Satir model-based health literacy programme for behaviour modification in patients with stable schizophrenia.

Abstract

Objectives: To develop a Satir model-based health literacy programme for individuals with stable schizophrenia and evaluate its effects on health literacy, health behaviours, relapse prevention, and key metabolic indicators.

Methods: The study comprised three phases: (1) situation analysis and health literacy survey in 972 outpatients with stable schizophrenia, (2) programme development and validation by five experts, and (3) a 12-week quasi-experimental pilot study in 24 outpatients with stable schizophrenia. Outcome measures included health literacy, health behaviours, relapse prevention behaviours, and metabolic indicators.

Results: In total, 15 men and nine women (mean age, 43.0 years) with stable schizophrenia completed the programme. After intervention, health literacy significantly improved (d = 0.56, p = 0.012), particularly in the accessing domain (d = 0.93, p < 0.001), while improvements in the understanding (d = 0.41, p = 0.055), appraising, and applying domains were not significant. Health behaviours also significantly improved (d = 0.61, p = 0.006), with a trend towards improved dietary habits (p = 0.051). Relapse prevention behaviours also significantly improved (d = 0.54, p = 0.015), particularly in the early warning sign monitoring domain (d = 0.45, p = 0.038). Triglyceride levels significantly decreased by a mean of 47.29 mg/dL (r = 0.59, p = 0.025), while HDL cholesterol significantly increased by a mean of 4.83 mg/dL (d = 0.69, p = 0.003).

Conclusions: The Satir model-based health literacy programme is feasible for rehabilitation in patients with stable schizophrenia. By fostering personal responsibility and intrapersonal restructuring, the programme empowered patients towards active self-regulation. Addressing the internal 'iceberg' is essential for sustainable metabolic health and recovery in schizophrenia.