The effect of home visits on self-efficacy in patients with schizophrenia: A clinical trial

Document Type : Research Paper


1 Instructor in health and psychiatry nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

2 MSc. in psychiatry nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

3 Instructor, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran


Introduction: One of the major problems of chronic patients such as schizophrenic patients with is difficulty in being able to take care of them and impose psychological burden on the family. This study aimed to determine the effect of home visits on self-efficacy in patients with schizophrenia.
Materials and Methods: In this clinical trial in 2017-2018, 60 patients with schizophrenia who admitted in Ibn-e-Sina hospital of Mashhad-Iran were randomly divided into experimental and control groups. The experimental group received the home visit program based on a community-based mental health group management method for two months (four to six 45-60 minute sessions), while the control group received routine care. The self-efficacy of both groups was measured by a general self-efficacy questionnaire before the intervention and at the end of the second month. Data were analyzed by SPSS software version 16 and descriptive statistics and independent t-test, Mann-Whitney, paired t-test, Wilcoxon, and Chi-square.
Results: The results showed that the mean score of self-efficacy in the two groups before the intervention was not statistically significant (P= 0.52) but after the intervention, self-efficacy score in the experimental group was significantly higher than the control group (P< 0.001). The results of Wilcoxon test also showed that the mean score of self-efficacy in experimental group was higher significantly in the post-intervention phase (P< 0.001)
Conclusion: The results of this study showed the positive effect of home visiting program on improving self-efficacy in schizophrenic patients. Therefore, it is recommended to use this program in empowering these patients.


  1. Haresabadi M, Bibak B, Hosein zadeh E, Bayati M, Arki M, Akbari H. [Assessing burden of family caregivers of patients with schizophrenia Admitted in Imam Reza hospital-Bojnurd 2010]. Journal of North Khorasan University of Medical Sciences 2012; 4(2): 172-80. (Persian)
  2. Jufang L, Lambert E, Lambert A. Predictors of family caregivers' burden and quality of life when providing care for a family member with schizophrenia in the People's Republic of China. Nurs Health Sci 2007; 9(3): 192-8.
  3. Omranifard V, Kheirabadi G, Mehrabi T. [Educational needs of schizopheric patients families]. Journal of Isfahan Medical School 2011; 29: 128. (Persian)
  4. Torres A, Mendez LP, Merino H, Moran EA. Rehab rounds: Improving social functioning in schizophrenia by playing the train game. Psychiatr Serv 2002; 53(7): 799-801.
  5. Stang P, Frank C, Yood MU, Wells K, Burch S. Impact of bipolar disorder: Result from a screening study. J Clin Psychiatry 2007; 9(1): 42-7.
  6. Akiskal SH. Mood disorders. In: Sadock BJ, Sadock VA, Ruiz P. (editors). Kaplan and Sadock’s comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams and Wilkins; 2009: 1629-45.
  7. Bandura A. Guide for constructing self-efficacy scales. In: Pajares F, Urdan TC. (editors). Self-efficacy beliefs of adolescents. Charlotte, NC: Information Age Publishing; 2006: 307-37.
  8. Farrell K, Wicks MN, Martin JC. Chronic disease self-management improved with enhanced self-efficacy. Clin Nurs Res 2004; 13(4): 289-308.
  9. Katch H, Mead H. The role of self-efficacy in cardiovascular disease self-management: A review of effective programs. Patient Intell 2010; 2(2): 33-44.
  10. Salehi N, Khankeh H. [A comparative study of the effect of strategy of follow-up after discharge on readmission (s), the length of hospitalization and mental status of the schizophrenic patients in Bandar Abbas city in 2010]. MS. Dissertation. University of Welfare and Rehabilitation, 2010. (Persian)
  11. Nasr T, Kausar R. Psychoeducation and the family burden in schizophrenia: A randomized controlled trial. Ann Gen Psychiatry 2009; 8(1): 17.
  12. Cross SE. Self-construals, coping, and stress in cross-cultural adaptation. J Cross Cult Psychol 1995; 26(6): 673-97.
  13. Barati M, Allahverdipour H, Moinei B, Farhadinasab A, Mahjub H, Jalilian F. [Evaluation of Problem Solving Skills Training (PSST) on perceived behavioral control aginst psychoactive drug abuse in college students]. Toloo-e-Behdasht 2011; 10: 81-93. (Persian)
  14. Solymani E, Hovida R. [A study on the concept of self-efficacy in Bandura social knowledge theory]. Quarterly journal of social sciences 2013; 63: 91-97. (Persian)
  15. Mohamadinejad F, Pedram Razi S, Aliasgharpour M, Tabari F, Kazemnejad A. [Effect of patient education program on self-efficacy in patients with diabetes]. Nursing research 2015; 10(1): 35-41. (Persian)
  16. Shamsaei F, Cheraghi F, Ghalehiha A. [The effect of Home care on treatment of schizophrenic patients' hospitalization in Hamadan hospital]. Scientific journal of Ilam University of Medical Sciences 2007; 15(2): 32-9. (Persian)
  17. Fallahi Khoshknab M, Khankeh HA, Mohammadi F, Hosaini MA, Rahgou A, Ghazanfari N. Home care effectiveness in preventing re-hospitalization of acute schizophrenic patients. Journal of research in nursing 2009; 4(14): 59-66. (Persian)
  18. Shabani H. [Instructional skills, methods and techniques of teaching]. 21th ed. Tehran: Tehran Publishers; 2007. (Persian)
  19. Heidari M, Fayazi S, Borsi S, Vafaizadeh M. [Effect of self-management program on self-efficacy in patients with chronic obstructive pulmonary disease]. Iran journal of nursing 2016; 29: 45-55. (Persian)
  20. Bowman KG. Postpartum learning needs. J Obstet Gynecol Neonatal Nurs 2005; 34(4): 438-43.
  21. Hosseini MA, Khankeh HR, A'laei S, Dibaei M. [Study influence of nursing home care upon complications of immobility in musculoskeletal system in patient with stroke that admitted at home in the city of Semnan 1381-82]. Journal of rehabilitation 2005; 5(4): 35-42. (Persian)
  22. Gao J, Wang J, Zheng P, Haardörfer R, Kegler MC, Zhu Y, et al. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC Fam Pract 2013; 14: 66.
  23. Sharfirad Gh, Azad Bakht L, Feizi A, Mohebi S, Kargar M, Rezaie A. [The role of self-efficacy in self-care among diabetic patients]. Journal of health system research 2011; 7(6): 648-59. (Persian)
  24. Conger JA, Rabindra N, Kanungo A. The empowerment process: Integrating theory and practice. Acad Manage Rev 1998; 13(3): 471-82.
  25. Lobban F, Glentworth D, Chapman L, Wainwright L, Postlethwaite A, Dunn G, et al. Feasibility of a supported self-management intervention for relatives of people with recent-onset psychosis: REACT study. Br J Psychiatry 2013; 203(5): 366-72.