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1 Structure of Illness Insight in Patients with Schizophrenia Hiromi AbSugawara Chizuru Mori Key Words illnessinsight, schizophrenia, drug-taking attitude Drug Attitude Inventory DAI Schedule for Assessment of Insight SAI-J SAI-J DAI Weiden Health Locus of Control HLCRotter Locus of Control LOC HLC National Hospital Organization Shimofusa Psychiatric Center University of Tsukuba Graducate School of Comprehensive Human Sciences Vol. No.

2 Internals Externals Internals Externals HLC HLCInternals Externals HLC HLC CHLC Chance Health Locus of Control HLC HLC HLC HLC HLC Internals Externals HLC Externals HLC SAI-JBrief Psychiatric Rating Scale BPRSSAI-J BPRS Schedule for Assessment of Insight SAI-JSAI-J Social Skills Training SST David SAI-J Health Locus of Control Vol. No.

3 BPRS-NM SAI-J SECL LSP Health Locus of Control JHLC DAI- The Schedule for Assessment of Insight SAI-J Brief Psychiatric Rating Scale Nursing Modification BPRS-NM Health Locus of Control JHLC Drug Attitude Inventory DAI- Self-Efficacy for Community Life scalsecl Life Skills ProfilLSP Health Locus of Control Lee HLC ICD- DSM- Vol. No.

4 Brief Psychiatric Rating Scale Nursing Modification BPRS-NMOverall Gorham Brief Psychiatric Rating Scal BPRS-NM Life Skills ProfileLSP LSP Rosen Parker Self-Efficacy for Community Life scal SECLSECL HLC Health Locus of Control JHLCJHLC Drug Attitude Inventory DAIDAI Hogan DAI DAI- DAI- Schedule for Assessment of Insight SAI-J SAI-J SAI-J David BPRS-NM LSP DAI- SAI-J IC SECL JHLC SPSS. J Amos. J Vol. No.

5 Cronbach α IC SAI-J SAI-J SAI-J... rang.. rang... rang ChlorpromazinCP. mg. range. BPRS-NM.. range CP BPRS CP : chlorpromazine BPRS : Brief Psychiatric Rating Scale-NM Vol. No.

6 SAI-J α. SAI-J..rang SAI-J..rangeSAI-J..range SAI-J..range SAI-J DAI- SECL JHLC JHLC- JHLC- JHLC- JHLC- JHLC- Cronbach α LSP LSP-. LSP-. LSP-. LSP-. LSP-. SAI-J The Schedule for Assessment of Insight DAI- Drug Attitude Inventory SECL Self-Efficacy for Community Life scale JHLC Health Locus of Control LSP Life Skills Profile α. LSP-α. LSP-..range LSP-.. rangelsp-..ranglsp-..ranglsp-..range DAI- DAI- α. DAI-.. range SECL α. SECL..rang JHLC JHLC- α. JHLC- α. JHLC- α. JHLC- α. JHLC- α. JHLC-..rangJHLC-..rangJHLC-..rang JHLC-..rang JHLC-.. rang LSP LSP-α. LSP- α. LSP-α. LSP- SAI-JSAI-JDAI- SAI DAI- r. p. SAI-J DAI- r. p. SAI-J DAI- r. p. SAI-J DAI- SAI-JSAI-J SECL SAISAI-J SAI-J Vol. No.

7 JHLC SAI-JSAI-J JHLC- JHLC- DAI- SECL r. p. r. p. SAI-J DAI- r. p. r. p. JHLC- SAI-J The Schedule for Assessment of Insight DAI- Drug Attitude Inventory JHLC Health Locus of Control DAI- JHLC JHLC- JHLC- JHLC- JHLC- JHLC- JHLC- JHLC- JHLC- r. p. SAI-J SAI-JSAI-J SAI-J SAI-J Vol. No.

8 . p.cfi.gfi. RMSEA. SECLJHLC- DAI-SAI-J JHLC LSP SAI-J.. SAI-J.. SAI-J SAI-J.. SAI-J. SAI-J SAI-J... e JHLC-. DAI- e.... SAI-J. SAI-J.. SECL. e. Vol. No.

9 .DAI-.. DAI-. HLC-... SAI-J SAI-J SAI-J Aaron DAI- DAI- DAI- DAI- SAI-J Philip Philip SECL SECL JHLC- JHLC- Vol. No.

10 JHLC- SAI-J DAI- SAI-J DAI- DAI- SAI-J DAI- DAI- BPRS-NS Vol. No.

11 SAI-J HLC SAI-J The objective of this study was to elucidate the factors affecting schizophrenia patients awareness of their illness, so that nursing interventions can be devised to enhance levels of insight in these patients. We investigated the following in participants with schizophrenia: the Japanese version of the Schedule for Assessment of Insight SAI-J, drug-taking attitude, health locus of control HLC, knowledge of disease/medication, experience in relation to disease/medication, psychotic symptoms, type of treatment, the attending physician s explanation of informed consent, and self-efficacy. Additionally, we conducted semi-structured interviews. Information on such factors as the participants awareness of their disease, drug-related experiences, emotions, and state of acceptance were extracted from an analysis of the interview results. Covariance structure analysis was used to examine the total scores of the individual scales and categories so as - to construct a path model for illness insight. The objective standpoint of the disease experience influenced the SAI-J and drug-related experience scores, leading to the emergence of feelings regarding medication. This affected the total scores on the drug-taking attitude scale. Our findings indicated that nursing intervention that improves insight should be able to help patients to take an objective standpoint of their disease experience and to express their medication-related experiences..,, -,. Hoffman, R, McGlashan, T: Corticocortical connectivity, autonomous network, and schizophrenia. Schizophrenia Bull,, -,..,, -,..,, -,.,.,, -,..,, -,..,, -,..,, -,.,,, -,. Weiden, P, Rapkin B, et al: Rating of medication influence ROMI Scale in Schizophrenia. Schizophrenia Bull,, -,.,.,, -,. Health Locus of Control.,, -,. Health Locus of Control.,, -,. HLC., -,. Vol. No.

12 ,,.,, -,.,, Health Locus of Control Health Locus of Control.,, -,. Health Locus of Control.,, -,.,,.,, -,..,, -,.. Review,, -,.,, SAI-J, DAI-.,, -,..,, -,..,, -,.. Schizophrenia Frontier,, -,. SST.,, -,. David, A, Buchanan, A, et al: The Assessment Insight in Psychosis. British Journal Psychiatry,, -,. Lee, C: Self-efficacy and behavior as predictors of subsequent behavior in an assertiveness training programme. Behav Res Ther,, -.. Overall, J E, Gorham, D R: The Brief Psychiatric Rating Scale. Psychological Reports,, -..,, Life Skills Profile LSP.,, -,.,, SECL.,, -,.,, Health Locus of Control.,, -,. Hogan, T P, Awad, A G, et al: A self-report scale predictive of drug compliance in schizophrenics. reliability and discriminative validity, Psychol Med,, -,.,, Drug Attitude Inventory.,, -,..,, -,.,, The Schedule for Assessment of InsightSAI-J.,, -,. Beck, A T, Baruch, E, et al: A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophrenia Research s -, -,.. -,,,. Philip D,,. -,,,.,, SECL.,, -,..,, -,..,, -,. Vol. No.

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