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Shokrgozar S, Abdollahi E, Abedrad M, Asadi P, Rouzbehan V, Nazari Z, Zare R. Investigating gender differences in quality of life and social support in patients with severe mental illnesses. Int J Soc Psychiatry 2024; 70:750-762. [PMID: 38439517 DOI: 10.1177/00207640241227366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND Severe mental illnesses (SMIs), including schizophrenia and bipolar disorder affect patients significantly. Gender has been identified as a key factor influencing the experience of SMIs with notable disparities in prevalence, symptoms, and treatment outcomes. Additionally, the quality of life (QoL) and social support for patients with SMIs can vary based on gender. AIMS This study examined gender differences in QoL and social support of patients with SMIs. METHOD Participants include 170 outpatients with schizophrenia and bipolar disorder at Shafa Hospital (2021). QoL and social support were assessed using World Health Organization QoL (WHOQOL-BREF) questionnaire and Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Group differences were analyzed using t-test or Mann-Whitney U test, and two-way multivariate analyses of variance explored the effect of gender and disease type. RESULTS It was indicated that females with schizophrenia reported higher QoL than males, but the opposite was observed for bipolar disorder. Gender differences in social support were not significant among schizophrenia patients, nor between the two patient groups. However, women with bipolar disorder and multiple hospitalizations experienced lower social support and QoL compared to men. Additionally, more hospitalizations were associated with decreased QoL in both genders with schizophrenia. CONCLUSIONS Findings suggest the need for gender- specific interventions and support policies to enhance QoL and social support in patients with SMI.
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Affiliation(s)
- Somayeh Shokrgozar
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Abdollahi
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Morvarid Abedrad
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parham Asadi
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Vida Rouzbehan
- Department of Psychiatry, Kavosh Behavioral, Cognitive and Addiction Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Nazari
- Department of Psychology, Lahijan Branch, Islamic Azad University, Iran
| | - Roghayeh Zare
- Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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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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Defar S, Abraham Y, Reta Y, Deribe B, Jisso M, Yeheyis T, Kebede KM, Beyene B, Ayalew M. Health related quality of life among people with mental illness: The role of socio-clinical characteristics and level of functional disability. Front Public Health 2023; 11:1134032. [PMID: 36875411 PMCID: PMC9978447 DOI: 10.3389/fpubh.2023.1134032] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background People with mental illness (PWMI) have declining health related quality of life (HRQoL), which is frequently equivalent to or greater than that of medical disorders. Although, HRQoL is rapidly being recognized as an essential treatment outcome indicator in modern psychiatry, research on the identification and significance of factors impacting QoL in PWMI is still in its early stages. Objective The aim of this study was to identify predictors of HRQoL among people with mental illness who underwent outpatient follow-up in Sidama region, southern Ethiopia. Methods We conducted a multicenter, cross-sectional study from April-1, to May-30, 2022. A total of 412 participants took part in the study, using an interviewer-administered structured questionnaire. The HRQoL was measured using the 12-item Short-Form Health Survey-Version 2 (SF-12v2) scale. To describe different variables, descriptive statistics were employed. To find independent HRQoL predictors, we used multivariable linear regression analysis. P-value of <0.05 were declared statistically significant at 95% confidence interval (CI). Result Out of 412 participants, nearly two-third 261 (63.3%) were male and nearly half 203 (49.3%) were diagnosed as schizophrenia. HRQoL was positively associated with social support (β = 0.321) and being single (β = 2.680). Conversely, functional disability (β = -0.545), being a student (β = -4.645) and jobless (β = -3.279) by occupation, and being diagnosed with depression (β = -2.839) were negatively impacted HRQoL among PWMI. Conclusion HRQoL of people with mental disorders in this study was significantly associated to social support, marital status, occupation, diagnosis and level of functional disability. Therefore, the mental health care system should develop HRQoL promoting measures that enhance PWMI functioning, social support and employment.
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Affiliation(s)
- Semira Defar
- Department of Midwifery, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yacob Abraham
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yared Reta
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Bedilu Deribe
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Meskerem Jisso
- School of Public Health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Tomas Yeheyis
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Kurabachew Mengistu Kebede
- Department of Anesthesia, Faculty of Medicine, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Bereket Beyene
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- School of Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Shoib S, Das S, Gupta AK, Saleem T, Saleem SM. Perceived stress, quality of life, and coping skills among patients with schizophrenia in symptomatic remission. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Schizophrenia is one of the worst diseases with its ubiquitous challenges due to its unique psychopathology and life events. Patients with schizophrenia use various coping strategies to overcome distress. The aim of the study was to evaluate the association between perceived stress, quality of life, and coping skills in patients with schizophrenia in remission. A total of 48 consecutive patients of schizophrenia, in remission, attending outpatient department of psychiatry at Academic hospital, South India, who satisfied the inclusion and exclusion criteria were recruited for the present study. The participants were assessed on Positive and Negative Symptoms Scale, Ways of Coping Checklist – Revised and Perceived Stress Scale and WHO Quality of Life. Results were analyzed using appropriate statistical package software v 16.0.
Result
Highest medial was found in self-controlling and positive reappraisal coping skills. Distancing is associated with high physical domain of quality of life whereas patients with good social support score more in social and physical domain of quality of life.
Conclusion
Patients with history of schizophrenia even though in remission dwell a stressful life. They often need different kind of social support or cognitive aids. In that view, studying their stress level, ability to cope with it, and quality of life will help us to manage them in better way.
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Association between Mutuality and Health-Related Quality of Life in Patient-Caregiver Dyads Living with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052438. [PMID: 33801391 PMCID: PMC7967568 DOI: 10.3390/ijerph18052438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/14/2021] [Accepted: 02/20/2021] [Indexed: 01/02/2023]
Abstract
Background: Although caregivers are a crucial support in the recovery of patients with schizophrenia, little is known about how mutuality is related to health-related quality of life within the dyadic (patient and caregiver) context. This study aimed to investigate the dyadic relationship between mutuality and health-related quality of life in patients with schizophrenia and caregivers. Methods: A cross-sectional, correlational study was conducted with a sample of 133 dyads of patients with schizophrenia and caregivers. Structured questionnaires were used to collect data. Data were analyzed using descriptive statistics, paired sample t-tests, Pearson’s product-moment correlations, and the Actor–Partner Interdependence Model. Results: Mutuality of patients was significantly higher than that of caregivers. Compared with caregivers, patients had significantly lower total scores for health-related quality of life. Patients’ and caregivers’ mutuality was related to their own health-related quality of life (actor effect) and their partners’ health-related quality of life (partner effect). Conclusion: Mutuality plays a critical role in health-related quality of life in dyads of patients with schizophrenia and caregivers. Viewing a dyad as a unit of nursing care reveals a promising approach for developing recovery-oriented modalities targeted at stimulating mutuality that may enhance health-related quality of life for both patients and caregivers.
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Shafie S, Samari E, Jeyagurunathan A, Abdin E, Chang S, Chong SA, Subramaniam M. Gender difference in quality of life (QoL) among outpatients with schizophrenia in a tertiary care setting. BMC Psychiatry 2021; 21:61. [PMID: 33509142 PMCID: PMC7842069 DOI: 10.1186/s12888-021-03051-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Patients with mental illness report lower quality of life (QoL) compared to the general population. Prior research has found several differences in clinical features and experiences of male and female patients with schizophrenia. Given these differences, it is also important to explore if there are any gender differences in terms of their QoL. This study aimed to investigate differences in QoL between and within each gender among outpatients with schizophrenia in Singapore. METHODS A total of 140 outpatients were recruited through convenience sampling at the Institute of Mental Health, Singapore. QoL was measured using the brief version of World Health Organization Quality of Life (WHOQOL-BREF) which consists of four domains: physical health, psychological health, social relationships, and environment. QoL scores of males and females were compared using independent t-tests, and multiple linear regressions were used to examine sociodemographic correlates of QoL in the overall sample and within each gender. RESULTS There was no significant difference in QoL domain scores between genders. Among males, Indian ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=3.03, p=0.018) while males having Technical Education/ Diploma/ A level education (versus Degree and above) were positively associated with social relationships domain (β=2.46, p=0.047). Among females, Malay ethnicity (versus Chinese ethnicity) was positively associated with physical health (β=1.95, p=0.026) psychological health (β=3.21, p=0.001) social relationships (β=2.17, p=0.048) and environment (β=2.69, p=0.006) domains, while females who were separated/divorced (versus single) were inversely associated with psychological health (β=- 2.80, p=0.044) and social relationships domains (β=- 4.33, p=0.011). Females who had Secondary and below education (versus Degree and above) were inversely associated with social relationships (β=- 2.29, p=0.028) and environment domains (β=- 1.79, p=0.048). CONCLUSIONS The findings show the importance of treatments targeting QoL to attend to both the clinical features of the illness as well patient's sociodemographic characteristics.
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Affiliation(s)
- Saleha Shafie
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore
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Fontecedro E, Furlan M, Tossut D, Pascolo-Fabrici E, Balestrieri M, Salvador-Carulla L, D’Avanzo B, Castelpietra G. Individual Health Budgets in Mental Health: Results of Its Implementation in the Friuli Venezia Giulia Region, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145017. [PMID: 32668599 PMCID: PMC7400620 DOI: 10.3390/ijerph17145017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022]
Abstract
Background: Individual Health Budget (IHB) is an intervention for recovery in mental health services, providing personalized care for subjects with severe disorders and complex needs. Little is known on its effectiveness and on the criteria for its delivery. Methods: A total of 67 IHB beneficiaries and 61 comparators were recruited among service users of the Mental Health Department of the Trieste Healthcare Agency, Italy. Data included sociodemographic and clinical variables, type of IHB, and Health of the Nation Outcome Scale (HoNOS) scores. Results: A comparison between groups showed significant differences in several socioeconomic and clinical characteristics. Multivariate logistic regression showed that IHB was positively associated to the 20–49 age group, single status, unemployment, low family support, cohabitation with relatives or friends, diagnosis of personality disorder, and a higher number of hospitalizations. The IHB group was at a higher risk of severe problems related to aggressive or agitated behaviors (OR = 1.4), hallucinations and delusions (OR = 1.5), and impairment in everyday life activities (OR = 2.1). Conclusions: IHB was used in patients with severe clinical and social problems. More resources, however, may be aimed at the working and social axes. More research is needed to better assess clinical and social outcomes of IHB and to adjust their intensity in a longitudinal perspective in order to enhance cost-effectiveness.
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Affiliation(s)
- Elisa Fontecedro
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (E.F.); (M.B.)
| | - Morena Furlan
- Central Health Directorate, Friuli Venezia Giulia Region, 34100 Trieste, Italy;
| | - Davide Tossut
- Welfare Area, Friuli Venezia Giulia Region, 33057 Palmanova, Italy;
| | - Elisabetta Pascolo-Fabrici
- Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy;
- Mental Health Department, WHO Collaborating Centre for Research and Training in Mental Health, Health University Agency of Trieste, 34100 Trieste, Italy
| | - Matteo Balestrieri
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (E.F.); (M.B.)
| | - Luis Salvador-Carulla
- Centre for Mental Health Research, Research School of Population Health, ANU College of Health and Medicine, Australian National University, 2601 Canberra, Australia;
- Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre, The University of Sydney, 2006 Sydney, Australia
| | - Barbara D’Avanzo
- Istituto di Ricerche Farmacologiche Mario Negri, IRCCS, 20156 Milano, Italy;
| | - Giulio Castelpietra
- Department of Medicine (DAME), University of Udine, 33100 Udine, Italy; (E.F.); (M.B.)
- Central Health Directorate, Friuli Venezia Giulia Region, 34100 Trieste, Italy;
- Correspondence: ; Tel.: +39-040-377-5575
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Desalegn D, Girma S, Abdeta T. Quality of life and its association with psychiatric symptoms and socio-demographic characteristics among people with schizophrenia: A hospital-based cross-sectional study. PLoS One 2020; 15:e0229514. [PMID: 32092123 PMCID: PMC7039432 DOI: 10.1371/journal.pone.0229514] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/09/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES To identify sociodemographic and illness-related factors associated with quality of life among people with Schizophrenia. METHODS A hospital-based cross-sectional study design was employed among 351 people with schizophrenia and attending the followup service at Jimma University Medical Center, psychiatric clinic during the study period. Participants were recruited using a systematic random sampling method and a sample fraction of two was used after the first person was identified by a lottery method. Data entry was done using EpiData version 3.1 and then exported to Statistical Package for Social Sciences version 25 for analysis. Multiple regression analysis was used to determine the statistically significant association between quality of life and independent variables. RESULTS Among the four domains of quality of life, respondents scored the lowest mean in the social relationships domain (10.14 ± 3.12). Final adjusted multiple regression model revealed, being divorced was negatively associated with the physical domain (β = -0.72, p = 0.02), having no formal education was negatively associated with physical health domain (β = -0.69, p = 0.001) and age was positively associated with the psychological domain (β = 0.371, p = 0.071). Being rural resident was negatively associated with physical domain (β = -0.48, p = 0.01), with environmental domain (β = -0.64, p = 0.03), with social relationships domain (β = -0.45, p = 0.04), and with overall quality of life (β = -1.93, p = 0.006). Positive symptoms (β = -0.22, p = 0.001), negative symptoms (β = -0.36, p = 0.001), and general psychopathology (β = -0.098, p = 0.006) were inversely associated with overall quality of life. CONCLUSION In this study, the social relationship domain of quality of life among people with schizophrenia has the lowest mean score. Some socio-demographic variables and psychiatric symptoms were found to be key significant associated factors of quality of life. Priority interventions to improve the social deficits and addressing psychiatric symptoms of people with schizophrenia is essential to improve their quality of life.
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Affiliation(s)
| | - Shimelis Girma
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Colillas-Malet E, Prat G, Espelt A, Juvinyà D. Gender differences in health-related quality of life in people with severe mental illness. PLoS One 2020; 15:e0229236. [PMID: 32084212 PMCID: PMC7034846 DOI: 10.1371/journal.pone.0229236] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/01/2020] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION AND PURPOSE The purpose was to analyze socioeconomic and clinical factors of psychosocial functioning and self-perception in relation to health-related quality of life (HRQOL) in people with severe mental health illness (SMI) by gender. MATERIALS AND METHOD A cross-sectional study was conducted on a sample of 133 women and 90 men. Recorded variables: HRQOL, SF-36 Physical Component Scores (PCS) and Mental Component Scores (MCS); sociodemographic and clinical data on psychosocial and self-perception functioning. Correlational studies using raw and adjusted linear regression models to evaluate the factors associated with HRQOL by obtaining coefficients, p-values and respective confidence intervals. RESULTS The mean PCS for women and men was 44.6 and 49.0 (p = 0.004) and 36.4 and 37.5 (p = 0.575), respectively for MCS. The factors associated with PCS in women were age, -0.2(-0.4:0); in work, 4.2(0.3:8.2); with an income higher than 700 euros/month, 4.4(1:7.7). In men, these factors were education level, 6.1(0.4:11.7); belief that they would not need help in the future, 4.6(0.1:9.2) and a higher need for psychosocial services, -6.6(-11.1:-2). Factors associated with MCS in women were, in work, 6.1(1.5:10.7); and having a high number of friends, 6.6(2.1:11.1). In men, these factors were, living alone, -7.1(-12.7:-1.4); lack of economic benefits, 8.5(3.2:13.8); and a higher need for psychosocial and social services, -3.6(-7.1:-0.2) and -7.7(-13.4:-2). CONCLUSIONS The dimensions affected and the factors that are associated with HRQOL for people with SMI differ by gender. Therefore, these differences should to be taken into account when designing interventions for improving HRQOL.
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Affiliation(s)
- Ester Colillas-Malet
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic–Universitat Central de Catalunya (UVic-UCC), Av. Universitària, Spain
| | - Gemma Prat
- Grup SaMIS (Salut Mental i Innovació Social), Divisió de Salut Mental de la Fundació Althaia, Manresa, Spain
| | - Albert Espelt
- Facultat de Ciències de la Salut de Manresa, Universitat de Vic–Universitat Central de Catalunya (UVic-UCC), Av. Universitària, Spain
- CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, C/ Melchor Fernández Almagro 3–5, Spain
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Dolors Juvinyà
- Grup de recerca de salut i atenció sanitària de la Universitat de Girona, Girona, Spain
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Rayan A, Aldaieflih M. Public stigma toward mental illness and its correlates among patients diagnosed with schizophrenia. Contemp Nurse 2019; 55:522-532. [PMID: 31535959 DOI: 10.1080/10376178.2019.1670706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Patients diagnosed with schizophrenia confront high degree of exclusion and prejudice, but the correlates of stigma among these patients have yet to be established.Aims: To assess stigma toward mental illness and its correlates among patients diagnosed with schizophrenia.Methods: A cross-sectional research design was used. One hundred and sixty Jordanian outpatients suffering from schizophrenia completed the study. Participants completed measures of demographic variables, pain intensity, depression and stigma toward mental illness.Results: Participants had a moderate level of perceived public stigma. Gender, age, family income, frequency of relapse, reasons for visit to the psychiatric clinic, perceived physical pain, and severity of depressive symptoms were significantly correlated with stigma toward mental illness. Clinical variables accounted for 15% additional variance above and beyond the 13% variance accounted for by demographic variables.Conclusions: Nurses should consider both demographic and clinical variables when implementing anti-stigma intervention programs for patients with schizophrenia.
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Affiliation(s)
- Ahmad Rayan
- Psychiatric and Mental Health Nursing, Zarqa University, Zarqa, Jordan
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Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study. J Affect Disord 2019; 256:164-175. [PMID: 31176189 DOI: 10.1016/j.jad.2019.05.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/14/2019] [Accepted: 05/27/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Little is known about the respective effects of depression and cognitive impairment on quality of life among older adults with schizophrenia spectrum disorder. METHODS We used data from the Cohort of individuals with Schizophrenia Aged 55-years or more (CSA) study, a large multicenter sample of older adults with schizophrenia or schizoaffective disorder (N = 353). Quality of life (QoL), depression and cognitive impairment were assessed using the Quality of Life Scale (QLS), the Center of Epidemiologic Studies Depression scale and the Mini-Mental State Examination, respectively. We used structural equation modeling to examine the shared and specific effects of depression and cognitive impairment on QoL, while adjusting for sociodemographic characteristics, general medical conditions, psychotropic medications and the duration of the disorder. RESULTS Depression and cognitive impairment were positively associated (r = 0.24, p < 0.01) and both independently and negatively impacted on QoL (standardized β = -0.41 and β = -0.32, both p < 0.01) and on each QLS quality-of-life domains, except for depression on instrumental role and cognitive impairment on interpersonal relations in the sensitivity analyses excluding respondents with any missing data. Effects of depression and cognitive impairment on QoL were not due to specific depressive symptoms or specific cognitive domains, but rather mediated through two broad dimensions representing the shared effects across all depressive symptoms and all cognitive deficits, respectively. LIMITATIONS Because of the cross-sectional design of this study, measures of association do not imply causal associations. CONCLUSIONS Mechanisms underlying these two broad dimensions should be considered as important potential targets to improve quality of life of this vulnerable population.
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Yu C, Lai CY, Chang Y, Wu C, Chung F. The symptoms, resourcefulness and quality of life in community‐based patients with schizophrenia. J Clin Nurs 2019; 28:3582-3589. [DOI: 10.1111/jocn.14953] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/01/2019] [Accepted: 05/26/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Ching‐Yun Yu
- School of Nursing Kaohsiung Medical University Kaohsiung Taiwan
| | - Chien Yu Lai
- School of Nursing National Taipei University of Nursing and Health Sciences Taipei Taiwan
| | - Yu‐Shan Chang
- Rehabilitation Department Shin Kao Feng Hospital Kaohsiung Taiwan
| | - Ching‐Kuan Wu
- Tsyr‐Huey Mental Hospital, Kaohsiung JEN‐AI'S Home Kaohsiung Taiwan
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Hasan AA, Tumah H. Determinants of quality of life among people diagnosed with schizophrenia at outpatient clinics. Perspect Psychiatr Care 2019; 55:30-39. [PMID: 29645261 DOI: 10.1111/ppc.12278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The study examines the determinants of the quality of life (QoL) among outpatients with schizophrenia in Jordan. DESIGN AND METHODS A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. FINDINGS The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was correlated positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. PRACTICAL IMPLICATIONS The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.
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Affiliation(s)
- Abd Alhadi Hasan
- Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
| | - Hussein Tumah
- Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
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Hasan AAH. The correlation between the quality of life and clinical variables among outpatients with schizophrenia. Psychiatry Res 2019; 271:39-45. [PMID: 30465980 DOI: 10.1016/j.psychres.2018.09.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 05/08/2018] [Accepted: 09/28/2018] [Indexed: 01/09/2023]
Abstract
The study identifies the correlation between the quality of life (QoL) among outpatients with schizophrenia and clinical outcomes. A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was related positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.
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Affiliation(s)
- Abd Al-Hadi Hasan
- Fakeeh College for Medical Sciences, Fakeeh College for Medical Science, 1222, Jeddah, Saudi Arabia.
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15
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Agenagnew L, Mamaru A, Hailesilassie H, Mekuriaw B, Dawud B, Abdisa E, Tolosa D, Abera M, Soboka M, Kerebih H, Yeshigeta E, Tesfaye E. Disability among patients with mental illness in Jimma Town, Southwest Ethiopia, 2017, communitybased crosssectional studyquestionnaire. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_42_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Determinants of Quality of Life in Spanish outpatients with schizophrenia spectrum disorders. EUROPEAN JOURNAL OF PSYCHIATRY 2018. [DOI: 10.1016/j.ejpsy.2017.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sum MY, Tay KH, Sengupta S, Sim K. Neurocognitive functioning and quality of life in patients with and without deficit syndrome of schizophrenia. Psychiatry Res 2018; 263:54-60. [PMID: 29499447 DOI: 10.1016/j.psychres.2018.02.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 02/02/2018] [Accepted: 02/12/2018] [Indexed: 11/15/2022]
Abstract
Deficit syndrome of schizophrenia is a subtype of schizophrenia characterized by primary and enduring negative symptoms. This study examined the differences in neurocognitive functioning and quality of life (QOL) between deficit and non-deficit patients, and specific predictors of both clinical measures. Overall, 344 subjects (175 patients with non-deficit schizophrenia (NDSZ), 58 patients with deficit schizophrenia (DSZ) and 111 healthy controls) were evaluated on severity of psychopathology, QOL and a smaller subset of 198 subjects (104 NDSZ, 27 DSZ, 67 healthy controls) underwent neurocognitive assessments. Multivariate analyses were used to determine differences in outcomes between subject groups and predictors of clinical measures. Both DSZ and NDSZ had significantly worse QOL compared with healthy controls. DSZ had more extensive cognitive deficits compared with healthy controls and performed worse on semantic fluency task compared to NDSZ. Multiple linear regression analysis found that DSZ, shorter duration of illness were associated with poorer QOL whereas fewer years of education, lower premorbid intelligence were associated with poorer overall neurocognitive functioning. The poorer QOL, greater extent of neurocognitive deficits especially semantic fluency associated with DSZ behoves the need for greater attention during clinical evaluation and treatment planning of this subgroup of individuals with schizophrenia.
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Affiliation(s)
- Min Yi Sum
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore
| | - Kai Hong Tay
- Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore
| | - Somnath Sengupta
- Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore
| | - Kang Sim
- Research Division, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore; Department of General Psychiatry, Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, 539747, Singapore.
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Health-related quality of life in outpatients with schizophrenia: factors that determine changes over time. Soc Psychiatry Psychiatr Epidemiol 2018; 53:239-248. [PMID: 29340780 DOI: 10.1007/s00127-018-1483-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 01/02/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE The objective of this study was to analyze the clinical factors associated with changes in HRQoL in outpatients with schizophrenia using both generic and condition-specific HRQoL scales. METHODS Adult outpatients with schizophrenia at least 18 years of age who did not have an acute psychotic exacerbation in the 3 months prior to baseline were recruited. PANSS dimensions were calculated based on Lindenmayer et al.'s five factors. HRQoL data were assessed by patients using the Schizophrenia Quality of Life Scale (SQLS), the Short Form-36 (SF-36), and the EuroQol-5 Dimension (EQ-5D) questionnaires. RESULTS Out of the 1345 patients included at baseline, 1196 (89%) were evaluated at 12 months. Regression models showed that the factor most consistently associated with HRQoL at endpoint was change in the PANSS negative symptoms score. A decrease in the PANSS negative symptoms score from baseline to 1 year was associated with a decrease in HRQoL during the same period. There were also significant associations of the change in PANSS excitatory factor with all the HRQoL scales except the SF-36 PCS. Female gender was associated with a decrease in all HRQoL ratings. There was also a relationship between years since onset and HRQoL. The longer the time since illness onset, the larger the decrease in HRQoL. CONCLUSIONS This study has found that, in outpatients with schizophrenia, changes in negative and excitement symptoms may have a greater an association with HRQoL than changes in positive, cognitive and depressive symptoms.
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Hsiao CY, Lu HL, Tsai YF. Effect of family sense of coherence on internalized stigma and health-related quality of life among individuals with schizophrenia. Int J Ment Health Nurs 2018; 27:138-146. [PMID: 28054432 DOI: 10.1111/inm.12302] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/21/2016] [Indexed: 01/19/2023]
Abstract
Health-related quality of life is an increasingly critical outcome of mental healthcare, yet its disease-independent attributes, particularly family-focused resilient indicators, for individuals with schizophrenia have not been explicitly examined. The aim of this study was to explore the degree of health-related quality of life and to examine the mediating effect of family sense of coherence on internalized stigma and health-related quality of life in individuals with schizophrenia. A cross-sectional and correlational study design was used. A total of 111 individuals with schizophrenia were enrolled from the in-patient psychiatric rehabilitation services of two psychiatric hospitals in Taiwan. Face-to-face structured interviews were applied to collect information. Data were analyzed with descriptive statistics and multiple regression analyses. The results indicated that affected individuals experienced impaired health-related quality of life. Family sense of coherence partially mediated the relationship between internalized stigma and health-related quality of life. This study indicates that knowledge about the role of family sense of coherence in mental health rehabilitation may assist mental healthcare professionals to provide therapeutic interventions to address internalized stigma, thereby promoting health-related quality of life in individuals living with schizophrenia.
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Affiliation(s)
- Chiu-Yueh Hsiao
- Department of Nursing, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Huei-Lan Lu
- Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan
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Cheng JF, Huang XY, Lin MJ, Wang YH, Yeh TP. The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden. J Clin Nurs 2017; 27:e668-e677. [PMID: 29076188 DOI: 10.1111/jocn.14123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. BACKGROUND The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. DESIGN A longitudinal quasi-experimental quantitative design. METHODS The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. RESULTS Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. CONCLUSIONS This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. RELEVANCE TO CLINICAL PRACTICE The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance.
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Affiliation(s)
- Jui-Fen Cheng
- School of Nursing, China Medical University and Hospital, Taichung, Taiwan
| | - Xuan-Yi Huang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Mei-Jue Lin
- Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Taichung, Taiwan
| | - Ya-Hui Wang
- Department of Nursing, Tsaotun Psychiatric Center, Ministry of Health and Welfare, Taichung, Taiwan
| | - Tzu-Pei Yeh
- Department of Nursing, China Medical University and Hospital, Taichung, Taiwan
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21
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Fleury MJ, Grenier G, Bamvita JM. Associated and mediating variables related to quality of life among service users with mental disorders. Qual Life Res 2017; 27:491-502. [DOI: 10.1007/s11136-017-1717-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 11/24/2022]
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Cai C, Yu L. Quality of Life in Patients With Schizophrenia in China: Relationships Among Demographic Characteristics, Psychosocial Variables, and Symptom Severity. J Psychosoc Nurs Ment Health Serv 2017; 55:48-54. [PMID: 28771287 DOI: 10.3928/02793695-20170627-03] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/26/2017] [Indexed: 11/20/2022]
Abstract
The aim of the current study was to examine the relationships among demographic characteristics, psychosocial variables, symptom severity, and quality of life (QOL), and the way these variables affect QOL in patients with schizophrenia living in Hubei, China. A convenience sample of 178 individuals with schizophrenia participated. The results suggest that the Schizophrenia Quality of Life Scale was positively and statistically significantly correlated with employment status (r = 0.232, p < 0.01) and monthly household income (r = 0.311, p < 0.01), positively correlated with personal empowerment (r = 0.692; p < 0.001), and negatively correlated with perceived stigma (r = -0.41, p < 0.01) and symptom severity (r = -0.54, p < 0.001). Illness uncertainty was not found to have a relationship with QOL in this sample. Among all variables, personal empowerment (accounting for 22.1% of variance) was the best positive predictor, whereas symptom severity (accounting for 7.6% of variance) was the best negative predictor of QOL in patients with schizophrenia. Implications for future research and practice are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 55(8), 48-54.].
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Pinho LGD, Pereira A, Chaves C. Influence of sociodemographic and clinical characteristics on the quality of life of patients with schizophrenia. Rev Esc Enferm USP 2017; 51:e03244. [PMID: 28902324 DOI: 10.1590/s1980-220x2016031903244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
Abstract OBJECTIVE Evaluating the quality of life of Portuguese patients with schizophrenia and linking it to sociodemographic and clinical aspects. METHOD A quantitative cross-sectional study carried out with individuals affected by schizophrenia, living in the entire continental territory of Portugal, through application of a sociodemographic and clinical questionnaire and the Quality of Life Scale short version (QLS7PT). Parametric and non-parametric tests were performed to evaluate the correlation between variables. RESULTS The sample consisted of 282 participants. The results point to a better quality of life for individuals living in autonomous residences or with their parents, who are employed/students, who have had the disorder for less time and are younger, who have completed the 12th grade of schooling and who are not medicated with first-generation neuroleptics. CONCLUSION The results indicate that some sociodemographic and clinical characteristics influence the quality of life of patients with schizophrenia and should be considered in the patient evaluation and in planning appropriate and effective strategies for their psychosocial rehabilitation.
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Rayan A, Obiedate K. The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia. J Am Psychiatr Nurses Assoc 2017; 23:404-413. [PMID: 28569084 DOI: 10.1177/1078390317710498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. AIMS The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. METHOD In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. RESULTS Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. CONCLUSIONS Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.
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Affiliation(s)
- Ahmad Rayan
- 1 Ahmad Rayan, PhD, Zarqa University, Zarqa, Jordan
| | - Khaldoon Obiedate
- 2 Khaldoon Obiedate, RN, MSN, CNS, Jordan University Hospital, Amman, Jordan
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25
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Taborda Zapata E, Montoya Gonzalez LE, Gómez Sierra NM, Arteaga Morales LM, Correa Rico OA. [Integrated management of patients with schizophrenia: beyond psychotropic drugs]. REVISTA COLOMBIANA DE PSIQUIATRIA 2016; 45:118-123. [PMID: 27132761 DOI: 10.1016/j.rcp.2015.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 06/25/2015] [Accepted: 07/06/2015] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Schizophrenia is a complex disease with severe functional repercussions; therefore it merits treatment which goes beyond drugs. THEME DEVELOPMENT It requires an approach that considers a diathesis-stress process that includes rehabilitation, psychotherapeutic strategies for persistent cognitive, negative and psychotic symptoms, psychoeducation of patient and communities, community adaptation strategies, such as the introduction to the work force, and the community model, such as a change in the asylum paradigm. DISCUSSION It is necessary to establish private and public initiatives for the integrated care of schizophrenia in the country, advocating the well-being of those with the disease. CONCLUSIONS The integrated management of schizophrenic patients requires a global view of the patient and his/her disease, and its development is essential.
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Brown BJ. Mutuality in health care: review, concept analysis and ways forward. J Clin Nurs 2016; 25:1464-75. [DOI: 10.1111/jocn.13180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 02/01/2023]
Affiliation(s)
- Brian J Brown
- Faculty of Health and Life Sciences; School of Applied Social Sciences; De Montfort University; Leicester UK
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Medici CR, Vestergaard CH, Hjorth P, Hansen MV, Shanmuganathan JWD, Viuff AG, Munk-Jørgensen P. Quality of life and clinical characteristics in a nonselected sample of patients with schizophrenia. Int J Soc Psychiatry 2016; 62:12-20. [PMID: 25987581 DOI: 10.1177/0020764015585330] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with schizophrenia experience low quality of life (QOL). AIMS To examine QOL in these patients and the relation between QOL and illness duration, adjusted daily doses (ADDs) of antipsychotics, body mass index (BMI), waist circumference and smoking. METHODS In this naturalistic, cross-sectional study, 82 patients were interviewed about smoking habits. Patients completed a QOL questionnaire (World Health Organization Quality of Life-Bref) consisting of physical, psychological, social and environmental domains and had height, weight and waist circumference measured. The characteristics and QOL were correlated using multiple regression analysis. RESULTS QOL was significantly lower in the patients than in the general population (p < .01). In first-ever diagnosed patients, QOL was associated with BMI (regression coefficient (RC): physical -0.73, psychological -1.44 and environmental -0.55; all p < .05), ADD (RC: physical 3.71, psychological 4.37 and environmental 2.94; all p < .10) and smoking (RC: physical -0.69; p < .01). In the long-term ill patients, QOL was associated with BMI (RC: physical -1.19 and psychological -1.28; all p < .05) and illness duration (RC: physical 1.38; p < .05). CONCLUSION Patients experienced low QOL. Lower QOL was associated with high BMI, low ADD and smoking in first-ever diagnosed patients and with high BMI and short illness duration in long-term ill patients.
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Affiliation(s)
- Clara R Medici
- Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark
| | - Claus H Vestergaard
- Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark
| | - Peter Hjorth
- Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark
| | - Mette V Hansen
- Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark
| | - Jan W D Shanmuganathan
- Department of Organic Psychiatric Disorders and Emergency Ward, Aarhus University Hospital, Risskov, Denmark
| | - Anne G Viuff
- Regional Psychiatric Services West, Herning, Denmark
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Brown B. Towards a critical understanding of mutuality in mental healthcare: relationships, power and social capital. J Psychiatr Ment Health Nurs 2015; 22:829-35. [PMID: 26608676 DOI: 10.1111/jpm.12269] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- B Brown
- School of Applied Social Sciences, De Montfort University, Leicester, UK
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29
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Zeng Y, Zhou Y, Lin J, Zhou Y, Yu J. Generic and disease-specific quality of life and its predictors among Chinese inpatients with schizophrenia. Psychiatry Res 2015; 228:724-8. [PMID: 26077848 DOI: 10.1016/j.psychres.2015.05.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 11/24/2022]
Abstract
This study aims to describe generic and disease-specific quality of life (QOL) and its predictors among Chinese inpatients with schizophrenia. A total of 209 subjects participated in this study: 121 men and 88 women. Their ages ranged from 18 to 64, with a mean age of 33.85 (S.D.=10.84). The total scores of generic and disease-specific QOL were statistically significant, correlated with patients׳ total symptom severity scores and social support scores (all P values less than 0.01). Multiple regression analysis revealed that monthly household income and subjective social support were statistically significant predictors of generic and disease-specific QOL. Duration of hospitalization, support use degree, negative and general psychopathology symptoms were additional significant predictors of disease-specific QOL. This study suggests the importance of improving subjective social support in order to promote generic and disease-specific QOL. Controlling negative and general psychopathology symptoms and improving support use degree could additionally enhance the disease-specific QOL in patients with schizophrenia.
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Affiliation(s)
- Yingchun Zeng
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Meidcal University, No 63 DuoBao Road, Liwan District, Guangzhou, Guangdong Province 510150 China.
| | - Ying Zhou
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Jiankui Lin
- Department of Nursing, Guangzhou Psychiatric Hospital, Guangzhou, China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical university, Daqing China
| | - Jianying Yu
- Department of Nursing, Hunan Psychiatric Hospital, Changsha, China
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Faugere M, Micoulaud-Franchi JA, Alessandrini M, Richieri R, Faget-Agius C, Auquier P, Lançon C, Boyer L. Quality of life is associated with chronic inflammation in schizophrenia: a cross-sectional study. Sci Rep 2015; 5:10793. [PMID: 26041435 PMCID: PMC4455112 DOI: 10.1038/srep10793] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 04/23/2015] [Indexed: 12/13/2022] Open
Abstract
Inflammation may play a crucial role in the pathogenesis of schizophrenia. However, the association between chronic inflammation and health outcomes in schizophrenia remains unclear, particularly for patient-reported outcomes. The aim of this study was to investigate the relationship between quality of life (QoL) and chronic inflammation assessed using C -Reactive Protein (CRP) in patients with schizophrenia. Two hundred and fifty six patients with schizophrenia were enrolled in this study. After adjusting for key socio-demographic and clinical confounding factors, patients with high levels of CRP (>3.0 mg/l) had a lower QoL than patients with normal CRP levels (OR = 0.97, 95% CI = 0.94–0.99). An investigation of the dimensions of QoL revealed that psychological well-being, physical well-being and sentimental life were the most salient features of QoL associated with CRP. Significant associations were found between lower educational level (OR = 4.15, 95% CI = 1.55–11.07), higher body mass index (OR = 1.16, 95% CI = 1.06–1.28), higher Fagerström score (OR = 1.22, 95% CI = 1.01–1.47) and high levels of CRP. After replications with longitudinal approaches, the association between QoL and chronic inflammation may offer interesting interventional prospects to act both on inflammation and QoL in patients with schizophrenia.
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Affiliation(s)
- M Faugere
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - J A Micoulaud-Franchi
- 1] Department of Clinical Neurophysiology, Sleep Clinique, Pellegrin University Hospital, 33076 Bordeaux, France [2] Bordeaux University, USR CNRS 3413 SANPSY, Research Unit, 33000 Bordeaux, France
| | - M Alessandrini
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - R Richieri
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - C Faget-Agius
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - P Auquier
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - C Lançon
- 1] Department of Psychiatry, La Conception University Hospital, 13009 Marseille, France [2] Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
| | - L Boyer
- Aix-Marseille Univ., EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005 Marseille, France
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Huang J, Tan SP, Walsh SC, Spriggens LK, Neumann DL, Shum DHK, Chan RCK. Working memory dysfunctions predict social problem solving skills in schizophrenia. Psychiatry Res 2014; 220:96-101. [PMID: 25110314 DOI: 10.1016/j.psychres.2014.07.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 07/19/2014] [Accepted: 07/19/2014] [Indexed: 12/21/2022]
Abstract
The current study aimed to examine the contribution of neurocognition and social cognition to components of social problem solving. Sixty-seven inpatients with schizophrenia and 31 healthy controls were administrated batteries of neurocognitive tests, emotion perception tests, and the Chinese Assessment of Interpersonal Problem Solving Skills (CAIPSS). MANOVAs were conducted to investigate the domains in which patients with schizophrenia showed impairments. Correlations were used to determine which impaired domains were associated with social problem solving, and multiple regression analyses were conducted to compare the relative contribution of neurocognitive and social cognitive functioning to components of social problem solving. Compared with healthy controls, patients with schizophrenia performed significantly worse in sustained attention, working memory, negative emotion, intention identification and all components of the CAIPSS. Specifically, sustained attention, working memory and negative emotion identification were found to correlate with social problem solving and 1-back accuracy significantly predicted the poor performance in social problem solving. Among the dysfunctions in schizophrenia, working memory contributed most to deficits in social problem solving in patients with schizophrenia. This finding provides support for targeting working memory in the development of future social problem solving rehabilitation interventions.
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Affiliation(s)
- Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| | - Shu-ping Tan
- Psychiatry Research Center, Huilongguan Hospital, Beijing, China
| | - Sarah C Walsh
- Behavioural Basis of Health Research Program, Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - Lauren K Spriggens
- Behavioural Basis of Health Research Program, Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - David L Neumann
- Behavioural Basis of Health Research Program, Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - David H K Shum
- Behavioural Basis of Health Research Program, Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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de Araújo AA, de Araújo Dantas D, do Nascimento GG, Ribeiro SB, Chaves KM, de Lima Silva V, de Araújo RF, de Souza DLB, de Medeiros CACX. Quality of life in patients with schizophrenia: the impact of socio-economic factors and adverse effects of atypical antipsychotics drugs. Psychiatr Q 2014; 85:357-67. [PMID: 24789610 DOI: 10.1007/s11126-014-9290-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This cross-sectional study compared the effects of treatment with atypical antipsychotic drugs on quality of life (QoL) and side effects in 218 patients with schizophrenia attending the ambulatory services of psychiatric in Rio Grande do Norte, Brazil. Socio-economic variables were compared. The five-dimension EuroQoL (EQ-5D) was used to evaluate QoL, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson-Angus Scale. Data were analysed using the χ (2) test and Student's t test, with a significance level of 5 %. Average monthly household incomes in the medication groups were 1.1-2.1 minimum wages ($339-$678). UKU Scale scores showed significant differences in side effects, mainly, clozapine, quetiapine and ziprasidone (p < 0.05). EQ-5D scores showed that all drugs except olanzapine significantly impacted mobility (p < 0.05), and proportions of individuals reporting problems in other dimensions were high: 63.6 % of clozapine users reported mobility problems, 63.7 and 56.3 % of clozapine and ziprasidone users, respectively, had difficulties with usual activities, 68.8 and 54.5 % of ziprasidone and clozapine users, respectively, experienced pain and/or discomfort, and 72.8 % of clozapine users reported anxiety and/or depression. Psychiatric, neurological, and autonomous adverse effects, as well as other side effects, were prevalent in users of atypical antipsychotic drugs, especially clozapine and ziprasidone. Olanzapine had the least side effects. QoL was impacted by side effects and economic conditions in all groups. Thus, the effects of these antipsychotic agents appear to have been masked by aggravating social and economic situations.
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Affiliation(s)
- Aurigena Antunes de Araújo
- Department of Biophysical and Pharmacology, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil,
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The effect of service satisfaction and spiritual well-being on the quality of life of patients with schizophrenia. Psychiatry Res 2014; 216:185-91. [PMID: 24582503 DOI: 10.1016/j.psychres.2014.01.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 11/15/2013] [Accepted: 01/28/2014] [Indexed: 11/20/2022]
Abstract
Quality of life (QOL) has been considered an important outcome measure in psychiatric research and determinants of QOL have been widely investigated. We aimed at detecting predictors of QOL at baseline and at testing the longitudinal interrelations of the baseline predictors with QOL scores at a 1-year follow-up in a sample of patients living in Residential Facilities (RFs). Logistic regression models were adopted to evaluate the association between WHOQoL-Bref scores and potential determinants of QOL. In addition, all variables significantly associated with QOL domains in the final logistic regression model were included by using the Structural Equation Modeling (SEM). We included 139 patients with a diagnosis of schizophrenia spectrum. In the final logistic regression model level of activity, social support, age, service satisfaction, spiritual well-being and symptoms' severity were identified as predictors of QOL scores at baseline. Longitudinal analyses carried out by SEM showed that 40% of QOL follow-up variability was explained by QOL at baseline, and significant indirect effects toward QOL at follow-up were found for satisfaction with services and for social support. Rehabilitation plans for people with schizophrenia living in RFs should also consider mediators of change in subjective QOL such as satisfaction with mental health services.
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