1
|
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.
Collapse
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
| |
Collapse
|
2
|
Zheng S, Wang R, Zhang S, Ou Y, Sheng X, Yang M, Ge M, Xia L, Li J, Zhou X. Depression severity mediates stigma and quality of life in clinically stable people with schizophrenia in rural China. BMC Psychiatry 2023; 23:826. [PMID: 37951892 PMCID: PMC10640747 DOI: 10.1186/s12888-023-05355-x] [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] [Received: 03/02/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Depressive symptoms associated with schizophrenia are closely related to stigma and quality of life(QOL). There is, however, no thorough research on the connection between the three. This study sought to investigate the possible factors influencing depressive symptoms in people with schizophrenia (PWS) in rural Chaohu, China, and to further explore the role of depression severity in stigma and lifestyle quality. METHODS Eight hundred twenty-one schizophrenia patients accomplished the entire scale, including the 9-item Patient Health Questionnaire (PHQ-9), the Social Impact Scale (SIS), and the World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF). A straightforward mediation model was employed to determine if the intensity of the depression could act as a mediator between stigma and QOL. RESULTS Two hundred seventy-nine schizophrenia patients (34%) had depressive symptoms (PHQ ≥ 10), and 542 patients (66%) did not (PHQ < 10). Logistic regression showed that marital status, job status, physical exercise, standard of living, and stigma contributed to the depressed symptoms of schizophrenia. Depression severity partially mediated the effect between stigma and QOL, with a mediating effect of 48.3%. CONCLUSIONS This study discovered a significant incidence of depressed symptoms associated with schizophrenia, with depression severity serving as a mediator variable connecting stigma and QOL and partially moderating the association.
Collapse
Affiliation(s)
- Siyuan Zheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Ruoqi Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Shaofei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Yangxu Ou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Xuanlian Sheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Meng Yang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Menglin Ge
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Jun Li
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China
- Anhui Psychiatric Center, Hefei City, China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei City, China.
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei City, China.
- Anhui Psychiatric Center, Hefei City, China.
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei City, China.
| |
Collapse
|
3
|
Fleury MJ, Cao Z, Grenier G, Ferland F. Profiles of quality of life among patients using emergency departments for mental health reasons. Health Qual Life Outcomes 2023; 21:116. [PMID: 37880748 PMCID: PMC10601205 DOI: 10.1186/s12955-023-02200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND This study identified profiles associated with quality of life (QoL) and sociodemographic and clinical characteristics of patients using emergency departments (ED) for mental health reasons and associated these profiles with patient service use. METHODS Recruited in four Quebec (Canada) ED networks, 299 patients with mental disorders (MD) were surveyed from March 1st, 2021, to May 13th, 2022. Data from medical records were collected and merged with survey data. Cluster analysis was conducted to identify QoL profiles, and comparison analyses used to assess differences between them. RESULTS Four QoL profiles were identified: (1) Unemployed or retired men with low QoL, education and household income, mostly having substance-related disorders and bad perceived mental/physical health conditions; (2) Men who are employed or students, have good QoL, high education and household income, the least personality disorders, and fair perceived mental/physical health conditions; (3) Women with low QoL, multiple mental health problems, and very bad perceived mental/physical health conditions; (4) Mostly women with very good QoL, serious MD, and very good perceived mental/physical health conditions. CONCLUSION The profiles with the highest QoL (4 and 2) had better overall social characteristics and perceived their health conditions as superior. Profile 4 reported the highest level of satisfaction with services used. To improve QoL programs like permanent supportive housing, individual placement and support might be better implemented, and satisfaction with care more routinely assessed in response to patient needs - especially for Profiles 1 and 3, that show complex health and social conditions.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute Research Centre Montreal, Montreal, QC, Canada.
- Douglas Mental Health University Institute Research Centre Montreal, Montreal, QC, Canada.
- Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.
| | - Zhirong Cao
- Douglas Mental Health University Institute Research Centre Montreal, Montreal, QC, Canada
| | - Guy Grenier
- Douglas Mental Health University Institute Research Centre Montreal, Montreal, QC, Canada
| | - Francine Ferland
- School of Social Work, Addiction Rehabilitation Center, Laval University, National Capital University Integrated Health and Social Services Center, Quebec City, QC, Canada
| |
Collapse
|
4
|
Lin C, Wan X, Zhang R, Yang X, Liu Y. Quality of life and its influencing factors in patients with schizophrenia. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2023; 48:472-480. [PMID: 37164931 PMCID: PMC10930085 DOI: 10.11817/j.issn.1672-7347.2023.220438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Indexed: 05/12/2023]
Abstract
Schizophrenia is a chronic mental disease. With the change of medical model, quality of life has gradually become an important prognostic indicator for patients with schizophrenia. People with schizophrenia have a lower quality of life than the general population or people with other chronic diseases, Sociodemographic factors such as age, gender, employment, education level, income and living situation; clinical factors such as psychiatric symptoms, medication compliance and insight; and psychosocial factors such as social support, cognition, stigma, self-esteem and needs are the main influencing factors for schizophrenia patients. Medication and psychological interventions such as social skills training, family intervention, cognitive correction and cognitive behavioral therapy can be used to improve the quality of life of patients with schizophrenia. Understanding the factors affecting the quality of life of schizophrenia patients and the improvement measures helps to provide reference for improving their quality of life.
Collapse
Affiliation(s)
- Chunying Lin
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041.
| | - Xiaoyan Wan
- Center of Health Management Cadre Training, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041
| | - Ruohan Zhang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041
| | - Xianmei Yang
- Department of Mental Health and Social Services, Sichuan Mental Health Center (Third Hospital of Mianyang), Mianyang Sichuan 621054, China
| | - Yuanyuan Liu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041.
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Fridén L, Hultsjö S, Lydell M, Jormfeldt H. Relatives' experiences of an equine-assisted intervention for people with psychotic disorders. Int J Qual Stud Health Well-being 2022; 17:2087276. [PMID: 35698741 PMCID: PMC9310814 DOI: 10.1080/17482631.2022.2087276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to describe relatives' experiences of an equine-assisted intervention for people with psychotic disorders. METHODS The study has a qualitative and descriptive design. Ten semi-structured interviews were performed with relatives of people with a psychotic disorder who had participated in an equine-assisted intervention. A conventional content analysis was used to analyse the data. RESULT The overall category "Being with the horses strengthens health capabilities" summarizes the four identified subcategories "The horses contribute to a context with a common focus", "Interaction with the horses enhances self-confidence and motivation", "The interplay with the horses nurtures positive emotions" and "Being with the horses encourages physical activity". CONCLUSIONS The result of this study contributes to the growing body of research about the potential outcomes of equine-assisted interventions. The result also indicates that equine-assisted interventions may improve health capabilities among people with psychotic disorders. The generated knowledge may be useful in mental health services when developing equine-assisted interventions.
Collapse
Affiliation(s)
- Linda Fridén
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Sally Hultsjö
- Department of Psychiatry, Region Jönköping County, Sweden and Department of Health, Medicine and Caring Sciences, Division of Nursing and Reproductive Health, Linköping University, Linköping, Sweden
| | - Marie Lydell
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | |
Collapse
|
7
|
Chen C, Chen Y, Huang Q, Yan S, Zhu J. Self-Care Ability of Patients With Severe Mental Disorders: Based on Community Patients Investigation in Beijing, China. Front Public Health 2022; 10:847098. [PMID: 35719645 PMCID: PMC9198226 DOI: 10.3389/fpubh.2022.847098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Severe Mental Disorders have become a topic of increasing interest in research due to their serious consequences for the quality of life and functioning. In the pages that follow, it will be argued that the self-care ability and its influencing factors among patients with severe mental disorders in Beijing, according to the questionnaire survey in 2019. Methods Proportionate stratified sampling was used to select representative patients as samples. The demographic characteristics of were obtained from the Management Information System for Severe Mental Disorders and the questionnaires. The self-care ability was measured by self-made scales. Descriptive statistics, t-test, and multiple linear regression were used to analyze the data. Results We surveyed 662 people and found that the deficiency of self-care ability is common in patients with severe mental disorders. Self-care ability was positively correlated with educated levels and guardian takes care of alone, and negatively correlated with age, course of disease and physical disease (P < 0.05). From a dimensional perspective, the daily basic activity was positively correlated with educated levels and negatively correlated with physical disease (P < 0.05); the housework ability was positively correlated with gender, educated levels and medication adherence, and negatively correlated with source of income and physical disease (P < 0.05); the social function was positively correlated with educated levels, guardian takes care of alone and medication adherence, and negatively correlated with age, source of income, course of disease and physical disease (P < 0.05). Conclusion The self-care ability of patients with severe mental disorders is affected by many factors, including patient characteristics and social factors. Therefore, targeted interventions are needed to help patients restore their self-care ability, which requires the joint efforts of the government and the whole society.
Collapse
Affiliation(s)
- Chen Chen
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| | - Yun Chen
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Qingzhi Huang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.,Beijing Institute of Mental Health, Beijing, China
| | - Shengming Yan
- Department of Sociology, Peking University, Beijing, China
| | - Junli Zhu
- School of Public Health, Capital Medical University, Beijing, China.,Research Center for Capital Health Management and Policy, Beijing, China
| |
Collapse
|
8
|
Su Y, D'Arcy C, Li M, Meng X. Trends and patterns of life satisfaction and its relationship with social support in Canada, 2009 to 2018. Sci Rep 2022; 12:9720. [PMID: 35691986 PMCID: PMC9189104 DOI: 10.1038/s41598-022-13794-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
The present study aims to explore the trends and patterns of life satisfaction in Canada from 2009 to 2018 and to examine changes in the associations between social support and life satisfaction over time. Data were from ten annual Canadian Community Health Surveys (CCHS). Each survey represents 97% of the Canadian population. Point estimates and 95% confidence intervals (CIs) of life satisfaction were calculated at the population level. Generalized linear regression was used to explore the relationship between life satisfaction and social support both nationally and in different population subgroups. The annual life satisfaction score gradually increased both at national and provincial levels from 2009 to 2018. Individuals who were women, aged between 12 and 19 years, living in rural areas, were most satisfied with their lives. There was a positive correlation between social support and life satisfaction for the provinces and the study years for which information on social support was available. Our findings suggest strengthening social support could be a public health target for promoting greater life satisfaction. Timely availability and analysis of life satisfaction and social support data could better inform policy and promote wellbeing at a population level.
Collapse
Affiliation(s)
- Yingying Su
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.,Douglas Research Centre, Montreal, QC, Canada
| | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.,Department of Psychiatry, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Muzi Li
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada.,Douglas Research Centre, Montreal, QC, Canada
| | - Xiangfei Meng
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, 6875 Boulevard LaSalle, Montreal, QC, H4H 1R3, Canada. .,Douglas Research Centre, Montreal, QC, Canada.
| |
Collapse
|
9
|
Johnson CA, Tran DN, Mwangi A, Sosa-Rubí SG, Chivardi C, Romero-Martínez M, Pastakia S, Robinson E, Jennings Mayo-Wilson L, Galárraga O. Incorporating respondent-driven sampling into web-based discrete choice experiments: preferences for COVID-19 mitigation measures. HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY 2022; 22:297-316. [PMID: 35035272 PMCID: PMC8747856 DOI: 10.1007/s10742-021-00266-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/22/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
To slow the spread of COVID-19, most countries implemented stay-at-home orders, social distancing, and other nonpharmaceutical mitigation strategies. To understand individual preferences for mitigation strategies, we piloted a web-based Respondent Driven Sampling (RDS) approach to recruit participants from four universities in three countries to complete a computer-based Discrete Choice Experiment (DCE). Use of these methods, in combination, can serve to increase the external validity of a study by enabling recruitment of populations underrepresented in sampling frames, thus allowing preference results to be more generalizable to targeted subpopulations. A total of 99 students or staff members were invited to complete the survey, of which 72% started the survey (n = 71). Sixty-three participants (89% of starters) completed all tasks in the DCE. A rank-ordered mixed logit model was used to estimate preferences for COVID-19 nonpharmaceutical mitigation strategies. The model estimates indicated that participants preferred mitigation strategies that resulted in lower COVID-19 risk (i.e. sheltering-in-place more days a week), financial compensation from the government, fewer health (mental and physical) problems, and fewer financial problems. The high response rate and survey engagement provide proof of concept that RDS and DCE can be implemented as web-based applications, with the potential for scale up to produce nationally-representative preference estimates.
Collapse
Affiliation(s)
- Courtney A Johnson
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Box G-S121-2, Providence, RI 02912 USA
| | - Dan N Tran
- Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA USA
| | - Ann Mwangi
- Department of Behavioural Science, School of Medicine, Moi University, Eldoret, Kenya
| | | | - Carlos Chivardi
- National Institute of Public Health (INSP), Cuernavaca, Morelos Mexico
| | | | - Sonak Pastakia
- Center for Health Equity and Innovation, Purdue University College of Pharmacy, Indianapolis, IN USA
| | | | | | - Omar Galárraga
- Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, Box G-S121-2, Providence, RI 02912 USA
| |
Collapse
|
10
|
Averous P, Charbonnier E, Dany L. Assessment of illness representations in mental disorders: A mini review. Encephale 2021; 47:137-142. [PMID: 33589282 DOI: 10.1016/j.encep.2020.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/10/2020] [Accepted: 09/28/2020] [Indexed: 11/16/2022]
Abstract
Health beliefs, and especially illness representations, have been widely used to understand clinical outcomes and psychosocial adjustment in people with physical diseases. However, this area of research has been under-explored in the field of mental health, and the few studies that have been conducted have used very different methods. Therefore, the aim of our study was to identify the tools and methods that have been used to evaluate illness representations in psychiatry. To this end, a mini review has been conducted and 58 articles were retained. This mini review highlights that the quantitative method is the most used, and that the scales mobilised are often adapted for the study, but not validated. Indeed, multiple modifications and adaptations have been made by the authors (e.g. deletion of subscales, addition of items), which lead to questions about the reliability of what is measured. In the future, it is essential to have a validated generic tool for mental disorders, which could be based on the Illness perceptions questionnaire for schizophrenia.
Collapse
Affiliation(s)
- P Averous
- Aix Marseille Univ, Aix-en-Provence, France; UNIV. NIMES, APSY-V, Nîmes cedex 1, France.
| | | | - L Dany
- Aix Marseille Univ, Aix-en-Provence, France; APHM, Timone, Service d'Oncologie Médicale, Marseille, France
| |
Collapse
|
11
|
Ogundare T, Onifade PO, Ogundapo 'D, Ghebrehiwet S, Borba CPC, Henderson DC. Relationship between quality of life and social integration among patients with schizophrenia attending a Nigerian tertiary hospital. Qual Life Res 2021; 30:1665-1674. [PMID: 33523402 DOI: 10.1007/s11136-021-02764-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Despite decades of de-institutionalization and the best efforts of community mental health services, individuals with schizophrenia living outside the hospital may be described as in the community but not of the community, and remain in a very real sense socially excluded. AIM AND OBJECTIVES To determine the relationship between social integration and quality of life among patients with schizophrenia attending the outpatient clinic of the Neuropsychiatric Hospital Abeokuta in Nigeria. METHODS One hundred and fifty-one patients were recruited. Sociodemographic questionnaire, MINI-PLUS, WHOQOL-BREF, Social Integration Scale and PANSS were administered. Multivariable regression analyses were performed to identify the determinants of quality of life and the relationship with social integration. RESULTS The mean (± SD) age of the respondents was 40.00 (± 10.23), 56.3% were males, 37.1% were single. Independent predictors of lower quality of life were: (1) more severe psychopathology for the domains of general health (p = 0.003), social relationship (p = 0.019) and environment (p = 0.008); (2) longer duration of illness for the social relationship (p = 0.028) and environment (p = 0.015) domains; and (3) negative symptoms (p = 0.034) for the physical domain. CONCLUSION There is a need to pay closer attention to social outcome measures such as quality of life and level of social integration among patients with schizophrenia who come in contact with psychiatry services, and not just on symptom remission only.
Collapse
Affiliation(s)
- Temitope Ogundare
- Neuropsychiatric Hospital, PMB 2002, Aro, Abeokuta, Ogun State, Nigeria. .,School of Public Health, Boston University, Boston, MA, 02118, USA.
| | - Peter O Onifade
- Neuropsychiatric Hospital, PMB 2002, Aro, Abeokuta, Ogun State, Nigeria
| | - 'Deji Ogundapo
- Neuropsychiatric Hospital, PMB 2002, Aro, Abeokuta, Ogun State, Nigeria
| | | | - Christina P C Borba
- Boston University School of Medicine, Boston, MA, 02118, USA.,Department of Psychiatry, Boston Medical Center, Boston, MA, 02118, USA
| | - David C Henderson
- Boston University School of Medicine, Boston, MA, 02118, USA.,Department of Psychiatry, Boston Medical Center, Boston, MA, 02118, USA
| |
Collapse
|
12
|
Valiente C, Espinosa R, Contreras A, Trucharte A, Caballero R, Peinado V. The feasibility and acceptability study of a positive psychology group intervention for people with severe psychiatric conditions. JOURNAL OF POSITIVE PSYCHOLOGY 2021. [DOI: 10.1080/17439760.2021.1871940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carmen Valiente
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, School of Education and Health, Camilo José Cela University, Madrid, Spain
| | - Alba Contreras
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Almudena Trucharte
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Rocío Caballero
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| | - Vanesa Peinado
- Department of Clinical Psychology, School of Psychology, Complutense University, Madrid, Spain
| |
Collapse
|
13
|
Celebre A, Stewart SL, Theall L, Lapshina N. An Examination of Correlates of Quality of Life in Children and Youth With Mental Health Issues. Front Psychiatry 2021; 12:709516. [PMID: 34539463 PMCID: PMC8440870 DOI: 10.3389/fpsyt.2021.709516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/10/2021] [Indexed: 11/13/2022] Open
Abstract
Quality of life (QoL) is significantly lower in children with mental health issues compared to those who are typically developing or have physical health problems. However, little research has examined factors associated with QoL in this particularly vulnerable population. To address this limitation, 347 clinically referred children and adolescents were assessed using the interRAI Child and Youth Mental Health (ChYMH) Assessment and Self-reported Quality of Life- Child and Youth Mental Health (QoL-ChYMH). Hierarchical multiple linear regression analyses were conducted to examine QoL at the domain-specific level. Children and adolescents who experienced heightened anhedonia and depressive symptoms reported lower social QoL (e.g., family, friends and activities; p = 0.024, 0.046, respectively). Additionally, children and youth who experienced heightened depressive symptoms reported lower QoL at the individual level (e.g., autonomy, health; p = 0.000), and level of basic needs (e.g., food, safety; p = 0.013). In contrast, no mental state indicators were associated with QoL related to services (e.g., school, treatment). Due to the paucity of research examining predictors of QoL in children and youth with mental health challenges, this study contributes to the field in assisting service providers with care planning and further providing implications for practice.
Collapse
Affiliation(s)
- Angela Celebre
- Faculty of Education, Western University, London, ON, Canada
| | | | - Laura Theall
- Child and Parent Resource Institute, London, ON, Canada
| | | |
Collapse
|
14
|
Brink M, Andersen K. Subjective health-related quality of life in community-dwelling middle-aged and older adults with early-onset schizophrenia. Nord J Psychiatry 2020; 74:585-593. [PMID: 32513037 DOI: 10.1080/08039488.2020.1769186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Long-term outcome in schizophrenia remains unsatisfactory due to continued premature deaths and insufficient health treatment. Subjective quality of life (SQoL) measurements hold important information and have meaningful implications regarding ways of improving general health status. This study investigated the physical and mental SQoL and associated clinical and sociodemographic outcomes among community-dwelling middle-aged and older people with early-onset schizophrenia.Materials and methods: A cross-sectional interview study where participants residing in the Region of Southern Denmark were identified through The Danish Psychiatric Central Register. Of a total of 278 eligible individuals, 59 people aged 55-82 years old participated. The SQoL measure Medical Outcomes Short Form 36 version 2 (SF36) was used. Scores were compared by age groups with normative data for the Danish population. Associated outcomes were measured using Positive And Negative Symptom Scale Remission and others.Results: Increased mental SQoL was associated with schizophrenia in remission (adjusted B 9.43, p = .001), increased Mental Health Recovery Measure score (adjusted B 0.55, p < .001) and increased GAF score (adjusted B 0.32, p < .001). Comparing with Danish Normative data, mental SQoL was reduced (p = .001) among 55-64-year olds, but presented levels similar to the general population at ages over 65 years. Physical quality of life was similar to the general population.Conclusion: Over 65-year olds with schizophrenia seemed to have SQoL similar to their age peers in the general population. Aiming treatment at achieving state of remission or recovery would be an amenable measure toward increasing mental SQoL among middle-aged people with schizophrenia.
Collapse
Affiliation(s)
- Maria Brink
- Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kjeld Andersen
- Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
15
|
Muller AE. A Systematic Review of Quality of Life Assessments of Offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2020; 64:1364-1397. [PMID: 31989846 DOI: 10.1177/0306624x19881929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Strength-based theories of rehabilitation emphasize the importance of opportunities for offenders to achieve "good lives" to not re-offend. The extent to which these groups feel enabled to achieve a good life may be measured through subjective, overall quality of life (QoL). The aim is to systematically review the QoL instruments used among detained offenders and synthesize the factors related to their QoL. A systematic literature review was conducted to retrieve articles that assessed the overall QoL of a sample of detained offenders using a validated instrument. The instruments' specificity, dimensionality, and respondent and administrator burden were assessed, and factors reported as significantly related to QoL were summarized. In total, 41 articles were included in the review: 20 reported on forensic samples and 20 on prisoners, with one study randomly assigning offenders to either forensic treatment or prison. Among the included articles, 12 validated instruments were utilized. Only one instrument, the Forensic Inpatient Quality of Life Questionnaire, was specifically developed for and validated in forensic patients. Detained offending populations reported lower QoL than the general population, and those with untreated mental illness reported the lowest. The most consistent predictors of QoL longitudinally were social factors, while substance use and detention-specific variables were not consistently related. In general, the relationships between poor mental health, loneliness, and poor QoL seen in offenders are also seen among other marginalized populations. To improve the evidence base for QoL assessment in this vulnerable group, current gold standard QoL instruments should be validated in detained populations.
Collapse
Affiliation(s)
- Ashley Elizabeth Muller
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, Oslo, Norway
| |
Collapse
|
16
|
Vazquez Arreola E, Wilson JR, Chen DG. Analysis of correlated data with feedback for time-dependent covariates in psychiatry research. Gen Psychiatr 2020; 33:e100263. [PMID: 32914055 PMCID: PMC7477964 DOI: 10.1136/gpsych-2020-100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 11/10/2022] Open
Abstract
In studies on psychiatry and neurodegenerative diseases, it is common to have data that are correlated due to the hierarchical structure in data collection or to repeated measures on the subject longitudinally. However, the feedback effect created due to time-dependent covariates in these studies is often overlooked and seldom modelled. This article reviews the methodological development of feedback effects with marginal models for longitudinal data and discusses their implementation.
Collapse
Affiliation(s)
- Elsa Vazquez Arreola
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, Arizona, USA
| | - Jeffrey R Wilson
- Department of Economics, W.P. Carey School of Business, Arizona State University, Tempe, Arizona, USA
| | - Ding-Geng Chen
- School of Social Work and Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
17
|
Prost SG, Panisch LS, Bedard LE. Quality of Life in Jail: Gender, Correlates, and Drivers in a Carceral Space. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2020; 64:1156-1177. [PMID: 31884837 DOI: 10.1177/0306624x19896906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Quality of life (QOL) is an important area of exploration in U.S. corrections linked closely to well-being and an important indicator of intervention efficacy. Little is known of QOL in U.S. jails despite the admittance of over 10-million people to these settings every year. Research regarding the dimensions, correlates, and gender disparities in QOL in jails is important to shaping gender-responsive supports and reducing recidivism. Independent t tests and correlational and regression analyses were used to explore dimensions, correlates, and gender disparities in QOL among persons incarcerated in a large, southeastern jail (N = 299). All QOL domains were significantly related to overall QOL, and psychological QOL contributed most readily to respondent's overall QOL. Females, on average, reported lower QOL than males with significant differences between the groups in physical health and psychological domains. The importance of psychological QOL intervention and healthcare continuity are discussed.
Collapse
|
18
|
Averous P, Charbonnier E, Dany L. Relationship Between Illness Representations, Psychosocial Adjustment, and Treatment Outcomes in Mental Disorders: A Mini Review. Front Psychol 2020; 11:1167. [PMID: 32612557 PMCID: PMC7309516 DOI: 10.3389/fpsyg.2020.01167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 05/06/2020] [Indexed: 01/04/2023] Open
Abstract
Understanding and improving the psychosocial adjustments (e.g., quality of life, depression) and treatment outcomes (e.g., adherence, beliefs about treatments) of people with mental disorders are major health issues. The self-regulation model (SRM) postulates that illness representations play a central role on adjustment and treatment of people with physical illnesses. Recently, the SRM has been used with people with mental disorders. However, the manifestations of somatic and psychiatric disorders can be very different. Therefore, the use of SRM in the field of mental health is very complex. This difficulty, as well as the growing interest for illness representations in the field of mental health, justifies the utility to conduct a review on this topic. The current review shows that illness representations are related to psychosocial adjustment and/or treatment outcomes for people with various mental disorders [e.g., psychotic disorders, mood disorder, posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD)]. However, some limitations to the applicability of SRM to mental disorders have been highlighted. These limitations should be considered in future studies.
Collapse
Affiliation(s)
- Priscillia Averous
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,UNIV. NIMES, EA 7352 CHROME, Nîmes, France
| | | | - Lionel Dany
- Aix Marseille Univ, LPS, Aix-en-Provence, France.,APHM, Timone, Service d'Oncologie Médicale, Marseille, France
| |
Collapse
|
19
|
Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks. Int J Integr Care 2020; 20:12. [PMID: 32565762 PMCID: PMC7292103 DOI: 10.5334/ijic.4718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. Methods: A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327). Results: For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban). Conclusion: The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.
Collapse
|
20
|
Wang J, Lloyd-Evans B, Marston L, Mann F, Ma R, Johnson S. Loneliness as a predictor of outcomes in mental disorders among people who have experienced a mental health crisis: a 4-month prospective study. BMC Psychiatry 2020; 20:249. [PMID: 32434492 PMCID: PMC7238641 DOI: 10.1186/s12888-020-02665-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loneliness has not until recently been a prominent focus in research on outcomes of mental illness. The aim of this study was to determine whether loneliness at baseline predicts poor outcomes at 4-month follow-up for individuals who have experienced mental health crises. The outcomes in this study included overall symptom severity, affective symptoms, self-rated recovery and health-related quality of life. METHODS Our study reports a secondary analysis of data from a randomised controlled trial. The sample (n = 399) was taken from patients who received treatment from community crisis services. Respondents (n = 310) completed the follow-up measurement 4 months after baseline. Loneliness at baseline was assessed using an eight-item UCLA Loneliness Scale. The four mental health outcomes were measured at both baseline and follow-up. Two scales (or part thereof) assessed objective social isolation and neighbourhood social capital at baseline. Regression analyses were conducted to investigate longitudinal associations between loneliness at baseline and mental health outcomes at follow-up. RESULTS Loneliness at baseline was associated with all four mental health outcomes at 4-month follow-up, adjusting for psychosocial, socio-demographic and clinical characteristics. A one-point higher loneliness score was associated with 0.74-point (95% CI 0.45, 1.02) and 0.34-point (95% CI 0.21, 0.47) increase in overall symptom severity score and affective symptoms score respectively, and with 1.08-point (95% CI -1.45, - 0.71) and 1.27-point (95% CI -1.79, - 0.75) decrease in self-rated recovery score and health-related quality of life score respectively. Loneliness was a better predictor of clinical outcomes than objective social isolation and social capital, even though the associations with clinical outcomes were reduced and no longer statistically significant following adjustment for their baseline values. A significant association with quality of life persisted after adjustment for its baseline score. CONCLUSIONS Greater loneliness at baseline predicted poorer health-related quality of life at follow-up. There were cross-sectional associations between loneliness and clinical outcomes, but their longitudinal relationship cannot be confirmed. Further research is needed to clearly establish their underpinning pathways. Reducing loneliness may be a promising target to improve recovery for mental health community crisis service users.
Collapse
Affiliation(s)
- Jingyi Wang
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - Brynmor Lloyd-Evans
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Louise Marston
- grid.83440.3b0000000121901201Research Department of Primary Care and Population Health, University College London, UCL Medical School, Rowland Hill Street, London, NW3 2PF UK
| | - Farhana Mann
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Ruimin Ma
- grid.83440.3b0000000121901201Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK. .,Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE, UK.
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
Subjective Quality of Life and Its Associations among First Episode Psychosis Patients in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010260. [PMID: 31905928 PMCID: PMC6981770 DOI: 10.3390/ijerph17010260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 11/17/2022]
Abstract
Background—Mental disorders have been found to affect quality of life (QOL) in patients. The current study aimed to determine QOL among first episode psychosis (FEP) patients and explore its associations with sociodemographic as well as clinical factors. Methods—Data for this study were collected as a part of an Early Psychosis Intervention Program (EPIP)-Smoking and Alcohol use survey. At baseline, 280 outpatients aged 15–40 years old diagnosed with FEP, with no prior or minimal treatment, no history of medical or neurological disorder, and no history of substance abuse, were recruited. Sociodemographic details, diagnosis, length of duration of untreated psychosis (DUP), and World Health Organization Quality of Life assessment—abbreviated version (WHOQOL-BREF) scores were obtained. Results—After adjusting for all covariates, older age (p = 0.036), females, and participants diagnosed with brief psychotic disorder (p = 0.04) were associated positively, whereas separated/divorced participants, those with lower education, unemployed (p = 0.01), and longer DUP were seen to be negatively associated with different domains of QOL. Conclusion—Higher WHOQOL-BREF scores denote better QOL. Overall, female participants as compared to male participants and those diagnosed with brief psychotic disorder in this sample reported better QOL.
Collapse
|
23
|
Profiles of Service Users with Severe Mental Disorders Based on Adequacy of Help. Psychiatr Q 2019; 90:613-627. [PMID: 31218514 DOI: 10.1007/s11126-019-09652-1] [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: 10/26/2022]
Abstract
This study has for aims to develop a typology describing adequacy of help based on socio-demographic, clinical and service utilization variables for 204 service users with severe mental disorders treated in the community. Study participants were recruited in an urban area of Quebec (Canada). Adequacy of help was assessed with the Montreal Assessment of Needs Questionnaire. A cluster analysis identified five profiles of service users. Adequacy of help was mainly related to continuity of care, help given by services, seriousness of needs and, to some extent, quality of life (QOL). Adequacy of help was highest among Class 3 participants, described as older individuals with mood disorders, who lived in autonomous housing and enjoyed good QOL. They received substantial help from both relatives and services. Adequacy of help was lowest for Class 5, which included individuals affected by co-occurring mental disorders but who also lived autonomously. Health service utilization was more strongly related to adequacy of help for this sample than were the socio-demographic and clinical factors tested.
Collapse
|
24
|
Iorfino F, Cross SP, Davenport T, Carpenter JS, Scott E, Shiran S, Hickie IB. A Digital Platform Designed for Youth Mental Health Services to Deliver Personalized and Measurement-Based Care. Front Psychiatry 2019; 10:595. [PMID: 31507465 PMCID: PMC6716201 DOI: 10.3389/fpsyt.2019.00595] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/26/2019] [Indexed: 12/21/2022] Open
Abstract
Mental disorders that commonly emerge during adolescence and young adulthood are associated with substantial immediate burden and risks, as well as potentially imparting lifetime morbidity and premature mortality. While the development of health services that are youth focused and prioritize early intervention has been a critical step forward, an ongoing challenge is the heterogeneous nature of symptom profiles and illness trajectories. Consequently, it is often difficult to provide quality mental health care, at scale, that addresses the broad range of health, social, and functional needs of young people. Here, we describe a new digital platform designed to deliver personalized and measurement-based care. It provides health services and clinicians with the tools to directly address the multidimensional needs of young people. The term "personalized" describes the notion that the assessment of, and the sequence of interventions for, mental disorders are tailored to the young person-and their changing needs over time, while "measurement-based" describes the use of systematic and continuing assessment of a young person's outcomes over the entire course of clinical care. Together, these concepts support a framework for care that transcends a narrow focus on symptom reduction or risk reduction. Instead, it prioritizes a broader focus on enhancing social, health, and physical outcomes for young people and a commitment to tracking these outcomes throughout this key developmental period. Now, with twenty-first century technologies, it is possible to provide health services with the tools needed to deliver quality mental health care.
Collapse
Affiliation(s)
- Frank Iorfino
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Research and development, Innowell, Pty Ltd., Sydney, NSW, Australia
| | - Shane P. Cross
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Tracey Davenport
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
- Research and development, Innowell, Pty Ltd., Sydney, NSW, Australia
| | | | - Elizabeth Scott
- School of Medicine, University of Notre Dame, Sydney, NSW, Australia
| | - Sagit Shiran
- Research and development, Innowell, Pty Ltd., Sydney, NSW, Australia
| | - Ian B. Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
25
|
Abstract
PURPOSE Measuring quality of life (QoL) under incarceration can be used to track successful rehabilitation and risk of re-offending. However, few studies have measured QoL among general incarcerated populations, and it is important to use psychometrically strong measures that pose minimal burdens to respondents and administrators. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH The aim of this analysis was to explore the utility of a short generic tool measuring overall QoL, the QOL5, in an incarcerated population. The authors drew data from the Norwegian Offender Mental Health and Addiction Study, a cross-sectional survey of 1,499 individuals from Norwegian prisons. FINDINGS Factor analysis suggested a unidimensional structure that explained 53.2 percent of variance in QoL scores. Intrascale correlations were high and internal consistency was acceptable ( α=0.764). The QOL5 was strongly correlated with mental health, moderately correlated with exercise frequency and weakly correlated with ward security. PRACTICAL IMPLICATIONS The QOL5 is a short measure that presents minimal burden to respondents and administrators. The authors recommend its further use in incarcerated populations to measure overall QoL as well as cross-cultural adaptation and validation in more languages. ORIGINALITY/VALUE In this analysis of the largest published sample to date of incarcerated individuals and their QoL, the QOL5 appears to be an acceptable and valid measure of overall QoL.
Collapse
Affiliation(s)
- Ashley Elizabeth Muller
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo , Oslo, Norway.,Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Bukten
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo , Oslo, Norway.,Division for Mental Health and Addiction, Oslo University Hospital , Oslo, Norway.,The Correctional Service of Norway Staff Academy, Oslo, Norway
| |
Collapse
|
26
|
Rios S, Perlman CM. Social Withdrawal Among Individuals Receiving Psychiatric Care: Derivation of a Scale Using Routine Clinical Assessment Data to Support Screening and Outcome Measurement. J Behav Health Serv Res 2019; 45:579-592. [PMID: 28439787 DOI: 10.1007/s11414-017-9554-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Social withdrawal is a symptom experienced by individuals with an array of mental health conditions, particularly those with schizophrenia and mood disorders. Assessments of social withdrawal are often lengthy and may not be routinely integrated within the comprehensive clinical assessment of the individual. This study utilized item response and classical test theory methods to derive a Social Withdrawal Scale (SWS) using items embedded within a routine clinical assessment, the RAI-Mental Health (RAI-MH). Using data from 60,571 inpatients in Ontario, Canada, a common factor analysis identified seven items from the RAI-MH that measure social withdrawal. A graded response model found that six items had acceptable discrimination parameters: lack of motivation, reduced interaction, decreased energy, flat affect, anhedonia, and loss of interest. Summing these items, the SWS was found to have strong internal consistency (Cronbach's alpha = 0.82) and showed a medium to large effect size (d = 0.77) from admission to discharge. Fewer individuals with high SWS scores participated in social activity or reported having a confidant compared to those with lower scores. Since the RAI-MH is available across clinical subgroups in several jurisdictions, the SWS is a useful tool for screening, clinical decision support, and evaluation.
Collapse
Affiliation(s)
- Sebastian Rios
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave. W, Waterloo, ON, N1H 7W5, Canada
| | - Christopher M Perlman
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave. W, Waterloo, ON, N1H 7W5, Canada.
| |
Collapse
|
27
|
Zaboski BA, Gilbert A, Hamblin R, Andrews J, Ramos A, Nadeau JM, Storch EA. Quality of life in children and adolescents with obsessive-compulsive disorder: The Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Bull Menninger Clin 2019; 83:377-397. [PMID: 31180235 DOI: 10.1521/bumc_2019_83_03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study examined quality of life (QOL) and its clinical correlates among 225 intensive treatment-seeking children and adolescents with obsessive-compulsive disorder (OCD) using the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q). Youth completed the PQ-LES-Q along with self-report measures assessing functional impairment, anxiety sensitivity, OCD symptoms, nonspecific anxiety, depression, and social anxiety. Parents completed measures on their child's anxiety, the presence of inattention/hyperactivity, depression, functional impairment, and frequency of family accommodation of symptoms. Contrary to expectation, child-reported OCD symptoms did not significantly predict QOL; however, lower overall QOL was strongly associated with the presence of comorbid major depressive disorder (g=3D -0.76) and slightly related to comorbid social phobia (g=3D -0.36). These results suggest that assessing and addressing comorbid conditions in the treatment of youth with OCD is an important component of intensive treatment.
Collapse
Affiliation(s)
- Brian A Zaboski
- School of Special Education, School Psychology, & Early Childhood Studies, University of Florida, Gainesville, Florida
| | | | | | | | | | | | - Eric A Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| |
Collapse
|
28
|
Muller AE, Skurtveit S, Clausen T. Performance of the WHOQOL-BREF among Norwegian substance use disorder patients. BMC Med Res Methodol 2019; 19:44. [PMID: 30832564 PMCID: PMC6399843 DOI: 10.1186/s12874-019-0690-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 02/22/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Quality of life (QoL) is an established outcome measure of substance use disorder treatment. The WHOQOL-BREF is the gold standard tool, but its appropriateness for particularly vulnerable patient populations must be further explored. This article examines the scaling qualities of the WHOQOL-BREF in a Norwegian substance use disorder population, and explores relationships with social and health variables. METHODS 107 participants in a larger national treatment study provided data during structured interviews. Item responses, responsiveness, and domain scaling qualities are reported. General linear models identified correlates of impaired QoL. RESULTS Three out of four domains exhibited acceptable scaling qualities, while the social relationships domain had low internal validity. 59% of the variance in physical health QoL was explained in our model by the negative main or interaction effects of depression, unemployment, social isolation, smoking, residential treatment, and weight dissatisfaction. 52% of the variance in psychological health QoL was explained by depression and being single. Depression also had significant main effects in social relationships QoL (R2 = .27) and environment QoL (R2 = .39), and social isolation and exercise had further interaction effects in environment QoL. CONCLUSIONS After one year in treatment, the impact of low social contact in reducing QoL, rather than specific substance use patterns, was striking. The social relationships domain is the shortest in the WHOQOL-BREF, yet social variables were important in other areas of QoL. Social support could benefit from more attention in treatment, as a lack of social support seems to be a strong risk factor for poor QoL in various domains. The WHOQOL-BREF exhibits otherwise satisfactory measurement characteristics and is an appropriate tool among this population.
Collapse
Affiliation(s)
- Ashley Elizabeth Muller
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Pb 1039 Blindern, 0315 Oslo, Norway
- Division of Health Services, Norwegian Institute of Public Health, Pb 4044 Nydalen, 0403 Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Pb 1039 Blindern, 0315 Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Heath, Pb 4044 Nydalen, 0403 Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Pb 1039 Blindern, 0315 Oslo, Norway
| |
Collapse
|
29
|
Fleury MJ, Sabetti J, Bamvita JM, Grenier G. Modeling variables associated with personal recovery among service users with mental disorders using community-based services. Int J Soc Psychiatry 2019; 65:123-135. [PMID: 30791820 DOI: 10.1177/0020764019831310] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Mental health research is evolving toward the identification of conceptual models and associated variables, which may provide a better understanding of personal recovery, given its importance for individuals affected by mental disorders (MDs). AIMS This article evaluated personal recovery in a sample of adults with MDs using an adapted conceptual framework based on the Andersen behavioral model, which evaluates predisposing, enabling and needs factors in service use. METHODS The study design was cross-sectional and included 327 mental health service users recruited across four local health service networks in Quebec (Canada). Data were collected using seven standardized instruments and participant medical records. Structural equation modeling was performed. RESULTS Quality of life (QOL), an enabling factor, was most strongly associated with personal recovery. Health behavior variables associated with recovery included the following: use of alcohol services, having a family physician, consulting a psychologist, use of food banks, consulting fewer professionals and not using drug services. Regarding needs factors, higher numbers of needs, lower severity of unmet health, social and basic needs and absence of mood disorders were also associated with personal recovery. No predisposing factors emerged as significant in the model. CONCLUSION Findings suggest that QOL, needs variables and comprehensive service delivery are important in personal recovery. Services should be individualized to the health, social and basic needs of service users, particularly those with mood disorders or co-occurring mental health/substance use disorders.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- 1 Department of Psychiatry, McGill University, Montreal, QC, Canada.,2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Judith Sabetti
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada.,3 School of Social Work, McGill University, Montreal, QC, Canada
| | - Jean-Marie Bamvita
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| | - Guy Grenier
- 2 Douglas Mental Health University Institute Research Centre, Montreal, QC, Canada
| |
Collapse
|
30
|
Gentil L, Grenier G, Bamvita JM, Dorvil H, Fleury MJ. Profiles of Quality of Life in a Homeless Population. Front Psychiatry 2019; 10:10. [PMID: 30761023 PMCID: PMC6364333 DOI: 10.3389/fpsyt.2019.00010] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
Quality of life (QOL) is a key indicator in mental health planning, program evaluation, and evaluation of patient outcomes. Yet few studies have focused on QOL in homeless populations. More specifically, research has yet to identify profiles of homeless individuals based on their QOL using cluster analysis. This study developed a typology of QOL for a sample of 455 homeless individuals recruited from 27 community and public organizations in Quebec (Canada). The typology was developed based on QOL scores, as well as sociodemographic, clinical, and service use variables. Study participants had to be at least 18 years old, with current or previous experience of homelessness. A questionnaire including socio-demographics, residential history, service utilization, and health-related variables was administered. Four clusters were identified using a two-step cluster analysis. QOL was highest in the cluster consisting of older women with low functional disability, and relatively few episodes of homelessness. The second cluster with high QOL scores included individuals living in temporary housing with relatively few mental health or substance use disorders (SUDs). The third cluster with low QOL included middle-aged women living in temporary housing, with criminal records, personality disorders, and SUDs. QOL was also lower in the fourth cluster composed of individuals with multiple homeless episodes and complex health problems as well as high overall service use. Findings reinforced the importance of disseminating specific programs adapted to the diverse profiles of homeless individuals, with a view toward increasing their QOL.
Collapse
Affiliation(s)
- Lia Gentil
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Guy Grenier
- Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Jean-Marie Bamvita
- Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Henri Dorvil
- School of Social Work, Université du Québec à Montréal, Montreal, QC, Canada
| | - Marie-Josée Fleury
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Research Center, Douglas Mental Health University Institute, Montreal, QC, Canada
| |
Collapse
|
31
|
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]
|
32
|
Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S. Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 2018; 18:156. [PMID: 29843662 PMCID: PMC5975705 DOI: 10.1186/s12888-018-1736-5] [Citation(s) in RCA: 604] [Impact Index Per Article: 100.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 05/11/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The adverse effects of loneliness and of poor perceived social support on physical health and mortality are established, but no systematic synthesis is available of their relationship with the outcomes of mental health problems over time. In this systematic review, we aim to examine the evidence on whether loneliness and closely related concepts predict poor outcomes among adults with mental health problems. METHODS We searched six databases and reference lists for longitudinal quantitative studies that examined the relationship between baseline measures of loneliness and poor perceived social support and outcomes at follow up. Thirty-four eligible papers were retrieved. Due to heterogeneity among included studies in clinical populations, predictor measures and outcomes, a narrative synthesis was conducted. RESULTS We found substantial evidence from prospective studies that people with depression who perceive their social support as poorer have worse outcomes in terms of symptoms, recovery and social functioning. Loneliness has been investigated much less than perceived social support, but there is some evidence that greater loneliness predicts poorer depression outcome. There is also some preliminary evidence of associations between perceived social support and outcomes in schizophrenia, bipolar disorder and anxiety disorders. CONCLUSIONS Loneliness and quality of social support in depression are potential targets for development and testing of interventions, while for other conditions further evidence is needed regarding relationships with outcomes.
Collapse
Affiliation(s)
- Jingyi Wang
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Farhana Mann
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Brynmor Lloyd-Evans
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Ruimin Ma
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
| | - Sonia Johnson
- Division of Psychiatry – University College London, 6th Floor, Maple House, 149 Tottenham Court Road, London, W1T 7NF England
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 0PE England
| |
Collapse
|
33
|
Meiring L, Visser M, Themistocleous N. A student-facilitated community-based support group initiative for Mental Health Care users in a Primary Health Care setting. Health SA 2017. [DOI: 10.1016/j.hsag.2017.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
34
|
Verhagen SJW, Simons CJP, van Zelst C, Delespaul PAEG. Constructing a Reward-Related Quality of Life Statistic in Daily Life-a Proof of Concept Study Using Positive Affect. Front Psychol 2017; 8:1917. [PMID: 29163294 PMCID: PMC5673660 DOI: 10.3389/fpsyg.2017.01917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/16/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Mental healthcare needs person-tailored interventions. Experience Sampling Method (ESM) can provide daily life monitoring of personal experiences. This study aims to operationalize and test a measure of momentary reward-related Quality of Life (rQoL). Intuitively, quality of life improves by spending more time on rewarding experiences. ESM clinical interventions can use this information to coach patients to find a realistic, optimal balance of positive experiences (maximize reward) in daily life. rQoL combines the frequency of engaging in a relevant context (a 'behavior setting') with concurrent (positive) affect. High rQoL occurs when the most frequent behavior settings are combined with positive affect or infrequent behavior settings co-occur with low positive affect. Methods: Resampling procedures (Monte Carlo experiments) were applied to assess the reliability of rQoL using various behavior setting definitions under different sampling circumstances, for real or virtual subjects with low-, average- and high contextual variability. Furthermore, resampling was used to assess whether rQoL is a distinct concept from positive affect. Virtual ESM beep datasets were extracted from 1,058 valid ESM observations for virtual and real subjects. Results: Behavior settings defined by Who-What contextual information were most informative. Simulations of at least 100 ESM observations are needed for reliable assessment. Virtual ESM beep datasets of a real subject can be defined by Who-What-Where behavior setting combinations. Large sample sizes are necessary for reliable rQoL assessments, except for subjects with low contextual variability. rQoL is distinct from positive affect. Conclusion: rQoL is a feasible concept. Monte Carlo experiments should be used to assess the reliable implementation of an ESM statistic. Future research in ESM should asses the behavior of summary statistics under different sampling situations. This exploration is especially relevant in clinical implementation, where often only small datasets are available.
Collapse
Affiliation(s)
- Simone J W Verhagen
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands.,GGzE Institute of Mental Health Care Eindhoven and De Kempen, Eindhoven, Netherlands
| | - Catherine van Zelst
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands
| | - Philippe A E G Delespaul
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands.,Department of Adult Psychiatry, Mondriaan Mental Health Trust, Heerlen, Netherlands
| |
Collapse
|
35
|
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]
|
36
|
Prigent A, Kamendje-Tchokobou B, Chevreul K. Socio-demographic, clinical characteristics and utilization of mental health care services associated with SF-6D utility scores in patients with mental disorders: contributions of the quantile regression. Qual Life Res 2017. [PMID: 28638967 DOI: 10.1007/s11136-017-1623-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) is a widely used concept in the assessment of health care. Some generic HRQoL instruments, based on specific algorithms, can generate utility scores which reflect the preferences of the general population for the different health states described by the instrument. This study aimed to investigate the relationships between utility scores and potentially associated factors in patients with mental disorders followed in inpatient and/or outpatient care settings using two statistical methods. METHODS Patients were recruited in four psychiatric sectors in France. Patient responses to the SF-36 generic HRQoL instrument were used to calculate SF-6D utility scores. The relationships between utility scores and patient socio-demographic, clinical characteristics, and mental health care utilization, considered as potentially associated factors, were studied using OLS and quantile regressions. RESULTS One hundred and seventy six patients were included. Women, severely ill patients and those hospitalized full-time tended to report lower utility scores, whereas psychotic disorders (as opposed to mood disorders) and part-time care were associated with higher scores. The quantile regression highlighted that the size of the associations between the utility scores and some patient characteristics varied along with the utility score distribution, and provided more accurate estimated values than OLS regression. CONCLUSIONS The quantile regression may constitute a relevant complement for the analysis of factors associated with utility scores. For policy decision-making, the association of full-time hospitalization with lower utility scores while part-time care was associated with higher scores supports the further development of alternatives to full-time hospitalizations.
Collapse
Affiliation(s)
- Amélie Prigent
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France.
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France.
- Inserm, ECEVE, U1123, 75010, Paris, France.
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France.
| | - Blaise Kamendje-Tchokobou
- Centre Hospitalier Départemental Georges Daumézon, Fleury-Les-Aubrais, 45400, France
- Agence Régionale de Santé Centre-Val de Loire, Cité administrative Coligny, 131 Rue du Faubourg Bannier, 45000, Orléans, France
| | - Karine Chevreul
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France
- Inserm, ECEVE, U1123, 75010, Paris, France
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France
- Department of Public Health, AP-HP, Robert-Debré University Hospital, 75019, Paris, France
| |
Collapse
|
37
|
Zhou Y, Cao Z, Yang M, Xi X, Guo Y, Fang M, Cheng L, Du Y. Comorbid generalized anxiety disorder and its association with quality of life in patients with major depressive disorder. Sci Rep 2017; 7:40511. [PMID: 28098176 PMCID: PMC5241829 DOI: 10.1038/srep40511] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/06/2016] [Indexed: 01/23/2023] Open
Abstract
The comorbidity of major depressive disorder (MDD) and generalized anxiety disorder (GAD) is common and often predicts poorer outcomes than either disorder alone. This study aimed to examine the prevalence of comorbid GAD and its association with quality of life (QOL) among MDD patients. A total of 1225 psychiatric outpatients were screened using the Hospital Anxiety and Depression Scale (HADS). Those who scored ≥8 on the HADS were interviewed using DSM-IV criteria by two senior psychiatrists. Patients diagnosed with MDD were further assessed using the 9-item Patient Health Questionnaire, Social Support Rating Scale, Pittsburgh Sleep Quality Index, and World Health Organization QOL Scale, brief version (WHOQOL-BREF). Ultimately, 667 patients were diagnosed with MDD, of 71.7% of whom had GAD. Compared to those with MDD alone, comorbid patients had lower scores on the physical (38.64 ± 10.35 vs.36.54 ± 12.32, P = 0.026) and psychological (35.54 ± 12.98 vs. 30.61 ± 14.66, P < 0.001) domains of the WHOQOL-BREF. The association between comorbid GAD and poor QOL on the two domains remained statistically significant in the multiple linear regression (unstandardized coefficients: −1.97 and −4.65, P < 0.001). In conclusion, the prevalence of comorbid GAD in MDD patients is high, and co-occurring GAD may exacerbate impaired physical and psychological QOL in Chinese MDD patients.
Collapse
Affiliation(s)
- Yongjie Zhou
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China.,Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Zhongqiang Cao
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Mei Yang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Xiaoyan Xi
- Affiliated Liyuan hospital, Tongji Medical College of Huazhong University of Science &Technology, YuanHu Road 39#, Wuhan, 430060, China
| | - Yiyang Guo
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| | - Maosheng Fang
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Lijuan Cheng
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science &Technology, GongNongBin Road 125#, Wuhan, 430012, China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science &Technology, HangKong Road 13, Wuhan, 430030, China
| |
Collapse
|
38
|
Bitter NA, Roeg DPK, van Nieuwenhuizen C, van Weeghel J. Identifying profiles of service users in housing services and exploring their quality of life and care needs. BMC Psychiatry 2016; 16:419. [PMID: 27881159 PMCID: PMC5120432 DOI: 10.1186/s12888-016-1122-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Housing services aim to support people with mental illness in their daily life and recovery. As the level of recovery differs between service users, the quality of life and care needs also might vary. However, the type and amount of care and support that service users receive do not always match their recovery. In order to improve the quality of care, this study aims to explore whether subgroups of service users exist based on three dimensions of recovery and to examine and compare the quality of life and care needs of the persons in these subgroups. METHODS Latent class analysis was performed with data from 263 service users of housing services in the Netherlands. Classes were based on three variables: personal recovery (Mental Health Recovery Measure), social recovery (Social Functioning Scale), and clinical recovery (Brief Symptom Inventory). Subsequently, the quality of life (MANSA) and care needs (CANSAS) of the different classes were analysed by the use of descriptive and inferential statistics. RESULTS Three classes could be distinguished. Class 1 (45%) comprised of people who score the highest of the three classes in terms of personal and social recovery and who experience the least number of symptoms. People in class 2 (44%) and class 3 (11%) score significantly lower on personal and social recovery, and they experience significantly more symptoms compared to class 1. The distinction between class 2 and 3 can be made on the significantly higher number of symptoms in class 3. All three classes differ significantly on quality of life and unmet needs. CONCLUSIONS The quality of life of service users of housing services needs improvement, as even persons in the best-recovered subgroup have a lower quality of life than the average population. Workers of housing services need to be aware of the recovery of a client and what his or her individual needs and goals are. Furthermore, better care (allocation) concerning mental and physical health and rehabilitation is needed. Care should be provided on all dimensions of recovery at the same time, therefore mental health care organisations should work together and integrate their services. TRIAL REGISTRATION ISRCTN registry ISRCTN77355880 retrospectively registered 05/07/2013.
Collapse
Affiliation(s)
- Neis A. Bitter
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
| | - Diana P. K. Roeg
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Chijs van Nieuwenhuizen
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,GGzE Centre for Mental Health Care, PO BOX 909, 5600 AX Eindhoven, The Netherlands
| | - Jaap van Weeghel
- Department of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands ,Phrenos Centre of Expertise, PO Box 1203, 3500 BE Utrecht, The Netherlands ,Parnassia Group, Dijk en Duin Mental Health Centre, PO Box 305, 1900 AH Castricum, The Netherlands
| |
Collapse
|
39
|
Yi S, Tuot S, Chhoun P, Pal K, Choub SC, Mburu G. Mental health among men who have sex with men in Cambodia: Implications for integration of mental health services within HIV programmes. Int J Equity Health 2016; 15:53. [PMID: 27009628 PMCID: PMC4806506 DOI: 10.1186/s12939-016-0342-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 03/15/2016] [Indexed: 01/09/2023] Open
Abstract
Background Poor mental health contributes to poor HIV prevention, treatment and care outcomes. This paper documents factors associated with psychological distress among men who have sex with men (MSM) in Cambodia and discusses potential ways in which routine mental health management could be integrated into HIV services. Methods A cross-sectional study was conducted in 2014 among 394 MSM randomly selected from two provinces using a two-stage cluster sampling method. A structured questionnaire was used to assess psychological distress, sexual behaviors, substance use, adverse childhood experiences and family dysfunction. Multivariate logistic regression analysis was performed to explore factors associated with levels of psychological distress. Results In total, 10.7 % of the respondents reported having suicidal thoughts and 6.6 % reported having attempted to commit suicide in the past three months, while 38.8 % had a higher level of psychological distress (GHQ-12 > 3), which indicates poor mental health. Higher levels of psychological distress were independently associated with older age (AOR = 1.09, 95 % CI 1.03–1.14), alcohol use (AOR = 3.3, 95 % CI 1.36–7.83), illicit drug use (AOR = 3.53, 95 % CI 1.12–11.18), poor self-reported quality of life (AOR = 7.45, 95 % CI 1.79–3.04), and reduced condom use at last sex (AOR = 0.40, 95 % CI 0.21–0.73). MSM with higher levels of psychological distress were significantly more likely to report that a family member said hurtful things to them (AOR = 1.80, 95 % CI 1.10–2.97), a parent or guardian had been physically abused (AOR = 3.51, 95 % CI 1.86–6.62), and a family member had been mentally ill (AOR = 4.01, 95 % CI 2.06–7.81) when they were growing up. Conclusions In order to mitigate psychological distress among MSM in Cambodia, integration of mental health interventions within HIV programmes should be strengthened. To achieve optimal impact, these interventions should also address alcohol and other substance use, and low condom use among distressed MSM. In addition, training of clinical and non-clinical HIV service providers to screen for mental health symptoms, and subsequent provision of peer-based outreach and social support for MSM identified with psychological distress is required.
Collapse
Affiliation(s)
- Siyan Yi
- Research Department, KHANA, Phnom Penh, Cambodia
| | | | - Pheak Chhoun
- Programs Department, KHANA, Phnom Penh, Cambodia
| | | | | | - Gitau Mburu
- Program Impact Unit, International HIV/AIDS Alliance, Brighton, UK. .,Department of Health Research, Lancaster University, Lancaster, UK.
| |
Collapse
|
40
|
Muller AE, Skurtveit S, Clausen T. Many correlates of poor quality of life among substance users entering treatment are not addiction-specific. Health Qual Life Outcomes 2016; 14:39. [PMID: 26940259 PMCID: PMC4778354 DOI: 10.1186/s12955-016-0439-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 02/25/2016] [Indexed: 11/16/2022] Open
Abstract
Background Quality of life (QoL) is an important measure and outcome within chronic disease management and treatment, including substance use disorders (SUD). The aim of this paper was to investigate correlates of poorer QoL of individuals entering SUD treatment in Norway, in order to identify subgroups that may most benefit from different interventions. Methods Twenty-one treatment facilities invited all incoming patients to participate. Five hundred forty-nine patients who enrolled between December 2012 and April 2015 are analyzed. QoL, substance use, mental and physical comorbidities, and exercise behaviors were measured. Multinomial regression analysis was used to determine variables significantly associated with poorer QoL. Results The majority of both genders (75 %) reported “poor” or “very poor” QoL at intake. Depression showed a strong association with poor QoL (relative risk ratio [RRR] 3.3, 95 % confidence interval [CI] 1.0–10.3) and very poor QoL (RRR 3.8, 1.2–11.8) among women. Physical inactivity among men was associated with very poor QoL (RRR 2.0, 1.1–3.7), as was reporting eating most meals alone (RRR 2.6, 1.4–4.8). Evaluating one’s weight as too low was also associated with poor QoL (RRR 2.0, 1.0-3.9) and very poor QoL (RRR 2.0, 1.1–3.7) among men. Consuming methadone/buprenorphine was a protective factor for men reporting poor QoL (RRR 0.5, 0.3–0.9) and very poor QoL (RRR 0.4, 0.2–0.9), as well as for women reporting very poor QoL (RRR 0.2, 0.0–0.6). Conclusions Factors associated with poorer QoL among other healthy and clinical populations, such as impaired social and physical well-being and psychological distress, were also seen associated in this sample. Treatment should be targeted towards patients with these particular vulnerabilities in addition to focusing on substance-related factors, and interventions proven to improve the QoL of other populations with these vulnerabilities should be explored in a SUD context.
Collapse
Affiliation(s)
- Ashley E Muller
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, 0318, Oslo, Norway.
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, 0318, Oslo, Norway. .,Department of Pharmacoepidemiology, Division of Epidemiology, The Norwegian Institute of Public Health, Oslo, Norway.
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Postbox 1171 Blindern, 0318, Oslo, Norway. .,Addiction Unit, Sørlandet Hospital HF, Kristiansand, Norway. .,Fulbright Scholar (2014-15), Alcohol Research Group (ARG), Emeryville, CA, USA.
| |
Collapse
|
41
|
A structural equation modelling approach to explore the determinants of quality of life in schizophrenia. Schizophr Res 2016; 171:27-34. [PMID: 26781001 DOI: 10.1016/j.schres.2016.01.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/03/2015] [Accepted: 01/04/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to analyse the relationships among psychotic symptoms, depression, neurocognition and functioning as determinants of quality of life (QoL) in patients with schizophrenia. METHODS In this cross-sectional study, we evaluated QoL with the Schizophrenia Quality of Life 18-item scale (S-QoL 18), neurocognition with multiple tests exploring memory, attention and executive functions, the severity of psychotic symptoms with the Positive and Negative Syndrome Scale (PANSS), depression with the Calgary Depression Scale for Schizophrenia (CDSS) and functioning using the Functional Remission Of General Schizophrenia (FROGS) scale. We used Structural Equation Modelling (SEM) to describe the relationships among the severity of psychotic symptoms, depression, neurocognition, functioning and QoL. RESULTS Two hundred and seventy-one outpatients with schizophrenia participated in our study. SEM showed good fit with χ(2)/df=1.97, root mean square error of approximation=0.06, comparative fit index=0.93 and standardized root mean square residuals=0.05. This model revealed that depression was the most important feature associated with QoL, mainly for the self-esteem, autonomy and resilience dimensions (direct path coefficient=-0.46). The direct path between functioning and QoL was also significant (path coefficient=0.26). The severity of psychotic symptoms and neurocognitive impairment were weakly and indirectly associated with QoL via functioning (path coefficients=-0.18 and 0.04, respectively). CONCLUSIONS This study contributes to a better understanding of the determinants of QoL in schizophrenia. Our findings should be considered in developing effective strategies for improving QoL among this population.
Collapse
|
42
|
Siegrist K, Millier A, Amri I, Aballéa S, Toumi M. Association between social contact frequency and negative symptoms, psychosocial functioning and quality of life in patients with schizophrenia. Psychiatry Res 2015; 230:860-6. [PMID: 26626950 DOI: 10.1016/j.psychres.2015.11.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 09/02/2015] [Accepted: 11/19/2015] [Indexed: 11/16/2022]
Abstract
The lack of social contacts may be an important element in the presumed vicious circle aggravating, or at least stabilising negative symptoms in patients with schizophrenia. A European 2-year cohort study collected negative symptom scores, psychosocial functioning scores, objective social contact frequency scores and quality of life scores every 6 months. Bivariate analyses, correlation analyses, multivariate regressions and random effects regressions were conducted to describe relations between social contact and outcomes of interest and to gain a better understanding of this relation over time. Using data from 1208 patients with schizophrenia, a link between social contact frequency and negative symptom scores, functioning and quality of life at baseline was established. Regression models confirmed the significant association between social contact and negative symptoms as well as psychosocial functioning. This study aimed at demonstrating the importance of social contact for deficient behavioural aspects of schizophrenia.
Collapse
Affiliation(s)
- Karin Siegrist
- Graduate School Public Health, Heinrich-Heine-Universität Düsseldorf, Dusseldorf, Germany.
| | - Aurelie Millier
- Creativ-Ceutical, 215 rue du Faubourg Saint Honoré, 75008 Paris, France.
| | | | - Samuel Aballéa
- Creativ-Ceutical, 215 rue du Faubourg Saint Honoré, 75008 Paris, France.
| | - Mondher Toumi
- Laboratoire de Santé Publique, Université de la Méditerranée, Marseille, France.
| |
Collapse
|
43
|
Adequacy of Help Received by Individuals with Severe Mental Disorders After a Major Healthcare Reform in Quebec: Predictors and Changes at 5-Year Follow-Up. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 43:799-812. [DOI: 10.1007/s10488-015-0695-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Fleury MJ, Bamvita JM, Grenier G, Caron J. Help Received for Perceived Needs Related to Mental Health in a Montreal (Canada) Epidemiological Catchment Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13016-37. [PMID: 26501306 PMCID: PMC4627014 DOI: 10.3390/ijerph121013016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 06/20/2015] [Accepted: 10/10/2015] [Indexed: 12/28/2022]
Abstract
This study sought to identify variables associated with help received in terms of information, medication, counselling and total help received (including other needs) among 571 individuals needing health care services for mental health problems. Study participants were randomly selected from an epidemiological survey. Data on help received were collected using the Canadian version of the Perceived Need for Care Questionnaire (PNCQ), and were analyzed using a multinomial logistic regression model. Most help received was in the form of counselling, followed by medication and information. Compared with individuals who received no help, those who reported receiving help for all their needs were more likely to have psychological distress, to be non-verbally aggressive, to consult more healthcare professionals, to be men and to be somewhat older. Compared with individuals who received no help, those who received partial help were more likely to be not addicted to drugs or alcohol, to consult more healthcare professionals, and to be older. Healthcare services should prioritize strategies (e.g., early detection, outreach, public education on mental and addiction disorders) that address barriers to help seeking among youth, as well as individuals addicted to drugs and alcohol or those presenting with aggressive behavior.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, PQ H4R 1R3, Canada.
- Montreal Addiction Rehabilitation Centre-University Institute (CRDM-IU), Montreal, PQ H2M 2E8, Canada.
| | | | - Guy Grenier
- Douglas Hospital Research Centre, Montreal, PQ H4H 2R3, Canada.
| | - Jean Caron
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, PQ H4R 1R3, Canada.
| |
Collapse
|
45
|
Fleury MJ, Grenier G, Bamvita JM. Predictive typology of subjective quality of life among participants with severe mental disorders after a five-year follow-up: a longitudinal two-step cluster analysis. Health Qual Life Outcomes 2015; 13:150. [PMID: 26391475 PMCID: PMC4578602 DOI: 10.1186/s12955-015-0346-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to create a predictive typology of quality of life at five-year follow-up of 204 individuals with severe mental disorders, according to clinical, socio-demographic, and health service use variables. METHODS Participant typology was carried out by means of two-step cluster analysis. Independent variables were measured at T0 and subjective quality of life (SQOL) at T2. RESULTS Analysis yielded four classes. SQOL at T2 was higher than the mean in Class 4 ("Older, poorly educated single men living in supervised housing, with psychotic disorders but with few serious needs, receiving substantial help from services") and lower than the mean in Class 2 ("Young females with serious needs and co-occurring mental and addiction disorders living in independent apartments"). CONCLUSION Given that predictive SQOL varies in relation to combinations of associated variables, it would be useful for treatments or service programs to target specific predictors to the different profiles.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, Douglas Hospital Research Centre, 6875 LaSalle Blvd, Montreal, QC, Canada, H4H 1R3. .,Montreal Addiction Rehabilitation Centre-University Institute, 6875 LaSalle Blvd., Montreal, QC, Canada, H2M 2E8.
| | - Guy Grenier
- Douglas Hospital Research Centre, Montreal, QC, Canada, H4H 1R3.
| | | |
Collapse
|
46
|
Loh SY, Abdullah A, Abu Bakar AK, Thambu M, Nik Jaafar NR. Structured Walking and Chronic Institutionalized Schizophrenia Inmates: A pilot RCT Study on Quality of Life. Glob J Health Sci 2015; 8:238-48. [PMID: 26234968 PMCID: PMC4804032 DOI: 10.5539/gjhs.v8n1p238] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/19/2015] [Accepted: 05/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lifestyle moderate-intensity physical activity can lower the risk of over twenty chronic health conditions, whilst inactivity reduces daily functioning and physical health of individuals living with schizophrenia. This study conducted in 2014 examines the effect of structured walking participation on QOL, psychosocial functioning and symptoms in Hospital Permai, one of the largest psychiatry institution in Asia METHOD Chronic patients with schizophrenia (n=104) who met inclusion criteria were randomised to either a 3-month structured walking intervention or a treatment-as-usual arm. The Positive and Negative Syndrome Scale (PANSS), global functioning (PSP) and QOL (SF-36) were measured at baseline and after the 3-month interval. RESULTS At 3 month follow-up, there were significant within group differences in QOL (SF-36), psychiatric symptoms (PANSS), and personal and social performance (PSP). There were statistically significant increase in the median SF-36 scores, with increases shown in physical functioning (p<.001), physical role limitations (p<.05), social functioning (p<.01) in the intervention group compared to treatment-as-usual group. Statistically significant reduction of median PANSS score of the intervention group were noted in positive (p<0.001) and negative (p<0.01) symptom, and general psychopathology (p<0.01) scales. Statistically significant increase in the median PSP score (p<0.01) was found in the intervention group compared with the treatment-as-usual group. Between-group differences at post intervention (favouring Intervention) were significant for PANSS positive and SF36 Physical CONCLUSION In long stayed chronic inmates, a simple but consistent, organized walking intervention has the potential to bring improvement in functioning, reduction in psychiatric symptoms and quality of Life. The emphasis of rehabilitation should target at lifestyle redesign intervention.
Collapse
|
47
|
Fleury MJ, Grenier G, Bamvita JM. Predictors of frequent recourse to health professionals by people with severe mental disorders. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2015; 60:77-86. [PMID: 25886658 PMCID: PMC4344949 DOI: 10.1177/070674371506000205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 07/01/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Based on Andersen's behavioural model, our study sought to determine predictors and blocks of factors that could explain why people with severe mental disorders (SMDs) more often seek the services of health professionals. METHODS This longitudinal study involved 292 users with SMDs located in Le Sud-Ouest, the southwest borough of Montreal. Data were collected from participants' medical records and through 7 questionnaires. Using Andersen's Behavioral Model of Health Services Use, independent variables were divided into 3 classes-predisposing factors, enabling factors, and need factors-and were introduced in this order in a hierarchical logistic model. RESULTS Among 292 users, 110 (37.7%) were frequent users who consulted about one health professional every 3 days. Participants who were more likely to call on health professionals were single and older, depended on welfare as their main source of income, lived in supervised housing, suffered from schizophrenia, schizophrenia spectrum disorders, and adjustment disorders, and, marginally, exhibited multiple mental disorders. CONCLUSION Mental health services could promote strategies to overcome the reluctance of younger people to seek professional services. Professionals should pay close attention to subsidiary conditions, such as adjustment disorders, from which people with SMDs may suffer. Interventions to improve the socioeconomic condition of unemployed people with SMDs may help to reduce health care service use among that clientele. Programs such as supported employment should be tailored and enhanced for people receiving welfare to decrease stigmatization and improve job market integration.
Collapse
Affiliation(s)
- Marie-Josée Fleury
- Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Researcher, Douglas Mental Health University Institute Research Centre, Montreal, Quebec; Scientific Director, Centre Dollard-Cormier, University Institute on Dependences, Montreal, Quebec
- Correspondence: Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard, Montreal, QC H4H 1R3;
| | - Guy Grenier
- Research Associate, Douglas Mental Health University Institute Research Centre, Montreal, Quebec
| | - Jean-Marie Bamvita
- Research Agent, Douglas Mental Health University Institute Research Centre, Montreal, Quebec
| |
Collapse
|
48
|
Abstract
Needs assessment facilitates mental health services planning, provision, and evaluation. This study aimed to (a) validate a new instrument, the Montreal Assessment of Needs Questionnaire (MANQ), and (b) use this to assess variations and predictors of need (number and seriousness) in 297 individuals with severe mental disorders for 18 months, during implementation of the Quebec Mental Health Action Plan. MANQ internal and external validations were adequate. Variables significantly associated with need number and seriousness variations were used to build multiple linear regression models. Autonomous housing, not receiving welfare, not having consulted a health educator, higher level of help from services, Alcohol Use Disorders Identification Test total score, and social support were associated with decreasing need number and seriousness over time. Having a higher education was also associated with decreasing need number. In a reform context, the MANQ's unique ability to detect rapid improvement in patient needs has usefulness for Quebec mental health planning.
Collapse
|
49
|
Health-related quality of life and utility scores in people with mental disorders: a comparison with the non-mentally ill general population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:2804-17. [PMID: 24608903 PMCID: PMC3987005 DOI: 10.3390/ijerph110302804] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/20/2014] [Accepted: 02/25/2014] [Indexed: 02/07/2023]
Abstract
There is a lack of comparable health-related quality of life (HRQoL) and utility data across all mental disorders and all inpatient and outpatient settings. Our objective was to investigate the HRQoL and utility scores of people with mental disorders in France, treated in outpatient and inpatient settings, and to identify the HRQoL and utility score losses attributable to mental disorders compared to the non-mentally ill general population. A cross-sectional survey was conducted to assess HRQoL (SF-12) and utility scores of patients with mental disorders and followed in four psychiatric sectors in France. Scores were described by demographic and clinical characteristics and were then adjusted on age and gender and compared with those of the non-mentally ill general population. Median HRQoL and utility scores were significantly lower in patients with mental disorders than in the non-mentally ill general population; median differences amounted to 5.4 for the HRQoL physical score, to 11.8 for the HRQoL mental score and to 0.125 for the utility score. Our findings underscore the negative impact of mental disorders on HRQoL in France and provide a baseline to assess the global impact of current and future organizational changes in the mental health care system.
Collapse
|
50
|
Bryła M, Burzyńska M, Maniecka-Bryła I. Self-rated quality of life of city-dwelling elderly people benefitting from social help: results of a cross-sectional study. Health Qual Life Outcomes 2013; 11:181. [PMID: 24168471 PMCID: PMC3819270 DOI: 10.1186/1477-7525-11-181] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 10/24/2013] [Indexed: 11/21/2022] Open
Abstract
Background The percentage of people aged 65 or older living in Poland is 13.6%, but 17.2% in Łódź. The aim of the study was to identify factors correlating with the self-rated quality of life of elderly inhabitants of cities applying for social help, on the basis of a cross-sectional study. Methods The study was conducted in Łódź, a large Polish city, between September 2011 and February 2012 in a group of people applying for help in the Municipal Social Welfare Centre. Four hundred and sixty-six respondents aged 65 or older were included in the study. The tool used in the study was an interview questionnaire. The respondents answered questions on their demographic situation, living conditions, financial, health and social situation. The authors also applied the WHOQOL-BREF Questionnaire, the Activities of Daily Living Scale (ADL) and the Geriatric Depression Scale (GSOD). For statistical purposes, the authors used single- and multiple-factor regression and the Statistica 9.0 Program. The results were presented as an odds ratio (OR) with a 95% confidence interval (CI); the adopted significance level was p < 0.05. The authors applied the Pearson’s x2 test in order to evaluate the structure of the studied group and the subpopulation, who were aged 65 or older and using social help, throughout the city. Results Logistic regression confirmed that a high quality of life depends on the following variables: university education (OR = 2.31; p < 0.05), an income which is sufficient to live (OR = 1.63; p < 0.05), no heart palpitations (OR = 2.32; p < 0.05), stable blood pressure (OR = 2.32; p < 0.05), no headaches (OR = 1.55; p < 0.05), no pain in the chest (OR = 1.51; p < 0.01), no shortness of breath (OR = 1.51; p < 0.01), no tiredness (OR = 2.08; p < 0.05), a score on the Geriatric Depression Scale pointing to a lack of suspected depression (OR = 9.88; p < 0.001 if the person does not suffer from depression and OR = 6.33; p < 0.001 if there is uncertain depression) as well as not using nursing services, a score on the ADL Scale confirming the person’s fitness and participation in family gatherings. Conclusions A subjective evaluation of the quality of life of the elderly depends on many factors. An identification of these factors might be helpful in implementing steps aimed at improving the quality of life of elderly people who, as a consequence, will need less social help: particularly nursing services.
Collapse
|