Title: Factors associated with good self-management in older adults with a schizophrenic disorder compared to older adults with physical illnesses. Short title: Older adults' self-management of schizophrenia Title: Factors associated with good self-manage

Abstract The number of older people living with a schizophrenic disorder (SD) is increasing yet little attention paid has been paid to the needs of this population relative to people with other chronic illnesses. In order to achieve optimal functioning people with a SD need to manage their illness and its impact, therefore this study set out to determine the factors associated with selfmanagement in this population. The illness management of people over 50 years of age and living with schizophrenia (n = 84) was compared to their peers who were diagnosed with a chronic physical illness (n = 216). Participants completed a survey which included an illness management inventory, self-rated health and sense of coherence. The results demonstrated that participants with a SD had lower illness management levels, particularly for understanding their symptoms and taking appropriate actions in relation to health care. Poor self-rated health and the presence of comorbid conditions had a pervasive negative effect on self-management factors in the SD group, whereas being married, having a greater sense of coherence and being voluntary to treatment had a positive effect. Nurses need to develop strategies to address general health and self management in older adults living with a SD. 3 Accessible summary • There are an increasing number of older people living with a schizophrenic illness and the specific needs of this population have received scant attention especially in relation to their illness self-management. • This study demonstrated that the illness self-management of a group of older adults diagnosed with a schizophrenic illness was worse in comparison to their peers with a diagnosed chronic physical illness. • In people with a schizophrenic disorder poor self-rated health and the presence of comorbid conditions negatively affect self-management factors, whereas being married, voluntarily treated and a greater sense of coherence have a positive effect. • Nurse can assist older people with a schizophrenic disorder to improve their illness selfmanagement by working collaboratively with them and enabling them to gain a better understanding of their illness, monitor their symptoms, attend to their general health and respond appropriately to symptoms of ill health.