A Causal Model of Personal Recovery Among People with Schizophrenia: A Cross-Sectional Study
DOI:
https://doi.org/10.60099/prijnr.2025.273106Keywords:
Cognitive insight, Coping self-efficacy, Negative emotions, Personal recovery, Schizophrenia Spectrum Disorders, Self-esteem, Social functioning, Social supportAbstract
Personal recovery in schizophrenia involves reclaiming autonomy and meaning beyond symptom remission, but is little studied. Examining the factors that shape this journey is critical for informing person-centered interventions, enhancing resilience, and improving long-term quality of life. This study developed and tested a causal model of factors influencing personal recovery in 315 patients with schizophrenia across five psychiatric hospitals in Thailand, using cross-sectional data and structural equation modelling. Data were gathered from validated measures of Recovery processes, Self-esteem, Anxiety and Depression, Cognitive Insight, Coping Self-efficacy, Social Support, and Personal-Social Performance, then analyzed with SPSS 26.0 and Mplus 7.0.
Participants reported moderate levels of personal recovery, and the final model, explaining 50% of variance, identified self-esteem as the most powerful driver, directly boosting recovery and buffering negative emotions. Negative emotions emerged as a significant risk factor undermining recovery. Cognitive insight further promoted recovery both directly and by easing negative emotions. Social support enhances recovery by uplifting self-esteem, strengthening coping confidence, and alleviating negative emotions. High coping self-efficacy also directly improved recovery and social functioning, although social functioning did not independently predict recovery. These results highlight the importance of integrating nursing interventions that build self-esteem, sharpen cognitive insight, reinforce coping skills, expand social support, and manage negative emotions to foster a positive recovery cycle in schizophrenia care.
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