Modelling of self-management in schizophrenia: The role of neurocognition, self-efficacy and motivation

Aims and objectives This study aimed to address the interrelationships among neurocognition, self-efficacy, motivation and self-management in individuals with schizophrenia. Background Self-management performance of individuals with schizophrenia is relatively poor. The effect of neurocognitive impairment on self-management in schizophrenia remains inconsistent, which may be attributed to the neglect of possible mediating factors. Little attention has been given to the role of motivation and self-efficacy for linking neurocognition to self-management. Design A cross-sectional study. Methods Three hundred and twenty patients were recruited with convenience sampling in this study. Patients' neurocognitive function, self-efficacy, motivation and self-management behaviours were measured. Pearson or Spearman correlation analysis and path analysis were performed to examine the interrelationships. This study followed STROBE checklist for cross-sectional studies (see Appendix S1). Results The final model, with good fit indices, revealed that (1) neurocognition, self-efficacy and motivation were directly associated with self-management, (2) self-efficacy and motivation partly mediated the impact of neurocognition on self-management and (3) motivation additionally mediated the association of self-efficacy and self-management. Conclusions Our study extends the current findings, indicating that self-efficacy and motivation may act as mediators in the relationship between neurocognition and self-management in schizophrenia. Relevance to clinical practice Mental health professionals should pay attention to interventions targeting both cognitive and psychosocial components to enhance self-management in individuals with schizophrenia.