Measuring Social Integration among Patients with Schizophrenia: Testing the Reliability of the Social Integration Scale in a Non-Western Setting

Abstract

Background: Social integration is a multidimensional construct that is thought to include both the behavioral component of active engagement in a wide range of activities and/or social relationships and the cognitive component of a sense of communality and identification with one’s social roles. Patients with schizophrenia have been described as being ‘in the community but not of the community’. Although patients with schizophrenia have adequate social networks, their level of engagement is low. Aim: To determine the social integration of patients with schizophrenia using the Social Integration Scale, and to determine the feasibility of using the Social Integration Scale in a non-western country. Methods: This study was conducted among outpatients with schizophrenia attending the Out-Patient Clinic of the Neuropsychiatric Hospital, Abeokuta, Nigeria, aged 18-65 years. MINI-PLUS, PANSS, WHOQOL-BREF and SIS were administered to consenting participants. Results: The mean (SD) age of participants were 40.9 (9.0) years, 52% were males, 42% were single, the mean (SD) age of onset of illness was 29.1 (8.8) years, 48% of them had greater than 10 years of illness duration, and 90% has had multiple episodes. PANSS shows a mean (SD) PANSS positive scale score of 8.46 (2.94), mean (SD) overall QOL score of 3.88 (1.15) and mean (SD) general health score of 4.02 (1.08). The Cronbach’s alpha of the SIS was 0.86, and factor analysis yielded 4 factors: 1) community participation, 2) giving and receiving help; 3) connectedness, and 4) initiation of social interactions. Conclusion: The SIS is a valid measure of social integration among patients with schizophrenia in Nigeria.