Liu Ying, Li Ying
Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China.
Department of Social Security, School of Labor and Human Resources, Renmin University of China, Haidian District, Beijing, 100872, China.
Soc Psychiatry Psychiatr Epidemiol. 2024 Sep 9. doi: 10.1007/s00127-024-02754-7.
Community participation is believed to be positively associated with recovery experiences and quality of life for people with serious mental illnesses (PSMIs). However, the underlying mechanism remains unclear. This study examined the mediating effect of self-stigma on the relationship between community participation and personal recovery experiences and quality of life among PSMIs.
Structural equation modeling and mediation analyses were conducted based on a community sample of 315 PSMIs in Beijing, China, who were surveyed using the Community Participation Domains Measure, Internalized Stigma of Mental Illness, Recovery Assessment Scale, Quality of Life Scale, and a demographic questionnaire. Most were in their middle age. About half were married, and half were females. Most participants got disability certificates.
The results indicate that community participation is directly associated with personal recovery of PSMIs (P < 0.01) and indirectly associated with personal recovery through the mediation of self-stigma (P < 0.01). Additionally, community participation does not have a direct effect on the quality of life of PSMIs but shows an indirect effect through the mediation of self-stigma (P < 0.01). The findings suggest that self-stigma mediates the relationship between community participation and both the subjective perception of recovery and quality of life.
The findings indicate that community participation for PSMIs should be enhanced. Tailored individual intervention services should be implemented to boost positive self-awareness and reduce self-stigma through active engagement in activities. Such participation has the potential to improve subjective experiences of recovery and overall quality of life.
社区参与被认为与严重精神疾病患者(PSMIs)的康复体验和生活质量呈正相关。然而,其潜在机制仍不清楚。本研究探讨了自我污名在社区参与与PSMIs的个人康复体验及生活质量之间关系中的中介作用。
基于对中国北京315名PSMIs的社区样本进行结构方程建模和中介分析,使用社区参与领域量表、精神疾病内化污名量表、康复评估量表、生活质量量表及一份人口统计学调查问卷对他们进行了调查。大多数人处于中年。约一半人已婚,一半为女性。大多数参与者持有残疾证。
结果表明,社区参与与PSMIs的个人康复直接相关(P < 0.01),并通过自我污名的中介作用与个人康复间接相关(P < 0.01)。此外,社区参与对PSMIs的生活质量没有直接影响,但通过自我污名的中介作用显示出间接影响(P < 0.01)。研究结果表明,自我污名在社区参与与康复的主观认知及生活质量之间的关系中起中介作用。
研究结果表明应加强PSMIs的社区参与。应实施有针对性的个体干预服务,通过积极参与活动来增强积极的自我认知并减少自我污名。这种参与有可能改善康复的主观体验和整体生活质量。