Effectiveness of a peer-led self-management programme for people with schizophrenia: protocol for a randomized controlled trial.
OBJECTIVE
To determine the effectiveness of a peer-led self-management programme for people with schizophrenia in reducing psychotic symptom severity, hospital readmission and psychiatric consultation and in enhancing cognition, empowerment, functioning level, medication adherence, perceived recovery, quality of life and social support.


BACKGROUND
Several self-management programmes have been developed to empower patients with severe mental illness in achieving recovery. Research suggests that peer-led self-management programmes have positive effects on patient recovery. However, the existing evidence is inconclusive, due to a lack of credible evidence and long-term follow-up evaluations.


METHODS
A stratified randomized controlled trial will be conducted at six community mental health rehabilitation centres


METHODS
A sample of 242 adults with schizophrenia will be recruited. A peer-led self-management programme, comprising six 2-hour sessions, will be implemented in the intervention group and a standard rehabilitation programme in the control group. Outcomes will be measured at baseline, postintervention and at the 6- and 12-month follow-ups. The measures will include cognition, empowerment, functioning level, medication adherence, perceived recovery, quality of life, social support, symptom severity, hospital readmission and psychiatric consultation. A mixed effects model will be used to analyse the results. Semi-structured interviews will be conducted to explore the peer-trainers' and participants' perspectives on the programme. Research Ethics Committee approval was obtained in December 2011 and funding was obtained in January 2012.


CONCLUSIONS
This study will provide evidence on the effectiveness of a peer-led self-management programme for patient recovery. It will identify a clinically useful and potentially effective intervention that incorporates empowerment concept.
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Sally Wai Chi
SW
Chan
Ziqiang
Z
Li
Piyanee
P
Klainin-Yobas
Steven
S
Ting
Moon Fai
MF
Chan
Pui-Wai
PW
Eu
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010379:Peer Group; D011209:Power, Psychological; D015397:Program Evaluation; D011788:Quality of Life; D012559:Schizophrenia / Q000534:rehabilitation*; D012648:Self Care / Q000523:psychology*; D012657:Self-Help Groups; D012846:Singapore; D012944:Social Support
empowerment; nurse; peer-led; peer-to-peer; protocol; randomized controlled trial; recovery; schizophrenia; self-management