Abstract
This longitudinal study assessed the effectiveness of different types of supported housing recently established for patients with chronic schizophrenia in the East German region of Dresden. Survey data covering a 2-year period are reported for five patient subgroups (n=244) living in a psychiatric nursing home, in social therapeutic hostels, in sheltered community residential care, at home with family and alone in their own homes. Psychopathological symptoms, social disabilities, subjective quality of life, and normative individual needs for care were the relevant outcome domains assessed. For all subgroups, changes in the outcome parameters were rather small, from a clinical perspective, demonstrating deterioration, particularly for the older and more severely disabled group living in the nursing home. Results from linear variance analytical statistical models showed that group assignment played a significant role only for the baseline-controlled development of social disabilities and subjective quality of life. Contrasts between the groups outlined the disadvantage of homes and hostels in terms of subjective quality of life and the advantage of maintaining integration in family life in terms of social disabilities. These results support health policy decisions that would invest more deliberately in forms of supported housing that endeavour to improve patients’ autonomous functioning in their own flats, as well as providing assistance to families taking care of patients with chronic schizophrenia.
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Notes
This definition was determined by the sample size of the smallest subgroup, i.e. patients living in sheltered community residences.
The PANSS includes all items of the 18-item version of the BPRS. BPRS sub-scales comprise anxiety/depression (ANDP), anergia (ANER), thought disorder (THOT), activation (ACTV), and hostility/suspiciousness (HOST). Individual psychopathological symptoms are assigned as follows: THOT = conceptual disorganisation, grandiosity, hallucinatory behaviour, unusual thought content; ACTV = tension, mannerism and posturing, excitement; HOST = hostility, suspiciousness, uncooperativeness.
All results reported on quality of life ratings were also found in non-baseline-adjusted analyses, whereas results on the quotients of the severity of social disabilities were only partly re-confirmed in such analyses. A table presenting all results of comparisons between groups within the general linear models can be requested from the corresponding author.
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Acknowledgements
Funded by grant no. 53-5459.20/3 of the Saxon State Ministry of Social, Health and Family Affairs. We gratefully acknowledge the assistance in translation by Charlene Reiss.
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Kallert, T.W., Leisse, M. & Winiecki, P. Comparing the effectiveness of different types of supported housing for patients with chronic schizophrenia. J Public Health 15, 29–42 (2007). https://doi.org/10.1007/s10389-006-0071-3
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DOI: https://doi.org/10.1007/s10389-006-0071-3