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The use of a Subjective wellbeing scale as predictor of adherence to neuroleptic treatment to determine poor prognostic factor in African population with Schizophrenia

Published online by Cambridge University Press:  19 July 2023

J. J. Boshe*
Affiliation:
1Mental health and Psychiatry, Kilimanjaro Christian Medical Center, Kilimanjaro, Tanzania, United Republic of 2Mental health and Psychiatry, University of Cape town, Cape town
D. Stein
Affiliation:
2Mental health and Psychiatry, University of Cape town, Cape town
M. Campbell
Affiliation:
3Rhodes University, Johannesburg, South Africa
*
*Corresponding author.

Abstract

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Introduction

Subjective well-being when on neuroleptic treatment (SWBN), has been established as a good predictor of adherence, early response and prognosis in patients with schizophrenia. The 20-item subjective well-being under neuroleptic treatment scale (SWN-K 20) is a self-rating scale that has been validated to measure SWBN. However the SWN-K20 has not been previously used to explore psychosocial and clinical factors influencing a low SWN-K20 score in an African population. This study uses the the SWN-K 20 scale among Xhosa speaking African patients with Schizophrenia to determine factors associated with SWBN in this population

Objectives

To investigate and identify demographic and clinical predictors of subjective well-being in a sample of Xhosa people with schizophrenia on neuroleptic treatment.

Methods

As a part of a large genetic study, 244 study participants with a confirmed diagnosis of schizophrenia completed the translated SWN-K 20 scale. Internal consistency analysis was performed, and convergent analysis and exploratory analysis were conducted using Principal Component Analysis (PCA). Linear regression methods were used to determine predictors of SWBN in the sample population.

Results

When translated into isiXhosa, the sasubscales of SWN-K 20 on their own were observed to be less reliable when compared to the scale in its entirety,internal consistency of 0.86 vs0. 59-0.47. The subscales were therefore noted to be not meaningful in measuring specific constructs but the full scale could be used to determine a single construct of general wellbeing.The validity of the SWN-K20 was further confirmed by moderate correlation scores with Global Assesment functioning scores (GAF), 0.44.There was a significant correlation between overall subjective well-being score with higher education level, and increased illness severity and GAF scores.

Conclusions

Patients’ perception of well-being while on neuroleptic treatment is an essential area of focus when aiming at improving patient centred treatment, compliance and overall treatment outcome. Treating individuals with SMI is difficult and made more complex when patient’s treatment experience and expectations are not elicited. Having a self-reported measurement like the SWN-K 20 available in a validated Xhosa language version provides helpful, possibly broad insights into the subjective well-being experiences of this patient group. Future studies should explore specific symptoms domains that are associated with a change in subjective wellbeing instead of general illness severity.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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