An assessment of the psychoeducational needs of long-term psychiatric patients

Objectives: We aimed to identify which illness related topics were of most interest to chronic psychiatric patients in our catchment area service, and to obtain a baseline measure of the amount of knowledge which patients with schizophrenia had about their illness. Method: Patients attending for a minimum of one year were recruited from the outpatient clinic and day centre. Participants completed three instruments: a brief questionnaire which asked about the details of their diagnosis and drug treatment regimen, the 'Educational Needs Questionnaire' (ENQ), and a modified form of the 'Understanding Schizophrenia Scale' (USS). Results: Forty-seven patients with a chronic psychotic illness participated in the study. Despite having attended the service for an average of 14 years, the majority of patients were unable to correctly identify their diagnosis. Most patients were able to name the drugs which they had been prescribed, but were not able to describe the dosage of these drugs. According to the ENQ results, patients expressed most interest in learning about general aspects of their illness, such as 'how to cope with stress', and less in how to manage specific illness related symptoms. Similarly, schizophrenia patients were found to know more about general aspects of their illness, such as rehabilitation and non-medical aspects of treatment, than about medication. Conclusion: Chronic psychiatric patients, especially those with schizophrenia, have very limited knowledge of their illness and its treatment. The focus of psychoeducation should be extended from insight and compliance to include broader 'quality of life' issues which appear to be of more concern to patients themselves. Patient participation in psychoeducation can thus be improved by including topics identified by such instruments as the ENQ. It is encouraging that cognitive deficits and negative symptomatology do not seem to prevent long-term psychiatric patients from benefiting from such inputs.