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Lundqvist LO, Rytterström P, Rask M, Brunt D, Sellin T, Grim K, Rystedt I, Schröder A. Influence of mental health service provision on the perceived quality of life among psychiatric outpatients: associations and mediating factors. Front Psychiatry 2024; 14:1282466. [PMID: 38293591 PMCID: PMC10824987 DOI: 10.3389/fpsyt.2023.1282466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024] Open
Abstract
ObjectiveTo investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.MethodsA total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients’ perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.ResultsVariables in mental health service provision showed few direct associations with patients’ perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (χ2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).ConclusionThis study shows that mental health service provision is associated with patients’ perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients’ QoL.
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Affiliation(s)
- Lars-Olov Lundqvist
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Patrik Rytterström
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Mikael Rask
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - David Brunt
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Tabita Sellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Katarina Grim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Ingrid Rystedt
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Agneta Schröder
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Nursing, Faculty of Health, Care and Nursing, Norwegian University of Science and Technology (NTNU), Gjövik, Norway
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Fojcik J, Górski M, Borowska A, Krzystanek M. The Impact of Health Education on the Quality of Life of Patients Hospitalized in Forensic Psychiatry Wards. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4533. [PMID: 36901541 PMCID: PMC10001608 DOI: 10.3390/ijerph20054533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE An original health education program, developed for a group of patients of forensic psychiatry wards, was the basis for conducting a study on the impact of educational influences on the quality of life of patients long-term isolated from their natural environment. The main aim of the study was to answer the question: Does health education affect the quality of life of patients in forensic psychiatry wards and is educational activity effective? METHODS The study was conducted at the State Hospital for Mental and Nervous Diseases in Rybnik, Poland, in the forensic psychiatry wards, and lasted from December 2019 to May 2020. During the study, patients gained knowledge in the field of broadly understood health education. The study group consisted of 67 men, aged 22-73, diagnosed with schizophrenia. The method of double measurements (before and after the health education cycle) was applied, using the WHOQOL-BREF scale of quality of life and the first author's questionnaire of patients' knowledge, from the educational program used. RESULTS Health education does not significantly affect the overall quality of life of patients staying in forensic psychiatry wards, but it does affect their somatic condition. The proprietary health education program is effective because the patients' knowledge has significantly improved. CONCLUSIONS The quality of life of interned patients with schizophrenia is not significantly related to educational activities, however, psychiatric rehabilitation through educational activities effectively increases the level of patients' knowledge.
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Affiliation(s)
- Joanna Fojcik
- Doctoral School, Faculty of Health Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Michał Górski
- Doctoral School, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-902 Bytom, Poland
| | - Agnieszka Borowska
- Department of Psychiatric Rehabilitation, Leszek Giec Upper-Silesian Medical Centre, Medical University of Silesia, 40-055 Katowice, Poland
| | - Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation in Katowice, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
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Kwakernaak S, Cahn W, Janssen R. Is change over time in psychotic symptoms related to social functioning? Int J Soc Psychiatry 2022; 68:1571-1579. [PMID: 34387531 DOI: 10.1177/00207640211039248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated. METHOD Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning. RESULTS Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms. CONCLUSIONS The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.
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Affiliation(s)
- Sascha Kwakernaak
- Altrecht Mental Health Care, Utrecht, The Netherlands.,Department of Tranzo Scientific Center for Care and Welfare, Tilburg University, The Netherlands
| | | | - Wiepke Cahn
- Altrecht Mental Health Care, Utrecht, The Netherlands.,Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands
| | - Richard Janssen
- Department of Tranzo Scientific Center for Care and Welfare, Tilburg University, The Netherlands.,Department of Health Care Governance, Erasmus University Rotterdam, The Netherlands
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Butler E, Pillinger T, Brown K, Borgan F, Bowen A, Beck K, D'Ambrosio E, Donaldson L, Jauhar S, Kaar S, Marques TR, McCutcheon RA, Rogdaki M, Gaughran F, MacCabe J, Ramsay R, Taylor D, McCrone P, Egerton A, Howes OD. Real-world clinical and cost-effectiveness of community clozapine initiation: mirror cohort study. Br J Psychiatry 2022; 221:740-747. [PMID: 35438068 DOI: 10.1192/bjp.2022.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Clozapine is the only drug licensed for treatment-resistant schizophrenia (TRS) but the real-world clinical and cost-effectiveness of community initiation of clozapine is unclear. AIMS The aim was to assess the feasibility and cost-effectiveness of community initiation of clozapine. METHOD This was a naturalistic study of community patients recommended for clozapine treatment. RESULTS Of 158 patients recommended for clozapine treatment, 88 (56%) patients agreed to clozapine initiation and, of these, 58 (66%) were successfully established on clozapine. The success rate for community initiation was 65.4%; which was not significantly different from that for in-patient initiation (58.82%, χ2(1,88) = 0.47, P = 0.49). Following clozapine initiation, there was a significant reduction in median out-patient visits over 1 year (from 24.00 (interquartile range (IQR) = 14.00-41.00) to 13.00 visits (IQR = 5.00-24.00), P < 0.001), and 2 years (from 47.50 visits (IQR = 24.75-71.00) to 22.00 (IQR = 11.00-42.00), P < 0.001), and a 74.71% decrease in psychiatric hospital bed days (z = -2.50, P = 0.01). Service-use costs decreased (1 year: -£963/patient (P < 0.001); 2 years: -£1598.10/patient (P < 0.001). Subanalyses for community-only initiation also showed significant cost reductions (1 year: -£827.40/patient (P < 0.001); 2 year: -£1668.50/patient (P < 0.001) relative to costs prior to starting clozapine. Relative to before initiation, symptom severity was improved in patients taking clozapine at discharge (median Positive and Negative Syndrome Scale total score: initial visit: 80 (IQR = 71.00-104.00); discharge visit 50.5 (IQR = 44.75-75.00), P < 0.001) and at 2 year follow-up (Health of Nation Outcome Scales total score median initial visit: 13.00 (IQR = 9.00-15.00); 2 year follow-up: 8.00 (IQR = 3.00-13.00), P = 0.023). CONCLUSIONS These findings indicate that community initiation of clozapine is feasible and is associated with significant reductions in costs, service use and symptom severity.
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Affiliation(s)
- Emma Butler
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Toby Pillinger
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Kirsten Brown
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Faith Borgan
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Alice Bowen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Katherine Beck
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Enrico D'Ambrosio
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Italy
| | | | - Sameer Jauhar
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Stephen Kaar
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Tiago Reis Marques
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, UK
| | - Robert A McCutcheon
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Maria Rogdaki
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - James MacCabe
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Rosalind Ramsay
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - David Taylor
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK and South London and Maudsley NHS Foundation Trust, UK
| | - Paul McCrone
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Alice Egerton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Oliver D Howes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Medical Research Council London Institute of Medical Sciences, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, UK and South London and Maudsley NHS Foundation Trust, UK
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Hurmuz M, Frandes M, Panfil AL, Stoica IP, Bredicean C, Giurgi-Oncu C, Papava I, Nirestean A. Quality of Life in Patients with Chronic Psychotic Disorders: A Practical Model for Interventions in Romanian Mental Health Centers. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:615. [PMID: 35630032 PMCID: PMC9143751 DOI: 10.3390/medicina58050615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Background and Objectives: Current psychiatric care is increasingly focusing on patients' quality of life (QoL). Research is still trying to determine the main factors which influence QoL. The present study aims to assess the QoL of patients with chronic psychotic-spectrum disorders, as well as its relation to symptomatology, functionality, adaptive behavior, and perceived level of recovery. Materials and Methods: The study included a sample of 78 patients with chronic psychosis. Symptomatology and illness severity were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression Scale-Severity (CGI-S) scales, respectively. The Global Assessment of Functioning Scale (GAFS) and the Adaptive Behavior Assessment System II (ABAS-II)-Adult Form were used for the assessment of patients' functionality, and the Quality-of-Life Inventory (QOLI) scale was applied for the evaluation of QoL. Results: According to the CGI-Severity scale, 20.5% of the patients were borderline mentally ill, and 24.4% were mildly ill. The highest number of patients (34.6%) were moderately ill, while 14.1% and 2.6% were markedly ill and severely ill, respectively. Among the moderately ill patients, more than half (63%) were patients with schizophrenia, 18.5% were patients with delusional disorder, and 18.5% were patients with schizoaffective disorder. Most of the patients (43.6%) presented moderate functioning deficiency, while 38.5% of the patients presented severe deficiency, according to the GAFS score. When assessed with the ABAS, we observed that almost half of the patients (44.9%) showed an average functioning across skill areas in the conceptual, social, and practical domains. A percent of 67.9% of the patients presented an average QoL, while 15.4% and 12.8% showed a very low and low QoL. QoL was not influenced by the patients' symptomatology, gender, and education level. Having children, family support, better social and conceptual skills, and a higher perceived level of recovery was correlated with an increased QoL, hierarchical multiple regression R2 = 0.379, F(9, 68) = 2.616, and p = 0.012. Conclusions: Psychiatric interventions in psychosis should focus not only on symptoms' control, but also on improving social and family support, as well as adaptive skills to increase the patients' QoL.
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Affiliation(s)
- Marinela Hurmuz
- Discipline of Psychiatry, Department of Clinical Sciences, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Str. G. Marinescu, 540139 Targu Mures, Romania; (M.H.); (A.N.)
- Mental Health Center No. 1, “Pius Branzeu” Timis County Emergency Clinical Hospital, 156 Bd. Liviu Rebreanu, 300182 Timisoara, Romania;
| | - Mirela Frandes
- Department of Functional Sciences—Medical Informatics and Biostatistics, “Victor Babes” University of Medicine and Pharmacy, 2 Sq. Eftimie Murgu, 300041 Timisoara, Romania
| | - Anca-Livia Panfil
- Liaison Psychiatry Department, “Pius Branzeu” Timis County Emergency Clinical Hospital, 156 Bd. Liviu Rebreanu, 300182 Timisoara, Romania;
| | - Ileana-Pepita Stoica
- Mental Health Center No. 1, “Pius Branzeu” Timis County Emergency Clinical Hospital, 156 Bd. Liviu Rebreanu, 300182 Timisoara, Romania;
| | - Cristina Bredicean
- Department of Neuroscience, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, 2 Sq. Eftimie Murgu, 300041 Timisoara, Romania; (C.B.); (C.G.-O.); (I.P.)
- “Dr. Victor Popescu” Emergency Military Clinical Hospital, 7 Str. G. Lazăr, 300080 Timisoara, Romania
| | - Catalina Giurgi-Oncu
- Department of Neuroscience, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, 2 Sq. Eftimie Murgu, 300041 Timisoara, Romania; (C.B.); (C.G.-O.); (I.P.)
- “Eduard Pamfil” Psychiatric Clinic, “Pius Branzeu” Timis County Emergency Clinical Hospital, 156 Bd. Liviu Rebreanu, 300182 Timisoara, Romania
| | - Ion Papava
- Department of Neuroscience, NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric Pathology, “Victor Babes” University of Medicine and Pharmacy, 2 Sq. Eftimie Murgu, 300041 Timisoara, Romania; (C.B.); (C.G.-O.); (I.P.)
- “Eduard Pamfil” Psychiatric Clinic, “Pius Branzeu” Timis County Emergency Clinical Hospital, 156 Bd. Liviu Rebreanu, 300182 Timisoara, Romania
| | - Aurel Nirestean
- Discipline of Psychiatry, Department of Clinical Sciences, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Str. G. Marinescu, 540139 Targu Mures, Romania; (M.H.); (A.N.)
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Tan EJ, Toh WL, Rossell SL. Examining relationships between state and trait psychotic symptoms and quality of life in schizophrenia spectrum disorders. Psychiatry Res 2022; 310:114450. [PMID: 35183988 DOI: 10.1016/j.psychres.2022.114450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
Abstract
Positive and negative symptoms are core aspects of schizophrenia and have been shown to influence patient quality of life (QOL). Previous studies have largely focused on current or state symptoms, with limited work on the contributions of trait symptoms to QOL. This study sought to examine the relationship between both state and trait symptoms and objective and subjective QOL. Fifty-three schizophrenia spectrum disorder patients and 47 healthy controls were recruited. State symptomatology was assessed using the Positive and Negative Syndrome Scale in the patients only. In all participants, trait symptoms were assessed using the Oxford-Liverpool Inventory of Feelings and Experiences, and QOL using Lehman's QOL Interview. Hierarchical linear regression analyses, controlling for depression and neurocognition, revealed that negative state symptoms were related to objective QOL within the patients, while negative trait symptoms were associated with both objective and subjective QOL in patients and healthy controls. No relationships were observed with positive state or trait symptoms and either QOL measure. The findings suggest a degree of complexity in the associations between symptoms and QOL, with primacy for negative symptoms at both state and trait levels. A greater appreciation of trait symptoms may help explain non-complementary QOL changes following symptom remission.
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Affiliation(s)
- Eric Josiah Tan
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Intharit J, Kittiwattanagul K, Chaveepojnkamjorn W, Tudpor K. Risk and protective factors of relapse in patients with first-episode schizophrenia from perspectives of health professionals: a qualitative study in northeastern Thailand. F1000Res 2021; 10:499. [PMID: 36033234 PMCID: PMC9379331 DOI: 10.12688/f1000research.53317.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Schizophrenia is a serious mental illness that can relapse after treatments.
Risk and protective factors for relapse are dependent on multicultural contexts. Objective: To identify risk and protective factors related to relapse in first-episode schizophrenia (FES) in northeastern Thailand from perspectives of health professionals. Methods: This qualitative research collected data from 21 health professional staff members (psychiatric nurses, psychiatrists, psychologists, social workers, occupational therapists and nutritionist) of a tertiary psychiatric hospital of northeastern Thailand who had been involved in mental health care for schizophrenia for at least 5 years by in-depth interviews and group interview using semi-structured interview schedule. Content analyses was used to identify staff perception of factors that put patients at risk of relapse. Results: Data analyses demonstrated that factors related to relapse in FES patients were drug adherence (drug discontinuation, limited access to new generation drugs, self-dose reduction and skipping medication, and poor insight), family factors (stressful circumstances and family supports), substance abuses (narcotics, addictive substances, caffeinated drinks), concurrent medical illness (insomnia, thyroid diseases, and pregnancy-related hormonal changes), and natural course of disease. Conclusion: Factors affecting relapse in FES was not only drug adherence. Family factors, drug abuses, and concurrent health status should be also taken into account. A comprehensive mental health care program should be developed for FES patients in the region.
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Affiliation(s)
- Jarunee Intharit
- Faculty of Public Health, Mahasarakham University, Kantarawichai, Maha Sarakham, 44150, Thailand
| | | | - Wisit Chaveepojnkamjorn
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Rajthevee, Bangkok, 10400, Thailand
| | - Kukiat Tudpor
- Faculty of Public Health, Mahasarakham University, Kantarawichai, Maha Sarakham, 44150, Thailand
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Alhadidi M, Abdullah KL, Tang LY, Danaee M, Al Hadid LAR. Knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among people diagnosed with schizophrenia in a long-term care facility. Perspect Psychiatr Care 2021; 57:225-234. [PMID: 32502330 DOI: 10.1111/ppc.12553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/17/2020] [Accepted: 05/24/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study assessed the level of knowledge about schizophrenia, insight into illness, and internalized stigma and their associated factors among patients with schizophrenia in Jordan. DESIGN AND METHODS A cross-sectional survey was conducted on 135 patients diagnosed with schizophrenia, who had been admitted to the largest psychiatric hospital in Jordan. FINDINGS The participants had a low level of knowledge, insight, and a high level of internalized stigma. No correlation was found between these variables. Meanwhile, the educational level and vacation were found to be predictors of knowledge. PRACTICE IMPLICATIONS This can help psychiatric nurses to identify which area needs to be improved to ensure the best service and care is provided to patients diagnosed with schizophrenia.
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Affiliation(s)
- Majdi Alhadidi
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Khatijah Lim Abdullah
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Li Yoong Tang
- Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social and Prevention Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lourance Abdel Razzaq Al Hadid
- Nursing Department, Princess Aisha Bint Al Hussein College of Nursing and Health Sciences, Al Hussein Bin Talal University, Ma'an, Jordan
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Factors influencing subjective recovery of people with recent-onset psychosis: A cross-sectional study in a low-income sub-Saharan country. Psychiatry Res 2020; 287:112282. [PMID: 30853117 DOI: 10.1016/j.psychres.2019.01.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 12/11/2018] [Accepted: 01/21/2019] [Indexed: 01/23/2023]
Abstract
People with psychosis were traditionally believed to have a chronic deteriorating condition with no hope of recovery. Recent studies have shown varied levels of recovery across countries. However, evidence from low-income, particularly African countries is scant. This study aimed to investigate levels of subjective recovery of people with recent-onset psychosis and identify its influencing factors. A cross-sectional study was conducted among 263 outpatients with recent-onset psychosis in a low-income country, Ethiopia. Psychiatric outpatients were randomly selected, and assessed by a set of questionnaires measuring their psychosocial, clinical and physical health conditions. Hierarchical multiple regression tests were used to identify factors influencing subjective recovery. The level of subjective recovery was found to be high, with a mean Questionnaire about the Process of Recovery score of 44.17. Individuals with higher quality of life were found to have significantly better subjective recovery level. Hopeless and centrally obese individuals were found to have significantly lower level of subjective recovery. Despite the limitations associated with a cross sectional study design, the results suggest that individuals with recent-onset psychosis in Ethiopia may have a better level of subjective recovery than those in high-income countries and their recovery is influenced by quality of life, hopelessness and central obesity.
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Marutani T, Chhim S, Nishio A, Nosaki A, Fuse-Nagase Y. Quality of life and its social determinants for patients with schizophrenia and family caregivers in Cambodia. PLoS One 2020; 15:e0229643. [PMID: 32130240 PMCID: PMC7055908 DOI: 10.1371/journal.pone.0229643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 02/11/2020] [Indexed: 11/30/2022] Open
Abstract
Due to inadequate human and financial resource support, the development of mental health services in Cambodia has been undertaken by various non-governmental organizations (NGOs). Schizophrenia is the most common functional psychotic disorder, causing severe and chronic symptoms, and the programs provided by the NGOs should have enhanced the quality of life (QoL) of patients and their caregivers; however, epidemiological research, which is a driving force behind the recognition of mental health as a global public health concern, is lacking for schizophrenia in Cambodia. This study therefore aimed to create QoL evaluation questionnaires available in Khmer (the Cambodian language) for patients with schizophrenia and family caregivers, and to identify the social determinants and predictors of their QoL. This cross-sectional study recruited 59 patients and 59 caregivers attending three clinics operated by two NGOs: the Transcultural Psychosocial Organization (TPO) Cambodia and the Supporters for Mental Health (SUMH) Cambodia. We conducted linguistic validation of the Schizophrenia Quality of Life Questionnaire 18-item version (S-QoL 18) and the Schizophrenia Caregiver Questionnaire (SCQ), then analyzed correlations between the QoL dimensions and socio-demographic factors. The main findings of this study were as follows: 1) the newly created Khmer versions of S-QoL 18 and SCQ are relatively good psychometric tools that are suitable for research to identify patients’ and caregivers’ needs to improve their QoL; and 2) engaging in paid work or being of the post-Khmer Rouge generation results in higher QoL for patients, but having low household economic status or being affected by chronic disease leads to lower QoL for family caregivers. These findings are useful for enabling community mental health professionals and aid organizations to create programs to lessen the patient and caregiver burden in Cambodia. Further research is necessary to develop practical projects that will improve patients’ and caregivers’ QoL in various clinical settings in Cambodia.
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Affiliation(s)
- Toshiyuki Marutani
- Health Support Center, Tokyo Institute of Technology, Yokohama, Japan
- Supporters for Mental Health, Tokyo, Japan
- * E-mail:
| | - Sotheara Chhim
- Transcultural Psychosocial organization Cambodia, Phnom Penh, Cambodia
| | - Akihiro Nishio
- Supporters for Mental Health, Tokyo, Japan
- Health Administration Center, Gifu University, Gifu, Japan
| | - Akiko Nosaki
- Supporters for Mental Health, Tokyo, Japan
- Psychiatric and Mental Health Nursing, Graduate School of Nursing, Chiba University, Chiba, Japan
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Factors influencing subjective recovery of people with recent-onset psychosis: A cross-sectional study in a low-income Sub-Saharan country. Psychiatry Res 2019; 274:421-429. [PMID: 30875619 DOI: 10.1016/j.psychres.2019.02.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
People with psychosis were traditionally believed to have a chronic deteriorating condition with no hope of recovery. Recent studies have shown varied levels of recovery across countries. However, evidence from low-income, particularly African countries is scant. This study aimed to investigate levels of subjective recovery of people with recent-onset psychosis and identify its influencing factors. A cross-sectional study was conducted among 263 outpatients with recent-onset psychosis in a low-income country, Ethiopia. Psychiatric outpatients were randomly selected, and assessed by a set of questionnaires measuring their psychosocial, clinical and physical health conditions. Hierarchical multiple regression tests were used to identify factors influencing subjective recovery. The level of subjective recovery was found to be high, with a mean Questionnaire about the Process of Recovery score of 44.17. Individuals with higher quality of life were found to have significantly better subjective recovery level. Hopeless and centrally obese individuals were found to have significantly lower level of subjective recovery. Despite the limitations associated with a cross sectional study design, the results suggest that individuals with recent-onset psychosis in Ethiopia may have a better level of subjective recovery than those in high-income countries and their recovery is influenced by quality of life, hopelessness and central obesity.
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Domenech C, Pastore A, Altamura AC, Bernasconi C, Corral R, Elkis H, Evans J, Malla A, Margari F, Krebs MO, Nordstroem AL, Zink M, Haro JM. Correlation of Health-Related Quality of Life in Clinically Stable Outpatients with Schizophrenia. Neuropsychiatr Dis Treat 2019; 15:3475-3486. [PMID: 31908462 PMCID: PMC6930014 DOI: 10.2147/ndt.s218578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/09/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Generic health-related quality of life (HRQoL) scales are increasingly being used to assess the effects of new treatments in schizophrenia. The objective of this study is to better understand the usefulness of generic and condition specific HRQoL scales in schizophrenia by analyzing their correlates. METHODS Data formed part of the Pattern study, an international observational study among 1379 outpatients with schizophrenia. Patients were evaluated with the Mini International Neuropsychiatric Inventory, the Clinical Global Impression-Schizophrenia (CGI-SCH) Scale and the Positive and Negative Syndrome Scale (PANSS) and reported their HRQoL using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D). The two summary values of the SF-36 (the Mental Component Score and the Physical Component Score, SF-36 MCS and SF-36 PCS) were calculated. RESULTS Higher PANSS positive dimension ratings were associated with worse HRQoL for the SQLS, EQ-5D VAS, SF-36 MCS, and SF-36 PCS. Higher PANSS negative dimension ratings were associated with worse HRQoL for the EQ-5D VAS, SF-36 MCS, and SF-36 PCS, but not for the SQLS or the EQ-5D tariff. PANSS depression ratings were associated with lower HRQoL in all the scales. There was a high correlation between the HRQoL scales. However, in patients with more severe cognitive/disorganized PANSS symptoms, the SQLS score was relatively higher than the EQ-5D tariff and SF-36 PCS scores. CONCLUSION This study has shown substantial agreement between three HRQoL scales, being either generic or condition specific. This supports the use of generic HRQoL measures in schizophrenia. CLINICALTRIALSGOV IDENTIFIER NCT01634542 (July 6, 2012, retrospectively registered).
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Affiliation(s)
- Cristina Domenech
- Universitat de Barcelona, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, CIBERSAM, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Adriana Pastore
- Department of Basic Medical Science, Neuroscience and Sense Organs, 'Policlinico' Hospital, University of Bari 'Aldo Moro', Bari, Italy
| | - A Carlo Altamura
- University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Ricardo Corral
- Fundación para el Estudio y Tratamiento de las Enfermedades Mentales (FETEM), Buenos Aires, Argentina
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria - FMUSP, Sao Paulo, Brazil
| | - Jonathan Evans
- Centre for Academic Mental Health, University of Bristol, Bristol, UK
| | - Ashok Malla
- Douglas Mental Health University Institute, McGill University, Montréal, QC, Canada
| | - Francesco Margari
- Department of Basic Medical Science, Neuroscience and Sense Organs, 'Policlinico' Hospital, University of Bari 'Aldo Moro', Bari, Italy
| | - Marie-Odile Krebs
- Service Hospitalo Universitaire, Laboratoire de Physiopathologie des Maladies Psychiatriques, Inserm, Université Paris Descartes, Hôpital Sainte-Anne, Paris, France
| | | | - Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany and Regional Clinical Centre, Ansbach, Germany
| | - Josep Maria Haro
- Universitat de Barcelona, Barcelona, Spain.,Parc Sanitari Sant Joan de Déu, CIBERSAM, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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