First- Episode Schizophrenia
Conditions
Keywords
Mobile -based family psychoeducation, Expressed emotion, Medication adherence, First-episode schizophrenia, Randomized controlled trial
Brief summary
This study examined the effects of family psychoeducation program via line application on expressed emotion of family members and medication adherence in patients with first-episode schizophrenia.
Detailed description
The investigators examined if LINE family Psychoeducation Program plus routine treatment is effective for reducing Expressed Emotion and improving Medication Adherence in real practice. Family members and patients with first-episode schizophrenia received a 7-week online family psychoeducation program via the LINE application, while the control group received routine care. Family caregivers completed the Thai Expressed Emotion Scale (TEES) and the Medication Adherence Report Scale (MARS). Baseline assessments were conducted prior to group allocation. Post-intervention assessments were conducted at week 8. Intervention fidelity was monitored through weekly quizzes and researcher oversight.
Interventions
BEHAVIORALMobile based family psychoeducation program
A structured 7week Online Psychoeducation Program delivered via the LINE application. The program was developed based on the Vulnerability Stress Model and aimed to reduce expressed emotion among family caregivers and improve medication adherence in patients with first-episode schizophrenia. The intervention consisted of seven video-based sessions, each lasting no more than 10 minutes, delivered weekly over seven consecutive weeks through a private LINE chat. Content covered program orientation, knowledge about schizophrenia, medication management and adherence, stigma and coping strategies, expressed emotion and family communication, stress management, and early warning signs of relapse.
Sponsors
Mahidol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Intervention model description
A structured 7week Online Psychoeducation Program delivered via the LINE application. The program was developed based on the Vulnerability Stress Model and aimed to reduce expressed emotion among family caregivers and improve medication adherence in patients with first-episode schizophrenia. The intervention consisted of seven video-based sessions, each lasting no more than 10 minutes, delivered weekly over seven consecutive weeks through a private LINE chat. Content covered program orientation, knowledge about schizophrenia, medication management and adherence, stigma and coping strategies, expressed emotion and family communication, stress management, and early warning signs of relapse.
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
for patients were: * a diagnosis of schizophrenia according to the International Classification of Diseases, 10th Revision ICD-10 (F20.00 to F20.09), with a duration of illness not exceeding five years from the date of initial diagnosis * received oral antipsychotic treatment for at least 6 months but no longer than five years * aged between 18 to 35 years. * mild psychotic symptoms severity, defined as a total score of 18 to 36 on the Brief Psychiatric Rating Scale (BPRS) * documented history of medication non-adherence, as recorded in medical records * availability of a primary caregiver and * ability to communicate in Thai and via telephone using the LINE application Inclusion criteria for family members were: * being a family member living in the same household as the patients and serving as the primary caregiver for at least six months without financial compensation * Aged 20 to 60 years * ownership of a mobile phone capable of using the LINE application * no prior participation in family psychoeducation programs * ability to speak, read, and write Thai * no history of psychiatric disorders, including schizophrenia, bipolar disorder, or major depressive disorder.
Exclusion criteria
for both patients and caregivers were: * acute exacerbation of psychotic symptoms requiring hospitalization during the study period * missing one or more scheduled intervention sessions * inability of the researcher to contact the family caregiver within one week despite repeated attempts.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Expressed Emotion | From enrollment (week 1) to post treatment at week 8 | Expressed Emotion was measured using the Thai Expressed Emotion Scale (TEES), developed by Sunpaveerawong. The instrument consists of 49 items encompassing seven components of expressed emotion. Negative expressed emotion includes Critical Comments (items 1-7), Hostility (items 8-15), Emotional Overinvolvement (items 16-20), and Emotional Under involvement (items 42-49), totaling 28 items. Positive expressed emotion includes Warmth (items 21-27), Positive Remarks (items 28-34), and Emotion Regulation (items 35-41), totaling 21 items. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Medication Adherence | From enrollment (week 1) to post treatment at week 8 | was assessed using the Medication Adherence Report Scale (MARS), The instrument consists of 5 items evaluating non-adherent behaviors: forgetting to take medication, altering dosage, temporarily stopping medication, intentionally skipping doses, and taking less medication than prescribed. Each item is rated on a 5-point Likert scale (1-5). A total score of 25 indicates full adherence, whereas scores \<25 indicate some degree of non-adherence. |
Countries
Thailand
Contacts
STUDY_CHAIRYajai Sitthimongkol, PhD
Faculty of Nursing, Mahidol University
Outcome results
None listed