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Purpose <p>KUPAA is a culturally adapted version of Family Psychoeducation (FPE) that has shown to be beneficial to people living with schizophrenia-spectrum disorders (PLWS), who may experience limitations across multiple functional domains. Family Psychoeducation can lead to improvement in functional outcomes that align with recovery goals; however, the mechanisms of action are unclear. The current study objective is to identify mechanisms by which the KUPAA intervention reduces disability and improves quality of life among care-seeking PLWS in Tanzania.</p> Methods <p>This clinical trial was conducted at Muhimbili National Hospital and Mbeya Zonal Referral Hospital and included a total of 66 dyads composed of PLWS ages 18–50 years and their caregivers. A causal mediation framework employing the g-formula was used to estimate the indirect effects of the KUPAA intervention on disability and quality of life, through the mediated pathways of hopefulness, self-stigma and generalized self-efficacy.</p> Result <p>A greater decrease in mean disability score and increase in quality of life score was observed among KUPAA participants, compared to controls. We found that generalized self-efficacy mediates 33% of the effect of KUPAA on quality of life and generalized self-efficacy and hope each mediate 36% of the effect of KUPAA on disability.</p> Conclusion <p>Results provide preliminary support for the hypothesis that KUPAA can reduce disability and improve quality life by reducing stigma, increasing hope and strengthening self-efficacy. Future psychosocial programs for PLWS should consider tailoring their interventions to focus on reducing stigma, increasing hope and fostering self-efficacy.</p>

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Mediators of functioning and quality of life among people living with schizophrenia participating in the culturally adapted family psychoeducation (KUPAA) trial in Tanzania

  • 期刊论文

  • 发表日期：

    2025年4月4日

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  • Joseph R. Egger,
  • Sylvia Kaaya,
  • Paul Lawala,
  • Praxeda Swai,
  • Beatrice Thadei,
  • Anna Minja,
  • Kayla Hendrickson,
  • Madeline Jin Van Husen,
  • Ellen Lukens,
  • Ezra Susser,
  • Lisa Dixon,
  • Joy Noel Baumgartner

摘要

Purpose

KUPAA is a culturally adapted version of Family Psychoeducation (FPE) that has shown to be beneficial to people living with schizophrenia-spectrum disorders (PLWS), who may experience limitations across multiple functional domains. Family Psychoeducation can lead to improvement in functional outcomes that align with recovery goals; however, the mechanisms of action are unclear. The current study objective is to identify mechanisms by which the KUPAA intervention reduces disability and improves quality of life among care-seeking PLWS in Tanzania.

Methods

This clinical trial was conducted at Muhimbili National Hospital and Mbeya Zonal Referral Hospital and included a total of 66 dyads composed of PLWS ages 18–50 years and their caregivers. A causal mediation framework employing the g-formula was used to estimate the indirect effects of the KUPAA intervention on disability and quality of life, through the mediated pathways of hopefulness, self-stigma and generalized self-efficacy.

Result

A greater decrease in mean disability score and increase in quality of life score was observed among KUPAA participants, compared to controls. We found that generalized self-efficacy mediates 33% of the effect of KUPAA on quality of life and generalized self-efficacy and hope each mediate 36% of the effect of KUPAA on disability.

Conclusion

Results provide preliminary support for the hypothesis that KUPAA can reduce disability and improve quality life by reducing stigma, increasing hope and strengthening self-efficacy. Future psychosocial programs for PLWS should consider tailoring their interventions to focus on reducing stigma, increasing hope and fostering self-efficacy.