Opinions of staff regarding the psychoeducation programme

65 Efective Implementation of a Structured Psychoeducation Programme among Caregivers of Schizophrenia Patients in the Community Schizophrenic patients in the intervention group have a shorter duration of illness. This is reflected in the profile of the caregivers in the intervention group, who had shorter duration as a caregiver. It is possible that this group of patients and their caregivers are more keen to learn about the disease in the earlier years.

5.1.2 Knowledge of caregivers on schizophrenia

There was a significant increase in the knowledge of the caregivers in the intervention group after the psychoeducation module was given, and the knowledge increment was sustained after 3 months. At 6 months there was no further knowledge increment but the score did not drop. This was the result of the continuous structured psychoeducation given to the caregivers. Furthermore, the staffs gave consistent attention to the caregiver and their patients and helped contribute to the increase in knowledge. During the study period, any uncertainties and doubts could be clarified as and when needed. In the control group, there was modest but insignificant improvement in the knowledge scores of caregivers. The slight initial improvement observed was probably due to the extra attention given by the staff during the study period. This gave rise to increase in awareness and interest among caregivers and patients, thus leading to improved scores even though no psychoeducation given. This observation is explained by the Hawthorne effect. Among the questions, knowledge on the following questions were poorly answered and understood: definition of symptoms such as hallucinations and delusions, the belief that medication is only necessary if the patient is not well, early warning signs and symptoms indicating relapse, and the interference of alcohol and drugs in the illness. 5.2 Comparison with other studies 5.2.1 Readmission rates Overall, there was no significant difference in the readmission rates between both groups. One possible reason for this is the short study duration of 6 months. A similar study by Chien Wong Chien WT et al., 2007 showed that readmission rates were reduced when patients were followed up over a period of 12 months. Two recent systematic reviews Pekkala E et al., 2002; Pharoah FM et al., 2003 reported that patients whose families received psychoeducation had reduced relapse rates of 4-fold after 1 year, and 2-fold the subsequent year. Another study by Aguglia and colleagues Aguglia E