Metacognitive Abilities within Personal Narratives of Inpatients with Schizophrenia: Associations with Clinical Insight and Drug Compliance

Abstract

Psychiatric nurses face many challenges in providing effective care for patients with schizophrenia who have poor insight. The understanding of metacognitive functions in schizophrenia may form a richer idea of why some patients deny illness and decline treatment, and may allow for further consideration of effective psychiatric care.  This study aimed to assess the metacognitive abilities within personal narratives among inpatients with schizophrenia and to investigate its relationship with clinical insight and drug compliance. The study followed a cross- sectional descriptive correlational research design. It was conducted on 65 male inpatients with schizophrenia, at El-Maamoura Hospital for Psychiatric Medicine in Alexandria, Egypt. Indiana Psychiatric Illness Interview was used to elicit a narrative of self and illness, the narratives of the study subjects were rated using the metacognitive assessment scale concurrently with the assessment of clinical insight and drug compliance. The results revealed a statistical significant positive correlation between metacognitive abilities, clinical insight and drug compliance. It was concluded that poor insight and drug non-compliance might be significantly improved when considering the metacognitive measures.  Recommendations encompassed that metacognitive assessment should be integrated in psychiatric care of inpatients with schizophrenia. A form of integrative psychotherapeutic intervention that could promote insight and drug compliance through stimulating metacognitive abilities should be developed in patients with schizophrenia. Replication of the study is also required on more diverse and larger groups of patients.

Keywords: Metacognitive abilities, Narratives, Schizophrenia, Clinical Insight, Drug compliance.

DOI: 10.7176/JEP/10-1-13