The development of the self-care ability to detect early signs of relapse among individuals who have schizophrenia

A qualitative study using interpretive interactionism investigated how individuals with schizophrenia develop an ability to detect early signs of relapse. A purposive sample of 15 respondents were interviewed about their illness experiences. Three sequential processes were identified. Responding reactively to psychic pain, initiated by a desire to escape from overwhelming distress, resulted in the differentiation of tolerable and intolerable pain. Refining perceptions of psychic pain followed and resulted in the identification of specific thoughts, feelings and behaviors associated with different levels of distress. Finally, actively reducing psychic pain resulted in a proactive surveillance for specific signs of increasing distress.