Corring Deborah J, Cook Joanne V
Specialized Adult St. Thomas Program, Regional Mental Health Care St. Thomas, P.O. Box 2004, St. Thomas, Ontario, Canada N5P 3V9.
Psychiatr Serv. 2007 Feb;58(2):240-4. doi: 10.1176/ps.2007.58.2.240.
This study explored the construct of quality of life from the perspective of adults diagnosed as having severe and persistent mental illness, such as schizophrenia.
Qualitative research strategies, specifically in-depth interviews (N=18) and focus groups (N=35), were used to collect data. Interviews and focus groups took place in hospitals, community clinics, community agencies, and clients' homes. A convenience, snowball sampling strategy was utilized.
Analysis using the constant comparative method resulted in the identification of two dominant themes. These themes permeated the results, crossed all domains, influenced the linkages between domains, and clearly influenced how individuals frame their expectations regarding quality of life. The first theme was the presence of stigma and its effects on everyday life and future planning, and the second was the pervasive fear of the return of major positive symptoms of psychosis, such as hallucinations, delusions, and general loss of contact with reality. In addition, four quality-of-life domains were identified-the experience of illness, relationships, occupation, and sense of self.
Many persons with mental illness simply wish for the basics in life-mental and physical health, supportive relationships, meaningful occupations, and a positive sense of self-believing that acquisition of these basics will lead to a more satisfactory quality of life. Ensuring that they are able to obtain the basics requires action on their part, by those who support them, by service providers that interact with them, and by a more accepting society.
本研究从被诊断患有严重且持续性精神疾病(如精神分裂症)的成年人的角度探讨生活质量的构成要素。
采用定性研究策略,具体为深度访谈(N = 18)和焦点小组(N = 35)来收集数据。访谈和焦点小组在医院、社区诊所、社区机构及患者家中进行。采用便利抽样和滚雪球抽样策略。
运用持续比较法进行分析,确定了两个主要主题。这些主题贯穿研究结果,跨越所有领域,影响各领域之间的联系,并明显影响个体对生活质量期望的构建方式。第一个主题是耻辱感的存在及其对日常生活和未来规划的影响,第二个主题是对精神病主要阳性症状(如幻觉、妄想及与现实的普遍失联)复发的普遍恐惧。此外,还确定了四个生活质量领域——疾病体验、人际关系、职业和自我认知。
许多精神疾病患者仅仅期望获得生活的基本要素——身心健康、支持性的人际关系、有意义的职业以及积极的自我认知——认为获得这些基本要素将带来更令人满意的生活质量。要确保他们能够获得这些基本要素,需要他们自身、支持他们的人、与他们互动的服务提供者以及更包容的社会采取行动。