Relationship between Perceived Quality of Life, Social Functioning, and Life Skills Performance of Patients with Chronic Psychiatric Conditions in a Long Stay Care Home

Article excerpt

Abstract

Objective: During the past decade, many patients with chronic psychiatric conditions have transferred to live in long stay care homes in Hong Kong. Few studies on the outcome of these rehabilitation services are available. This study aimed to investigate the relationships between quality of life, social functioning, and life skills performance of patients residing in such rehabilitation facilities.

Methods: 179 residents were recruited, and 171 were assessed on 3 occasions during 1 year to examine the relationships between demographic characteristics, quality of life, social functioning level, and life skills performance.

Results: The residents had high perceived quality of life and low level of social disability with a gradual increase in the perceived quality of life and reduction in the level of social disability during the study period. Perceived quality of life was not correlated with level of social functioning. Life skills performance levels were correlated with level of social functioning, but were not correlated with level of perceived quality of life.

Conclusion: The findings suggest that patients with chronic psychiatric conditions can lead a more independent life with high perceived quality in a long stay care home. Further studies are required to evaluate the factors contributing to high perceived quality of life and impact of skills training programmes on social functioning of these patients. Key words: Chronic, Long stay care home, Quality of life, Social functioning

Introduction

Since the 1980s, there has been a large-scale planned transfer of patients from psychiatric hospitals to community care in Hong Kong. Residential care provisions of various levels of supervision have been developed. One of those residential services is the long stay care home (LSCH), which is specially designed for people with chronic psychiatric illness. The first LSCH was opened in 1989. It has capacity for 200 residents. Two more LSCHs were opened in the mid-1990s, catering for another 370 residents.

Recently, quality of life has become an important outcome measure of community services for patients with chronic psychiatric illness. (1,2) Despite its significance, quality of life is still rarely measured in routine clinical practice. Often, symptoms of psychiatric disorder are interpreted as equivalence to poor quality of life, while psychiatric disorders often result in social deficit that renders patients difficult to assess. Furthermore, the stigmatising effect of psychiatric disorder has detrimental effects on multiple aspects of life for many psychiatric patients.

Since the average life expectancy of the general population, including patients with psychiatric illness, has increased by 40% due to the improved standard of living, Sartorius argues that the ultimate goal of rehabilitation for patients with a chronic psychiatric illness is improvement in their quality of life. (3) Therefore, quality of life should be considered an important indicator of the success of a rehabilitation process.

Social Functioning

Dysfunctional social behaviour has long been recognised as a common feature of chronic psychiatric illness. With recent advances in pharmacological treatment, many patients with a chronic psychiatric illness can live independently in the community. Cohen and Kochanowicz found that social deficit of psychiatric patients often leads to social disintegration and isolation. (4) Thus, Bennett suggested that psychiatric rehabilitation of patients with a chronic psychiatric illness should aim to help them optimise their social functioning. (5) The same applies to preventing further deterioration.

Literature on the relationship between quality of life and level of social functioning is scarce. Several studies have shown that problems in social functioning may lead to low quality of life for patients with chronic psychiatric illness. …