 4 and 1 of the PROCESS Macro in SPSS, controlling for demographic variables.

Results

Insight into illness emerged as both a mediator and a moderator in the relationship between psychotic symptoms and self-care ability. Specifically, insight into illness mediated the relationship by partially alleviating the adverse effects of psychotic symptoms on self-care ability. Furthermore, insight into illness acted as a moderator, with greater insight significantly reducing the impact of psychotic symptoms on an individual’s capacity for self-care.

Conclusion

Improving insight into illness is vital to help patients with chronic schizophrenia manage psychotic symptoms and improve self-care. Mental health nurses should prioritize interventions aimed at improving insight, which may significantly improve self-care and overall quality of life.

查看原文本刊更多论文

慢性精神分裂症患者精神病症状与自我照顾能力的调节作用：疾病洞察

目的：探讨疾病认知如何调节慢性精神分裂症患者精神病症状与自我照顾能力的关系。方法：采用横断面方便抽样方法，于2020年4月至12月在台湾北部7个康复单位招募203名参与者。使用阳性和阴性症状量表（PANSS）测量精神病症状，使用精神病洞察力评估表（SIP）评估疾病洞察力，使用自我照顾能力评估量表评估自我照顾能力。采用SPSS中PROCESS Macro模型4和模型1进行中介和调节分析，控制人口统计变量。结果：在精神病症状与自我照顾能力的关系中，对疾病的洞察既是中介又是调节因子。具体而言，对疾病的洞察通过部分缓解精神病症状对自我照顾能力的不良影响而介导了这种关系。此外，对疾病的洞察力起到了调节作用，更深刻的洞察力显著降低了精神病症状对个人自我照顾能力的影响。结论：提高对疾病的认识对于帮助慢性精神分裂症患者控制精神病症状和提高自我保健能力至关重要。心理健康护士应优先考虑旨在提高洞察力的干预措施，这可能会显著提高自我保健和整体生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Asian Nursing Research NURSING-

CiteScore

4.20

自引率

4.50%

发文量

审稿时长

45 days

期刊介绍： Asian Nursing Research is the official peer-reviewed research journal of the Korean Society of Nursing Science, and is devoted to publication of a wide range of research that will contribute to the body of nursing science and inform the practice of nursing, nursing education, administration, and history, on health issues relevant to nursing, and on the testing of research findings in practice.