1 Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
2 Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Int J Soc Psychiatry. 2019 Jun;65(4):322-332. doi: 10.1177/0020764019842291. Epub 2019 Apr 29.
Few studies on quality of life (QoL) among people with mental illness have been conducted in South Africa, and none in community dwelling individuals. However, a greater understanding of subjective QoL may inform community-based medical, psychotherapeutic, or social interventions. This study examined the QoL, clinical and sociodemographic characteristics of psychiatric patients attending community mental health clinics in the Gauteng Province of South Africa.
A cross sectional interview-based study was conducted with 121 adult patients attending community psychiatric clinics. To reduce the impact of acute psychiatric symptoms on subjective QoL, only clinically stable patients were included. Sociodemographic details and clinical characteristics were recorded. Subjective QoL was assessed using the World Health Organization QOL-Bref scale (WHOQOL-Bref), and severity of psychiatric illness measured with the Brief Psychiatric Rating Scale, expanded version 4.0 (BPRS-E).
Just over half of the sample rated their overall QoL as good or very good. Residual psychiatric symptomatology was the strongest predictor of a poor QoL in all four domains of the WHOQOL-Bref. The most severe BPRS scores were for the symptoms of depression, anxiety and somatic concern. Perceived social support significantly predicted a better QoL in the psychological, social relationships and environmental domains.
This study highlights the negative impact of residual psychiatric symptoms on subjective QoL and the importance of social support in enhancing QoL.
在南非,很少有研究关注精神疾病患者的生活质量(QoL),更没有研究关注社区居住的个体。然而,对主观 QoL 的更深入了解可能会为基于社区的医疗、心理治疗或社会干预提供信息。本研究调查了南非豪登省社区精神卫生诊所就诊的精神科患者的生活质量、临床和社会人口统计学特征。
对 121 名成年患者进行了横断面访谈研究,这些患者在社区精神病诊所就诊。为了减少急性精神症状对主观 QoL 的影响,仅纳入了临床稳定的患者。记录了社会人口统计学细节和临床特征。使用世界卫生组织生活质量简表(WHOQOL-Bref)评估主观生活质量,使用简明精神病评定量表扩展版 4.0(BPRS-E)评估精神病严重程度。
超过一半的样本对他们的整体生活质量评价为良好或非常好。在 WHOQOL-Bref 的所有四个领域中,残留的精神症状是生活质量较差的最强预测因素。BPRS 得分最高的是抑郁、焦虑和躯体关注症状。感知到的社会支持显著预测了心理、社会关系和环境领域的生活质量更好。
本研究强调了残留的精神症状对主观生活质量的负面影响,以及社会支持在提高生活质量方面的重要性。