Work

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

Year: 2025

Type: article

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.

Source: Asian Nursing Research

DOI: 10.1016/j.anr.2025.10.004

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

Institutions: National Yang Ming Chiao Tung University, Ministry of Health and Welfare, Bali Psychiatric Center, University of South Florida

Language: English

Topic: Schizophrenia research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,500