Quality of Life Research

, Volume 15, Issue 9, pp 1459–1469 | Cite as

Clinical characteristics and objective living conditions in relation to quality of life among community-based individuals of schizophrenia in Hong Kong

Original Paper

Abstract

Quality of life (QOL) has gained importance as an outcome measure for people with schizophrenia living in the community following deinstitutionalization. This study aims at exploring the effects of clinical characteristics and objective living conditions on QOL. In this study, 201 community-based individuals with schizophrenia were recruited from five different types of objective living conditions comprising long stay care home, halfway house, supported hostel/housing, living with family, and living alone. Clinical characteristics including cognitive abilities, symptom levels, and community/social functioning were assessed by the Allen Cognitive Level Screen, the Scales for the Assessment of Negative Symptoms and Positive Symptoms, and the Chinese version of the Multnomah Community Ability Scale respectively. The outcome measure of QOL was measured by the Chinese version of the WHO Quality of Life Measure. Analysis of covariance showed significant differences in community/social functioning, cognitive abilities, and negative symptoms; but not in QOL under different objective living conditions. Further simultaneous multiple regressions found out that community/social functioning was the robust significant predictor of QOL. Yet caution should be noted in making the conclusion with the objective living condition of long stay care home, as it provides a protective element for the perseverance of QOL.

Keywords

Chinese Community Quality of life Schizophrenia 

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References

  1. 1.
    Katschnig H (1997) How useful is the concept of quality of life in psychiatry. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of Life in Mental Disorders. Chichester, John Wiley and Son, pp 3–16Google Scholar
  2. 2.
    Sartorius N (1997) Quality of life and mental disorders: a global perspective. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of Life in Mental Disorders. Chichester, John Wiley and Son, pp 319–328Google Scholar
  3. 3.
    Chan GWL, Ungvari GS, Leung JP (2001) Residential services for psychiatric patients in Hong Kong. HK J Psychiatry 11:13–17Google Scholar
  4. 4.
    Awad AG, Voruganti LNP (2000) Intervention research in psychosis: Issues related to the assessment of quality of life. Schizophr Bull 26:557–564PubMedGoogle Scholar
  5. 5.
    Oliver JPJ, Mohamad H (1992) The quality of life of the chronically mentally ill: A comparison of public, private, and voluntary residential provisions. Br J Soc Work 22:391–404Google Scholar
  6. 6.
    Zissi A, Barry MM (1997) From Leros asylum to community-based facilities: Level of functioning and quality of life among hostels residents in Greece. Int J Soc Psychiatry 43:104–116PubMedGoogle Scholar
  7. 7.
    Chan CC, Lui WWS, Wan DLY, Yau SSW (2002) Evaluating service recipient outcomes in psychiatric residential services in Hong Kong. Res Soc Work Pract 12:570–581CrossRefGoogle Scholar
  8. 8.
    Chan GWL, Ungvari GS, Shek DTL, Leung JP (2003) Hospital and community-based care for patients with chronic schizophrenia in Hong Kong. Soc Psychiatry Psychiatr Epidemiol 38:196–203PubMedCrossRefGoogle Scholar
  9. 9.
    Chan WL (2004) Hospital and community-based care for patients with chronic schizophrenia in Hong Kong: Quality of life and its correlates. Dissertation Abstracts Int: Section B: The Sci Eng 64:3183Google Scholar
  10. 10.
    Cheung HK (2001) A 2-year prospective study of patients from Castle Peak hospital discharged to the first long-stay care home in Hong Kong. HK J Psychiatry 11:1–12Google Scholar
  11. 11.
    Law KKP, Yau SB, Wan DLY, Chan CCH (2002) Relationship between perceived quality of life, social functioning, and life skills performance of patients with chronic psychiatric conditions in a long stay care home. HK J Psychiatry 12:2–7Google Scholar
  12. 12.
    Huxley P (1998) Quality of life. In: Mueser KT, Tarrier N (eds) Handbook of Social Functioning in Schizophrenia. Boston, Allyn & Bacon, pp 52–65Google Scholar
  13. 13.
    Barry MM, Crosby C (1996) Quality of life as an evaluative measure in assessing the impact of community care on people with long-term psychiatric disorders. Br J Psychiatry 168:210–216PubMedGoogle Scholar
  14. 14.
    Browne S, Roe M, Lane A et al (1996) Quality of life in schizophrenia: Relationship to sociodemographic factors, symptomatology and tardive dyskinesia. Acta Psychiatr Scand 94:118–124PubMedGoogle Scholar
  15. 15.
    Leff J, Dayson D, Gooch C et al (1996) Quality of life of long-stay patients discharged from two psychiatric institutions. Psychiatr Serv 47:62–67PubMedGoogle Scholar
  16. 16.
    Palmer BW, Heaton RK, Gladsjo JA et al (2002) Heterogeneity in functional status among older outpatients with schizophrenia: Employment history, living situation, and driving. Schizophr Res 55:205–215PubMedCrossRefGoogle Scholar
  17. 17.
    Simpson CJ, Hyde CE, Faragher EB (1989) The chronically mentally ill in community facilities. A study of quality of life. Br J Psychiatry 154:77–82PubMedCrossRefGoogle Scholar
  18. 18.
    Anderson RL, Lewis DA (2000) Quality of life of persons with severe mental illness living in an intermediate care facility. J Clin Psychol 56:575–581PubMedCrossRefGoogle Scholar
  19. 19.
    Dickerson FB, Ringel NB, Parente F (1998) Subjective quality of life in out-patients with schizophrenia: Clinical and utilization correlates. Acta Psychiatr Scand 98:124–127PubMedGoogle Scholar
  20. 20.
    Tanzman B (1993) An overview of surveys of mental health consumersȁ9 preferences for housing and support services. Hosp Commun Psychiatry 44:450–455Google Scholar
  21. 21.
    Hansson L, Middelboe T, Sørgaard KW et al (2002) Living situation, subjective quality of life and social network among individuals with schizophrenia living in community setting. Acta Psychiatr Scand 105:343–350CrossRefGoogle Scholar
  22. 22.
    Nelson G, Hall GB, Walsh-Bowers R (1997) A comparative evaluation of supportive apartments, group homes, and board-and-care homes for psychiatric consumer/survivors. J Community Psychol 25:167–188CrossRefGoogle Scholar
  23. 23.
    Nelson G, Hall GB, Walsh-Bowers R (1999) Predictors of the adaptation of people with psychiatric disabilities in group homes, supportive apartments, and board-and-care homes. Psychiatr Rehabil J 22:381–389Google Scholar
  24. 24.
    Cheung HK. Measurement of quality of life (QOL) in patients with persistent serious mental illness in 4 different community settings using 2 different QOL scales. Paper presented at the Regional Meeting of World Psychiatric Association. Beijing, China, 1997Google Scholar
  25. 25.
    Leiße M, Kallert TW (2000) Social integration and the quality of life of schizophrenic patients in different types of complementary care. Eur Psychiatry 15:450–460PubMedCrossRefGoogle Scholar
  26. 26.
    Buchanan RW, Holstein C, Breier A (1994) The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance. Biol Psychiatry 36:717–725PubMedCrossRefGoogle Scholar
  27. 27.
    Lieh-Mak F, Lee PWH (1997) Cognitive deficit measures in schizophrenia: Factor structure and clinical correlates. Am J Psychiatry 154:39–46PubMedGoogle Scholar
  28. 28.
    Kasckow JW, Twamley E, Mulchahey JJ et al (2001) Health-related quality of well-being in chronically hospitalized patients with schizophrenia: comparison with matched outpatients. Psychiatry Res 103:69–78PubMedCrossRefGoogle Scholar
  29. 29.
    Sota TL (2000) Outcome in schizophrenia: Are cognitive variables predictors of rehospitalization and quality of life? Dissertation Abstracts Int: Section B: The Sci Eng 60:4253Google Scholar
  30. 30.
    Aksaray G, Oflu S, Kaptanoðlu C, Bal C (2002) Neurocognitive deficits and quality of life in outpatients with schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 26:1217–1219PubMedCrossRefGoogle Scholar
  31. 31.
    Heslegrave RJ, Awad AG, Voruganti LNP (1997) The influence of neurocognitive deficits and symptoms on quality of life in schizophrenia. J Psychiatry Neurosci 22:235–243PubMedGoogle Scholar
  32. 32.
    Browne S, Clarke M, Gervin M et al (2000) Determinants of quality of life at first presentation with schizophrenia. Br J Psychiatry 176:173–176PubMedCrossRefGoogle Scholar
  33. 33.
    Galletly CA, Clark CR, McFarlane AC, Weber DL (1997) Relationships between changes in symptom ratings, neuropsychological test performance and quality of life in schizophrenic patients treated with clozapine. Psychiatry Res 72:161–166PubMedCrossRefGoogle Scholar
  34. 34.
    Packer S, Husted J, Cohen S, Tomlinson G (1997) Psychopathology and quality of life in schizophrenia. J Psychiatry Neurosci 22:231–234PubMedGoogle Scholar
  35. 35.
    Patterson TL, Kaplan RM, Grant I et al (1996) Quality of well-being in late-life psychosis. Psychiatry Res 63:169–181PubMedCrossRefGoogle Scholar
  36. 36.
    Corrigan PW, Buican B (1995) The construct validity of subjective quality of life for the severely mentally ill. J Nerv Ment Dis 183:281–285PubMedCrossRefGoogle Scholar
  37. 37.
    Norman RMG, Malla AK, McLean T et al (2000) The relationship of symptoms and level of functioning in schizophrenia to general wellbeing and the quality of life scale. Acta Psychiatr Scand 102:303–309PubMedCrossRefGoogle Scholar
  38. 38.
    Patterson TL, Shaw W, Semple SJ et al (1997) Health-related quality of life in older patients with schizophrenia and other psychoses: Relationships among psychosocial and psychiatric factors. Int J Geriatr Psychiatry 12:452–461PubMedCrossRefGoogle Scholar
  39. 39.
    Arns PG, Linney JA (1995) Relating functional skills of severely mentally ill clients to subjective and social benefits. Psychiatr Serv 46:260–265PubMedGoogle Scholar
  40. 40.
    Angermeyer MC, Kilian R (1997) Theoretical models of quality of life for mental disorders. In: Katschnig H, Freeman H, Sartorius N (eds) Quality of Life in Mental Disorders. Chichester, John Wiley and Son, pp 19–30Google Scholar
  41. 41.
    Wilson IB, Cleary PD (1995) Linking clinical variables with health-related quality of life. JAMA 273:59–65PubMedCrossRefGoogle Scholar
  42. 42.
    American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th ed. Washington DC, APAGoogle Scholar
  43. 43.
    Health and Welfare Bureau (1999) Rehabilitation Division, Hong Kong rehabilitation programme plan: Towards a new rehabilitation era. (1998–99 to 2002–03). Hong Kong, Government SecretariatGoogle Scholar
  44. 44.
    Allen CK (1985) Occupational therapy for psychiatric diseases: Measurement and management of cognitive disabilities. Boston, Little BrownGoogle Scholar
  45. 45.
    Allen CK. Allen Cognitive Level Test Manual and Kit. Colchester, CT: S & S/Worldwide, 2000Google Scholar
  46. 46.
    Allen CK (1992) Cognitive disabilities. In: Katz N (eds) Cognitive Rehabilitation: Models for Intervention in Occupational Therapy. Boston, Andover Medical, pp 1–21Google Scholar
  47. 47.
    Allen CK, Blue T (1998) Cognitive disabilities model: How to make clinical judgments. In: Katz N (eds) Cognition and Occupation in Rehabilitation. Rockville MD, American Occupational Therapy Association, pp 225–279Google Scholar
  48. 48.
    Henry AD, Moore K, Quinlivan M, Triggs M (1998) The relationship of the Allen Cognitive Level test to demographics, diagnosis and disposition among psychiatric inpatients. Am J Occup Ther 52:638–643PubMedGoogle Scholar
  49. 49.
    Heying LM (1985) Research with subjects having senile dementia. In: Allen CK (eds) Occupational Therapy for Psychiatric Diseases: Measurement and Management of Cognitive Disabilities. Boston, Little Brown, pp 339–365Google Scholar
  50. 50.
    Katz N (1985) Research on major depression. In: Allen CK (eds) Occupational Therapy for Psychiatric Diseases: Measurement and Management of Cognitive Disabilities. Boston, Little Brown, pp 299–313Google Scholar
  51. 51.
    Lee SN, Gargiullo A, Brayman S et al (2003) Adolescent performance on the Allen Cognitive Levels Screen. Am J Occup Ther 57:342–346PubMedGoogle Scholar
  52. 52.
    Mayer MA (1988) Analysis of information processing and cognitive disability theory. Am J Occup Ther 42:176–183PubMedGoogle Scholar
  53. 53.
    Penny NH, Mueser KT, North CT (1995) The Allen Cognitive Level Test and social competence in adult psychiatric patients. Am J Occup Ther 49:420–427PubMedGoogle Scholar
  54. 54.
    Velligan DI, Bow-Thomas CC, Mahurin R et al (1998) Concurrent and predictive validity of the Allen Cognitive Levels Assessment. Psychiatry Res 80:287–298PubMedCrossRefGoogle Scholar
  55. 55.
    Velligan DI, True JE, Lefton RS et al (1995) Validity of the Allen Cognitive Levels assessment: A tri-ethnic comparison. Psychiatry Res 56:101–109PubMedCrossRefGoogle Scholar
  56. 56.
    Andreasen NC (1984) Scale for the Assessment of Positive Symptoms (SAPS). Iowa City IA, University of IowaGoogle Scholar
  57. 57.
    Andreasen NC (1983) Scale for the Assessment of Negative Symptoms (SANS). Iowa City IA, University of IowaGoogle Scholar
  58. 58.
    Andreasen NC (1982) Negative symptoms in schizophrenia: Definition and reliability. Arch Gen Psychiatry 39:784–788PubMedGoogle Scholar
  59. 59.
    Kay SR, Opler LA, Lindenmayer JP (1988) Reliability and validity of the Positive and Negative Syndrome Scale for schizophrenics. Psychiatry Res 23:99–110PubMedCrossRefGoogle Scholar
  60. 60.
    McGlashan TH, Fenton WS (1992) The positive-negative distinction in schizophrenia: Review of natural history indicators. Arch Gen Psychiatry 49:63–72PubMedGoogle Scholar
  61. 61.
    Norman RMG, Malla AK, Cortese L, Diaz F (1996) A study of the interrelationship between and comparative interrater reliability of the SAPS, SANS and PANSS. Schizophr Res 19:73–85PubMedCrossRefGoogle Scholar
  62. 62.
    Ng RMK, Leung SP (2000) A 5-year outcome study of chronically ill psychiatric patients in Hong Kong. HK J Psychiatry 10:27–36Google Scholar
  63. 63.
    Tang WK, Ungvari GS (2002) Efficacy of electroconvulsive therapy combined with antipsychotic medication in treatment-resistant schizophrenia: A prospective open trial. J ECT 18:90–94PubMedGoogle Scholar
  64. 64.
    Tang WK, Ungvari GS (2003) Efficacy of electroconvulsive therapy in treatment-resistance schizophrenia: a prospective open trial. Prog Neuropsychopharmacol Biol Psychiatry 27:373–379PubMedCrossRefGoogle Scholar
  65. 65.
    Barker S, Barron N, McFarland BH, Bigelow DA (1994) A Community Ability Scale for chronically mentally ill consumers: Part I. Reliability and validity. Community Ment Health J 30:363–383PubMedCrossRefGoogle Scholar
  66. 66.
    Dickerson FB, Parente F, Ringel NB (2000) The relationship among three measures of social functioning in outpatients with schizophrenia. J Clin Psychol 56:1509–1519PubMedCrossRefGoogle Scholar
  67. 67.
    Dickerson FB, Origoni AE, Pater A et al (2003) An expanded version of the Multnomah Community Ability Scale: anchors and interview probes for the assessment of adults with serious mental illness. Community Ment Health J 39:131–137PubMedCrossRefGoogle Scholar
  68. 68.
    Hendryx M, Dyck DG, McBride D, Whitbeck J (2001) A test of reliability and validity of the Multnomah Community Ability Scale. Community Ment Health J 37:157–168PubMedCrossRefGoogle Scholar
  69. 69.
    Leung KF, Tay M, Cheng SW et al (1997) Hong Kong Chinese Version World Health Organization Quality of Life Measure – Abbreviated version. Hong Kong, Hong Kong Hospital AuthorityGoogle Scholar
  70. 70.
    Green MF (1996) What are the functional consequences of neurocognitive deficits in schizophrenia. Am J Psychiatry 153:321–330PubMedGoogle Scholar
  71. 71.
    Green MF, Kern RS, Braff D, Mintz J (2000) Neurocognitive deficits and functional outcome in schizophrenia: Are we measuring the “right stuff”. Schizophr Bull 26:119–136PubMedGoogle Scholar
  72. 72.
    Mares AS (2001) Determinants of subjective quality of life among seriously mentally ill residents of board and care homes. Dissertation Abstracts International 61:4550Google Scholar
  73. 73.
    Nelson G, Wiltshire C, Hall GB et al (1995) Psychiatric consumer/survivorsȁ9 quality of life: Quantitative and qualitative perspectives. J Community Psychol 23:216–233Google Scholar
  74. 74.
    Skantze K, Malm U, Dencker S et al (1992) Comparison of quality of life with standard of living in schizophrenic outpatients. Br J Psychiatry 161:797–801PubMedCrossRefGoogle Scholar
  75. 75.
    Horan ME, Muller JJ, Winocur S, Barling N (2001) Quality of life in boarding houses and hostels: A residentsȁ9 perspective. Community Ment Health J 37:323–334PubMedCrossRefGoogle Scholar
  76. 76.
    Nelson G, Fowler HS (1987) Housing for the chronically mentally disabled: Part II – process and outcome. Can J Community Men Health 6:79–91Google Scholar
  77. 77.
    Rössler W, Salize HJ, Cucchiaro G et al (1999) Does the place of treatment influence the quality of life of schizophrenics. Acta Psychiatr Scand 100:142–148PubMedGoogle Scholar
  78. 78.
    Hall GB, Nelson G (1996) Social networks, social support, personal empowerment and the adaptation of psychiatric consumer/survivors: Path analytic models. Soc Sci Med 43:1743–1754PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Frederick Ka Ching Yeung
    • 1
  • Sunny Ho Wan Chan
    • 2
  1. 1.Department of Social Work and Social AdministrationUniversity of Hong KongHong KongChina
  2. 2.Department of Occupational TherapyPamela Youde Nethersole Eastern HospitalHong KongChina

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