Impact of Acceptance and Commitment Therapy (ACT) on Medication Adherence of People with Schizophrenia

  • Apri Rahma Dewi Nursing Department, Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Indonesia
  • Achir Yani S Hamid Mental Health Nursing Department, Faculty of Nursing, Universitas Indonesia, Indonesia
  • Herni Susanti Nursing Department, Sekolah Tinggi Ilmu Kesehatan Panca Bhakti, Indonesia
Keywords: schizophrenia, acceptance and commitment therapy, medication adherence

Abstract

Ineffective health management and adherence are the problems of mentally ill patients. Thus, if left untreated, they could create significant disadvantages for clients, their families, the community, and even the government.  This case study aimed to identify the effect of Acceptance and Commitment Therapy (ACT) on clients with Ineffective health management and to identify adherence, acceptance, and commitment to the regimen. The research approach used in this study was case study conducted on 5 respondents consisting of mentally ill patients with Ineffective health management. The ACT was given for 4 sessions through two to four meetings. The analyzed clients were measured using MARS (Medication Adherence Rating Scale). After the client was given ACT and nursing intervention, the adherence increased by 71% (14 points), and the acceptance ability and commitment increased to 70% on five clients. Medication adherence, acceptance, and commitment levels were lower in the younger clients, who get stigma and lack of family support. Mentally ill patients given ACT will survive more than others without ACT because they have agreed to stay healthy by taking medication regularly. So, this study recommended ACT to increase the health management of mentally ill patients as the approach to increase adherence and commitment to treatment.

References

Abdullah-Koolmees, H., et al. (2018). Predicting rehospitalization in patients treated with antipsychotics: a prospective observational study. Therapeutic Advances in Psychopharmacology, 8(8), 213–229. DOI: 10.1177/ 2045125318762373

Antiss, T. & Blonna, R. (2015). Acceptance and Commitment Therapy. Mastery of Coaching

Bach, P., & Hayes, S. C. (2002). The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 70, 1129-1139.

Bai, T., Xie, W., Wei, Q., Chen, Y., Mu, J., Tian, Y., & Wang, K. (2017). Electroconvulsive therapy regulates emotional memory bias of depressed patients. Psychiatry Research, 257, 296–302.

Brain, Cecilia. (2014). Stigma, discrimination and medication adherence in schizophrenia. Psychiatry research, 220(3), 811.

Chan AHY, Horne R, Hankins M, Chisari C. The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence. Br J Clin Pharmacol, 86(7), 1281-1288. doi:10.1111/bcp.14193.

Çiftçi, B et al. (2015). What Level of Self-Care Agency in Mental Illness? The Factors Affecting Self-Care Agency and Self-Care Agency in Patients with Mental Illness. Archives of Psychiatric Nursing, 29, 372–376. doi.org/10.1016/j.apnu.2015.06.007

Eifert, G. & Forsyth, J.P. (2005). Acceptance and commitment therapy for anxiety disorders: a practitioners treatment guide to using mindfulness, acceptance, and values based behaviour change strategies. Oakland CA

Gellad,W.F., Grenard, J.L & Marcum ZA.(2011). A systematic review of barriers to medication adherence in the elderly: looking beyond cost and regimen complexity. Am J Geriatr Pharmacother, 9, 11–23.

Hanssen, H., & Sommerseth, R. (2014). Den familiære relasjonens betydning for pårørendes behov i møte med helsetjenesten. (Norwegian). Nordic Magazine for Health Research / Nordisk Tidsskrift for Helseforskning, 10(2), 62–75.

Hasson-Ohayon, I., Levy, I., Kravetz, S., Vollanski-Narkis, A., & Roe, D. (2011). Insight into mental illness, self-stigma, and the family burden of parents of persons with a severe mental illness. Comprehensive Psychiatry, 52(1), 75–80

Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665. doi:10.1016/S0005-7894(04) 80013-3.

Herdman, & S. Kamitsuru (Eds.). (2014). NANDA International nursing diagnoses: Definitions and classification, 2015‐2017. Wiley‐Blackwell.

Hoare, P. N., Mcilveen, P., & Hamilton, N. (2012). Acceptance and commitment therapy (ACT) as a career counselling strategy. International Journal for Educational and Vocational Guidance, 12(3), 171-187. doi:http://remote-lib.ui.ac.id:2090/10.1007/s10775-012-9224-9

Holubova, Michaela et al. (2016). Coping strategies and self-stigma in patients with schizophrenia-spectrum disorders. Journal: Patient preference and adherence, 10, 1151-1158. DOI: 10.2147/PPA.S106437

James, D.L., Jennifer, E.B. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71(12), 2150-2161

Jonsdottir H,Friis S,Horne R,Pettersen KI,Reikvam A,Andreassen OA. (2009). Beliefs about medications: measurement and relationship to adherence in patients with severe mental disorders. Acta Psychiatr Scand, 119, 78–84

Jung, S.H., Kim, W.H., Choi, H.J., et al. (2011). Factors affecting treatment discontinuation and treatment outcome in patients with schizophrenia in Korea:10-year follow-up study. Psychiatry Invest, 8, 22–29

Kaplan, H.I., Sadock, B.J., & Greb, J.A. (2010). Sinopsis Psikiatri: Ilmu pengetahuan Perilaku Psikiatri Klinis. Binarupa Aksara

Kondrátová, L., König, D., Mladá, K. et al. (2019). Correlates of Negative Attitudes towards Medication in People with Schizophrenia PsychiatrQ,90, 159. 2067/10.1007/s11126-018-9618-z

Laan,W., Does, Y., Sezgi, B., et al. (2010). Low treatment adherence with antipsychotics is associated with relapse in psychotic disorders within six months after discharge. Pharmacopsychiatry, 43, 221–224.

Marc, Emos et al. (2001). Relationship Between Age, Health Beliefs and Adherence in Kidney Transplant Recipients (KTRs). American journal of kidney diseases, 71(4), 536. DOI: 10.1053/j.ajkd.2018.02.090

RISKEDAS (2013) at: http://www.depkes.go.id/article/view/201410270010/lighting-the-hope-for-schizoprenia-warnai-peringatan-hari-kesehatan-jiwa-tahun-2014.html#sthash.ECMh3ETT.dpuf

RISKEDAS (2018) at: http://www.depkes.go.id

Semiun, Y. (2006). Teori Kepribadian dan Terapi Psikoanalitik Freud. Yogyakarta

Stansfeld, S., Smuk, M., Onwumere, J., Clark, C., Pike, C., McManus, S., Harris, J., & Bebbington, P. (2014). Stressors and common mental disorder in informal carers – An analysis of the English Adult Psychiatric Morbidity Survey 2007. Social Science & Medicine, 120, 190–198

Vigod, S. N., Kurdyak, P. A., Dennis, C. L., Leszcz, T., Taylor,V. H., Blumberger,D. M.,& Seitz,D. P. (2013). Transitional interventions to reduce early psychiatric readmissions in adults: Systematic review. British Journal of Psychiatry, 202(3), 187–194. doi:10.1192/bjp.bp.112.115030

WHO. (2017). Mental Disorders. Retrieved from http://www.who.int/mediacentre/factsheets/fs396/en/

Published
2023-09-08
How to Cite
1.
Apri Rahma Dewi, Hamid AYS, Susanti H. Impact of Acceptance and Commitment Therapy (ACT) on Medication Adherence of People with Schizophrenia. NHSJ [Internet]. 2023Sep.8 [cited 2023Oct.2];3(3):313-9. Available from: https://nhs-journal.com/index.php/nhs/article/view/267