Abstract:
A consecutive sample of patients with Schizophrenia who attend rural outpatient clinics in
Polonnaruwa district was interviewed. Focus group discussions were conducted with 2
groups of care takers who were parents and spouses. Most patients were Sinhalese
Buddhists and with more or less balanced age and sex distributions. Most were from low
and middle income groups and educated up to secondary level. Majority of the patients were
known for more than 2 years. Treatment defaults were common (nearly 70 percent ) and
when it happens it was mostly (67 percent ) a complete default. Most common reasons for
defaults were misconceptions (46 percent ) and side effects were causing defaults among 20
percent. Patient outcomes that were assessed using number of symptoms, clinical judgment,
and need for readmissions as indicators identified; age, sex, knowledge of patient,
knowledge of principal care giver, number of side effects experienced, and clinic access as
the factors associate with the patient outcome. Patients were more or less satisfied with
clinic arrangements and happy to receive information from medical staff and through
leaflets and booklets. Care givers reported usual pattern of problems associated with
looking after patients with Schizophrenia. Problems were mostly attributed to positive and
negative s m toms. Stigma was experienced more by spouses when compared to parents of
patients. Recommendations are made to strengthen the field follow up care, patient and
caregiver education. Use of psycho-social approaches of management in addition to
pharmacotherapy is deemed necessary. Patient's clinic access problems should be alleviated
drug supplies should be ensured. Community based recommended to have a wider insight in
the wellbeing of schizophrenic parents living in the community
