article · BMC Psychiatry
This research assesses empowerment and related psychosocial factors among individuals living with schizophrenia in Tanzania who are receiving treatment. Using endline data from the KUPAA pilot trial, which examined a culturally adapted family psychoeducation model, the study analysed sixty-six pairs of patients and caregivers across two tertiary hospitals. The findings show that greater participation in society, higher levels of hopefulness, and stronger self-efficacy correspond with greater empowerment. Conversely, worse family functioning and elevated internalised stigma associate with lower empowerment. In multivariable models, internalised stigma, family functioning, hope, and self-efficacy demonstrated stronger associations with empowerment than general societal participation. Overall, the work emphasises that recovery-oriented interventions in low-resource environments should systematically measure empowerment and integrate patients' lived experiences into psychosocial programmes.
Mental health services in resource-constrained regions often focus primarily on clinical symptoms rather than patient agency. By demonstrating how factors like family support, reduced stigma, and self-belief underpin empowerment, this research provides healthcare planners with clear guidance on what elements to prioritise when designing effective recovery-oriented support systems for individuals living with severe psychiatric conditions.
The abstract does not indicate a commercialisation pathway, as it focuses on clinical trial observations and recommendations for public health intervention design. However, the findings could inform the design and evaluation criteria used by healthcare providers, non-governmental organisations, and programme developers creating culturally adapted psychosocial interventions for psychiatric recovery in low-resource settings.
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PURPOSE: As low-resource settings move to address the treatment and social service gap for people living with schizophrenia (PLWS), person-centered and recovery-oriented interventions should monitor impacts on empowerment. This study explores empowerment and associated factors among PLWS in Tanzania. METHODS: This study uses endline data from the Culturally Adapted Family Psychoeducation for Adults with Psychotic Disorders in Tanzania (KUPAA) pilot trial. Participants included 66 dyads of PLWS and caregivers recruited from two tertiary-level hospitals. The main outcome variable of interest was empowerment (Rogers 28-item Empowerment Scale), and the main exposure variable was Participation in Society (Domain 6 of the WHO Disability Assessment Schedule, WHODAS 2.0). Key psychosocial correlates of interest included hopefulness, general self-efficacy, internalized stigma, and family functioning. Bivariate and multivariable analyses were used to explore variable relationships. RESULTS: There were 21 women and 40 men with a mean age of 32 years. Bivariate analyses revealed greater participation in society (p < 0.0003) was correlated with greater empowerment, higher hopefulness (p < 0.0001) and higher self-efficacy (p < 0.0001). Lower empowerment was correlated with higher self-stigma (p < 0.0001) and worse family functioning (p < .001). Multivariable models indicated more participation in society was associated with higher empowerment, but when hope, self-efficacy, internalized stigma, and/or family functioning were added to the models, those factors were more strongly correlated with empowerment than participation in society. CONCLUSION: Empowerment is increasingly being recognized as an important outcome of psychosocial interventions. Understanding empowerment and its possible effects on recovery-centered outcomes is important when thinking of future interventions for PLWS in low-resource settings. Future recovery-oriented interventions and research should both consider including empowerment measurement among PLWS and incorporate their lived experiences in psychosocial treatment programming.
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DOI: 10.1186/s12888-025-06700-y
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