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与精神障碍患者生活质量相关的关联和中介变量。

Associated and mediating variables related to quality of life among service users with mental disorders.

机构信息

Department of Psychiatry, Douglas Hospital Research Centre, McGill University, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.

Douglas Hospital Research Centre, Montreal, QC, H4H 1R3, Canada.

出版信息

Qual Life Res. 2018 Feb;27(2):491-502. doi: 10.1007/s11136-017-1717-z. Epub 2017 Oct 11.

Abstract

PURPOSE

This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records.

METHODS

Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified.

RESULTS

Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL.

CONCLUSIONS

Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

摘要

目的

本研究旨在确定与魁北克(加拿大) 338 名精神障碍服务使用者的生活质量(QoL)相关的变量和中介变量。使用九个标准化问卷和参与者的病历收集数据。

方法

使用生活满意度领域量表评估生活质量。将独立变量组织到六个模块的概念框架中。使用结构方程模型,确定与 QoL 相关的关联和中介变量。

结果

需求严重程度较低是与 QoL 最相关的最强变量,其次是康复、更高的服务连续性、性别(男性)、获得的帮助充足性、不独居、无物质使用或情绪障碍、以及更高的功能状态,依此类推。康复是唯一的中介变量,将需求严重程度较低、服务连续性较高以及减少饮酒与 QoL 联系起来。研究结果表明,更高的服务连续性为康复创造了有利条件,减少了服务使用者的需求严重程度并提高了他们的生活质量。缺乏以康复为导向的服务可能会影响饮酒者的生活质量,因为物质使用障碍与生活质量呈直接负相关。

结论

决策者和精神卫生专业人员应促进服务连续性,并加强初级保健和专业服务之间的协作,同时支持以康复为导向的服务,鼓励服务使用者参与其治疗和随访。社区组织应努力减少需求的严重程度,特别是对女性服务使用者和独居者。

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