The Effect of Convalescent Nursing Combined With Occupational Therapy and Group Painting Art Therapy on Medication Adherence and Quality of Life in Patients With Schizophrenia: A Randomized Controlled Trial

Objective: To evaluate an integrated intervention combining convalescent nursing, occupational therapy, and group painting art therapy for medication adherence, quality of life, and related outcomes in patients with schizophrenia. Methods: In this single-center randomized controlled trial, 150 patients with schizophrenia were randomized 1:1 to a control group (routine convalescent nursing) or an observation group (routine nursing plus occupational therapy and group painting art therapy) for 15 weeks; 146 participants (73 per group) completed the intervention. The primary outcomes were medication adherence (MMAS-8) and quality of life (WHOQOL-BREF); secondary outcomes were symptom severity (PANSS), social functioning (SFS), mood (HAMD-17, HAMA-14), and cognition (MoCA). Repeated measures were analyzed with linear mixed-effects models, and an intention-to-treat sensitivity analysis was performed. Results: Group × time estimates favored the observation group for MMAS-8 (β = 1.46, 95% CI [0.98, 1.94]) and the study-defined WHOQOL-BREF composite (β = 12.34, 95% CI [8.77, 15.91]; both FDR p < .001). PANSS, SFS, HAMD-17, HAMA-14, and MoCA also favored the observation group (all FDR p < .001). WHOQOL-BREF domain changes were non-uniform. Recorded adverse-event rates were 16.44% and 19.18% (Fisher exact p = .829). Conclusions: In this single-center trial, the integrated program was associated with greater 15-week improvements in medication adherence, quality of life, and several secondary outcomes than routine nursing alone. Adverse-event rates were similar between groups, but the findings require confirmation in larger multicenter studies using standardized safety assessment.