Personal barriers to participation in chosen instrumental activities of daily living among community-dwelling persons with schizophrenia in Rwanda

Abstract

Background: Mental disorders are a major health concern across the globe. Schizophrenia, one of the mental disorders, affects approximately 20 million people globally and 5 million people within the African continent. Schizophrenia can affect all areas of life, including participation in instrumental activities of daily living (IADLs). Objectives: The study aimed to explore personal barriers affecting participation in chosen IADLs among community-dwelling persons with schizophrenia in Kigali city, Rwanda. Method: A qualitative, embedded case study design and constructivist epistemology paradigm were used. Purposive sampling and semi-structured interviews were conducted with 20 participants that included 10 persons diagnosed with schizophrenia (case 1) and 10 of their caregivers (case 2). Data were analysed according to the seven steps of Ziebland and Mcpherson. Findings: The two themes identified were community negative attitudes and individual hindrances to participation in IADLs. Theme 1 demonstrated the community’s poor support towards persons with schizophrenia due to the stigma attached to mental health illness, which is reported elsewhere. This paper reports on individual hindrances to participation, which revealed limited knowledge and skills, decreased motivation and interest, financial problems, maladaptive behaviours, medication side effects, loss of social interaction and isolation, and disorganised in performing activities to negatively affect persons with schizophrenia’s full participation in their chosen IADLs. Conclusion: Community-dwelling persons with schizophrenia are experiencing various hindrances to participating in their chosen IADLs, which shows a need for support from different stakeholders to improve access and participation of persons with schizophrenia in their daily activities based on their abilities. Contribution: Different barriers affecting participation of the persons with schizophrenia in their chosen IADLs were highlighted together with the common affected IADLs. It is recommended that when right support is provided, persons with schizophrenia may function at their maximum abilities in their activities of choice and may live at their highest independence level.

Keywords

• individual hindrances
• schizophrenia
• personal barriers
• medication side effect isolation
• instrumental activities of daily living
• community participation
• decreased motivation.