الفهرس 
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Abstract
Negative symptoms, amotivation, and lack of enjoyment are key symptoms of
schizophrenia and the most debilitating aspects of functioning. It is worth noting that there are
multiple therapeutic modalities and psychosocial interventions for the treatment of this
disorder. Positive emotion training program is a new form of positive psychotherapy and
offers a possible adjunctive intervention that may improve negative symptoms, amotivation,
and lack of enjoyment among patients with schizophrenia. Recent literature indicates that
psychiatric and mental health nurses can play a pivotal role in applying new intervention as a
means of holistic, bio psychosocial and recovery-oriented models of care to patients with
schizophrenia. By utilizing positive emotion training program in psychiatric nursing practice,
nurses are able to take a more holistic approach for caring and assessing the needs of patients
who suffer from schizophrenia.
Research Design:
A quasi experimental research design was used to conduct this study.
Setting:
The study was conducted in the psychiatric inpatient wards of EL-Maamoura Hospital
for Psychiatric Medicine affiliated to the Ministry of Health and population.
Subjects:
The study subjects include 60 randomly selected patients with schizophrenia. The study
subjects were divided equally into two groups (a study and control group).
Tools of the study:
Data were collected using the following tools:
Tool I: A Socio-Demographic and Clinical Data, Structured interview Schedule:
This tool was developed by the researcher to elicit data about the general socio-demographic
and clinical characteristics of the studied subjects.
Tool II: Scale for Assessment of The Negative Symptoms of schizophrenia (SANS):
This scale was developed by Andreasen (1983). It consists of 25 items. The scale is rated on a
6-point Likert scale from 0 (not present) to (5 severe). The total score ranges from 0 to 125.
Tool III: The Behavioral Inhibition and Activation Scale (BIS/BAS): This scale
(BIS/BAS) was developed by Carver and White (1994). It is a self-reported scale consisting
of 20 items graded on a 4-point Likert scale, ranging from 1(strongly agree) to 4 (strongly
disagree). It consists of 2 subscales: behavioral inhibition (BIS) and behavioral activation
(BAS).
Tool IV: The Savoring Belief Inventory (SBI): This scale was developed by Bryant
(2003). It is a self-reported scale for measuring beliefs about one’s capacity for enjoying
things. The scale has 24 items, twelve positively-worded and twelve negatively-worded items.
It measures a person’s thinking regarding their capacity to enjoy positive experiences in terms
of past experiences, current experiences, and future anticipation.
The main results of the study:
I: Socio- demographic characteristics:
- 60% of the study group and 46.7% of the control are between 25 to less than 35 years
with a mean age of 31.27 ± 5.82 and 31.37 ± 7.55 years respectively
- 63.3% of the study group live in urban areas and 83.3% of the control group.
- An equal percentage (36.7%) of both the study and control groups have a university
education, while more than one third of both study group (36.7 %) and control group
(33.3 %) have secondary education.
- More than half (53.3%) of the study group and 46.7% of the control groups are living
with one or both parents, while 23.3% of patients in both groups live alone.
- Both groups were matched in relation to all socio-demographic data
II: Clinical characteristics:
- The duration of illness ranged between 5 to 10 years for 53.3% of patients in the study
group and 70% for those in the control one
- More than half (53.3 %) of the study group start to develop the illness at the age of 20
to less than 25 years compared to 63.3 % of the control group
- Patients currently hospitalized for one to three months represent 40% of the study
group and 46.7% of the control group.
- 53.3% and 70% of the study and control groups respectively, have more than six times
of previous psychiatric hospitalization for the study and control groups respectively.
- Both groups were matched in relation to all clinical characteristics.
III: Negative symptoms
- There is no statistically significant difference in the level of negative symptoms
between the study and control groups before the intervention (2=1.067, p=0.302).
While, after implementing the intervention there is a statistically significant difference
between them (2=16.254, p=0.001).
IV. Motivation
- Regarding avoidance motivation, there is no statistically significant difference in the
level and total mean score of avoidance motivation between the study and control
groups in before intervention phase (p <0.05). While, after implementing the
intervention there is a statistically significant difference between them (p=<0.001*).
- In relation to approach motivation, there is no statistically significant difference
between the study and control groups in the total approach motivation (2=0.267,
p=0.606) and in their mean score of (t=1.173, p =0.246) before intervention phase.
yet, there is a statistically significant difference after implementing the intervention
between the study and control group in the total approach motivation (2=40.502*
p=<0.001*) and in their mean score (t=14.823*, p =<0.001*).
V. Savoring (enjoyment) beliefs
- There is no statistically significant difference between the study and control groups in
the total of savoring (enjoyment) beliefs (p=0.589) and in their mean score (t=0.074, p= 0.942) before implementing the intervention. yet, there is a statistically significant
difference after implementing the intervention between the study and control group in
(t=27.483*, p =<0.001*).
The main recommendations of the study:
- Integrate the positive emotion training protocol as part of the psychiatric hospitals
routine to improve the patients’ motivation, enjoyment and to reduce their negative
symptoms.
- Discharge plan for patients with schizophrenia should include positive emotion
regulation tasks to promote motivation, enjoyment and decrease negative symptoms,
and thus decrease patients’ relapses and foster their adaptation back to community.
- Conducting in services positive emotion training program for psychiatric nursing staff
on the importance of challenging defeatist thoughts, anticipating, maintaining positive
emotions and how to motivate patients to share experiences with each other’s
regularly.
- Further studies must be conducted on a larger sample size to ensure generalizability of
the results,
- Future studies are needed to determine the sustainability of the effect of positive
emotion training and the feasibility of its applications in the community to investigate
its effect on patients’ recovery after they have been discharged from the hospital.