Effects of a Nurse-Led Behavioral Activation Program on Negative Symptoms, Depression, and Resilience in Patients with Schizophrenia in South Korea: A Quasi-Experimental Study

This study examines the efficacy of a behavioral activation (BA) program in reducing negative symptoms and depression, and enhancing resilience in inpatients with schizophrenia. This study had a nonequivalent control group pretest-post-test quasi-experimental design. We collected data between November 12, 2024, and January 31, 2025, at a psychiatric hospital in South Korea. The participants were recruited using convenience sampling and assigned to either an experimental (n = 17) or control group (n = 17), with members of the two groups in separate wards. The experimental group attended a BA program twice a week for 5 wk (a total of 10 sessions), while the control group received standard care. The outcome variables were negative symptoms, as measured by the PANSS-N; depression scores on the BDI-II; and resilience scores on the CD-RISC-25. These were assessed at baseline, immediately after program completion, and 5 wk later. We analyzed the data using repeated-measures ANOVAs and generalized estimating equations. The experimental group showed reductions in negative symptoms (F = 32.79, p < 0.001) and depression (χ2 = 14.07, p = 0.001), and increased resilience (χ2 = 32.15, p < 0.001). Significant group-by-time interaction effects were observed for negative symptoms (F = 13.05, p = 0.001), depression (Wald χ2 = 70.94, p < 0.001), and resilience (Wald χ2 = 205.42, p < 0.001). The findings indicate that a nurse-led BA program can effectively reduce negative symptoms and depression while enhancing resilience in inpatients with schizophrenia.