Predicting employment status and subjective quality of life in patients with schizophrenia.
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ABSTRACT:
SUBMITTER: Fujino H
PROVIDER: S-EPMC5506698 | biostudies-other | 2016 Mar
REPOSITORIES: biostudies-other
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Project description:Lack of insight is a well-established phenomenon in schizophrenia, and has been associated with reduced rater-assessed functional performance but increased self-reported well-being in previous studies. The objective of this study was to examine factors that might influence insight (as assessed by the Insight and Treatment Attitudes Questionnaire [ITAQ] or PANSS item G12) and subjective quality-of-life (as assessed by Lehman QoL Interview [LQOLI]), using the large National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Uncooperativeness was assessed by PANSS item G8 ("Uncooperativeness"). In the analysis, we found significant moderating effects for insight on the relationships of subjective life satisfaction assessment to symptom severity (as assessed by CGI-S score), objective everyday functioning (as assessed by rater-administered Heinrichs-Carpenter Quality of Life scale), clinically rated uncooperativeness (as assessed by PANSS G8), and discontinuation of treatment for all causes (all P > 0.05 for statistical interaction between insight and subject QoL). Patients with chronic schizophrenia who reported being "pleased" or "delighted" on LQOLI were found to have significantly lower neurocognitive reasoning performance and poorer insight (ITAQ total score). Our findings underscore the importance of reducing cognitive and insight impairments for both treatment compliance and improved functional outcomes.
| S-EPMC4788499 | biostudies-literature
Project description:IntroductionClinical symptoms and sociodemographic variables predict level of functioning and quality of life in patients with schizophrenia. However, few studies have examined the effect of personality traits on quality of life and overall functioning in schizophrenia. Personality traits are premorbid to illness and may predict the way patients experience schizophrenia. The aim of this study was to examine the individual and additive effects of two core personality traits-neuroticism and extraversion-on quality of life and functioning.MethodsPatients with schizophrenia-spectrum disorders (n=153) and healthy controls (n=125) completed personality and quality of life questionnaires. Global functioning was assessed during a clinician-administered structured interview. Neuroticism and extraversion scores were analyzed both as continuous variables and as categorical extremes (High versus Normal Neuroticism, Low versus Normal Extraversion).ResultsQuality of life was significantly associated with neuroticism, extraversion, and the neuroticism×diagnosis and extraversion×diagnosis interactions. For patients, a lower neuroticism score (in the normal range) was associated with quality of life scores comparable to controls; whereas high neuroticism scores in patients were associated with the lowest quality of life. For overall functioning, only diagnosis had a significant effect.ConclusionNeuroticism modulates quality of life and may provide an important key to improving the life of patients with schizophrenia.
| S-EPMC5376216 | biostudies-literature
Project description:Background: Recently, the community rehabilitation model for schizophrenia patients has become increasingly popular, and the Shanghai Pudong New Area has developed a relatively complete community rehabilitation model. This study analyzed the correlation between family function and subjective quality of life in the rehabilitation of patients living with schizophrenia in the community. Methods: This study evaluated persons living with schizophrenia using the Family Assessment Device and the Subjective Quality of Life Scale. A convenient sampling method was used to select 281 rehabilitation patients living with schizophrenia in the community and 166 hospitalized persons living with schizophrenia. Results: There was a significant difference in the Family Assessment Device scores between rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia (p < 0.0001). The difference in the scores of the subjective quality of life assessment between rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia was not statistically significant (p > 0.05). The regression analysis showed that quality of family function had a significant effect on the subjective quality of life in rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia. (F = 10.770 p < 0.001), (F = 2.960 p < 0.01). Conclusions: The quality of family function plays an important role in improving the subjective quality of life in rehabilitation patients living with schizophrenia in the community. It may be beneficial to add some methods to improve family function in the current model of rehabilitation in the community.
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Project description:AIM:This study evaluated adherence to treatment, quality of life and subjective well-being in patients with psychosis treated with long-acting injectable risperidone. Subjects enrolled were part of a larger study where patients were observed in an adherence to treatment program of the University of Rome Tor Vergata. MATERIALS AND METHODS:A total of 27 nonadherent patients (21 men, six women; mean age: 36.1 years; range: 23-63 years) were enrolled. Maximum observational period was 30 months. RESULTS:A total of 12 patients were under treatment for 30 months (44.44%) but only nine had a valid 30-month follow up, while the remaining three patients initially treated at our unit continued long-acting risperidone at their local centre. Reductions of monthly mean values of Scale for the Assessment of Positive Symptoms (SAPS) [repeated measures analysis of variance (rm-ANOVA): p < 0.0001] and Scale for Assessment of Negative Symptoms (SANS) (p < 0.0001), increase of monthly mean values of Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) (p < 0.0001) and Schizophrenia Quality of Life Scale (S-QoL) (p < 0.01) were observed. Significant differences with respect to SAPS baseline values from the sixth month, SANS baseline values from the seventh month, SWN baseline values from the eighth month, S-QoL baseline values from the eighteenth month were shown in post hoc tests. Reduction of SAPS mean values was associated with increase of SWN (p < 0.0001) and S-QoL (p < 0.0001) mean values as demonstrated by correlation analysis. The same inverse correlation was found between reduction of SANS mean values and increases of SWN (p < 0.0001) and S-QoL (p = 0.0001) mean values. CONCLUSIONS:Long-term treatment with long-acting risperidone may be associated with improvement to adherence to therapy and quality of life. Patients may show improvement in psychopathological symptoms, subjective well-being and quality of life.
| S-EPMC4622121 | biostudies-literature
Project description:BackgroundClinical trials on osteoarthritis (OA) flare-ups treatment usually focus only on objective measures of health status, albeit recent literature suggestions on the importance of patients' subjectivity. Aim of the study was to evaluate the effects of OA and of its different types of medical treatment(s) on Health Related Quality of Life (HRQoL) in terms of both subjective satisfaction and functional status.MethodsAn observational study on prospective data collected from the Evaluation of Quality of life in OA (EQuO) clinical trial (April 1999-November 2000) was conducted; outpatients from 70 participating centers (Orthopedy or Rheumatology Departments in Italy) with a diagnosis of OA of the hip or knee were consecutively enrolled. Patients were observed at OA flare-ups (baseline) and at follow up 4 weeks after treatment. Patients' objective and subjective HRQoL were assessed by means of the SF-36 and the Satisfaction Profile (SAT-P, which focuses on subjective satisfaction); Present Pain at baseline and Pain Relief at follow up were also evaluated.ResultsAmong the 1323 patients, 1138 (86%) were prescribed one drug/treatment of osteoarthritis, 169 (13%) 2 drugs/treatments, and 16 (1%) 3 drugs/treatments; most of treatments involved the prescription of NSAIDs; non-coxib, COX2 selective NSAIDs were prescribed in about 50% of patients. Follow-up visits were performed after 29.0 days on average (+/- 7.69 SD). For all SF-36 domains, all SAT-P items and factors, the differences between baseline and follow up scores resulted statistically significant (p < 0.001), enlighting an improvement both in health status and in subjective HRQoL.ConclusionBesides the classic health status measures, the assessment of patients' subjective satisfaction provides important clues on treatments efficacy of OA within the patient-centered medicine model. In clinical practice this could lead to a better doctor-patient communication and to higher levels of treatment adherence.
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Project description:Kidney transplantation (KTx) in end-stage renal disease is associated with a significant increase in quality of life (QoL) and self-perceived health, optimally leading to the maintenance of employment or return to work (RTW) in working-age patients. The aim of this study was to assess individual factors including the QoL and mental health of kidney transplant recipients (KTRs) associated with employment after transplantation. A cross-sectional study including working-age patients with a history of KTx after 2012 was conducted at two Austrian study centers (Vienna and Graz). Brief Symptom Inventory (BSI-18), World Health Organization Quality of Life (WHOQOL-Bref) and Workability Index (WAI) were assessed along with detailed questionnaires on employment status. Out of n = 139 KTRs (43.2 ± 9.07 years; 57.6% male), 72 (51.8%) were employed. Employed patients were more frequently in a partnership (p = 0.018) and had higher education levels (p = 0.01) and QoL scores (<0.001). Unemployed KTRs reported fatigue and mental health issues more often (p < 0.001), and had significantly higher anxiety, depression and somatization scores (BSI-18). In unadjusted logistical regression, workability score (WAS; odds ratio (OR) = 3.39; 95% confidence interval (CI) = 1.97-5.82; p < 0.001), partnership (OR = 5.47; 95% CI 1.43-20.91; p = 0.013) and no psychological counseling after KTx (OR = 0.06; 95% CI = 0.003-0.969; p = 0.048) were independently associated with employment. Self-assessed mental health, workability and QoL were significantly associated with employment status after KTx. Thus, in order to facilitate RTW after KTx in Austria, vocational rehabilitation and RTW programs addressing KTRs should focus on increasing social support and care for their mental health.
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Project description:Sleep disorders are often not regarded as an important health problem, despite their impact on heath. Insomnia is the most frequent sleep disorder in mental health. The aim is to quantify the prevalence of insomnia in a population with schizophrenic disorder and assess its influence on quality of life. This is a descriptive, analytical and cross-sectional study conducted in a sample of 267 schizophrenic patients over 18 years of age using consecutive non-probabilistic sampling. The variables of interest were collected by means of the "Cuestionario Oviedo de Sueño," "Insomnia Severity Index" and EuqoQol-5D. The estimation of insomnia in our schizophrenic population according to the International Classification of Disease (ICD-10) criteria was 23.2%. The likelihood of insomnia when there are problems in the quality of life is significant in all its dimensions: mobility OR: 3.54 (95% CI 1.88- 6.65), self-care OR: 2.69 (95% CI 1.36-5.32), usual activities OR: 3.56 (95% CI 1.97-6.44), pain/discomfort OR: 4.29 (95% CI 2.37-7.74) and anxiety/depression OR: 3.01 (95% CI 1.61-5.65). The prevalence of insomnia fluctuates depending on the diagnostic criteria; however, the schizophrenic population shows high prevalence in some clinical characteristics. People with insomnia have a lower quality of life.
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Project description:Long-term and cumulative social experiences influence an individual's objective and subjective social status. Social determinants of health are more effectively investigated by longitudinal rather than cross-sectional studies. The primary focus of this study was the prospective effect of socioeconomic transition on health-related quality of life trajectories. The study population were adults over 18 years of age who responded in all nine waves of the Korea Health Panel (2009-2017). Data were analyzed by group-based trajectory modeling to identify health trajectories, and group-based multi-trajectory modeling to investigate combined change patterns of objective and subjective social status (i.e., multi-SES trajectories). To predict the effects of underlying socioeconomic measures on health trajectory group membership, we included these time-stable covariates in trajectory modeling and estimated the risk of belonging to each trajectory based on the measures. The health-related quality of life trajectories showed three patterns during the period 2013 to 2017; 13.7% of individuals had a low and declining health trajectory and the others had a higher stable health trajectory. Four types of multi-SES trajectory were derived during the period 2009 to 2013; the richer had a steeper income slope while there were slight changes in subjective social status among all groups. These combined longitudinal SES patterns in 2009-2013 were strong predictors of subsequent health trajectory group membership in 2013-2017. These findings indicate that rich countries, such as South Korea, may encounter growing income inequality, where individuals become entrenched in income disparity that pins down their perceptions of social position. Over time this rigid social structure will widen the gap in health-related quality of life.
| S-EPMC8919292 | biostudies-literature
Project description:BackgroundThe success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries.MethodsData were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010-2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return.ResultsOverall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30-49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return.ConclusionThere is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.
| S-EPMC6129999 | biostudies-literature
Project description:BACKGROUND: A couple of decades ago, hospitals or psychiatric institutions were in charge of caring for patients with schizophrenia; however, nowadays this role is performed by one or more patient's relatives. Evidence shows that informal caregivers experience negative changes in their quality of life (QOL). The aim of this study is to review the main factors associated with the QOL of caregivers of people with schizophrenia. METHODS: A search through databases from journals published last decade between 1998 and 2008 was performed. In accordance with the inclusion criteria, titles and abstracts of citations obtained from the search were examined independently by two authors and irrelevant articles discarded. The full text of those studies considered relevant by either reviewer were obtained and assessed independently. Where differences of opinion rose they were resolved by discussion. Out of the 258 references, 37 were included in the review. Studies which assessed factors associated with caregivers of people with schizophrenia's quality of life were included and the information summarized. RESULTS: Evidence suggest that physical, emotional and economic distress affect negatively caregiver's QOL as a result of a number of unfulfilled needs such as, restoration of patient functioning in family and social roles, economic burden, lack of spare time, among other factors. CONCLUSION: Decreased QOL may be associated with caregivers' burden, lack of social support, course of the disease and family relationships problems. In addition, in developing countries, QOL is affected by caregivers' economic burden. High quality research is needed in order to identify factors associated with QOL over time and testing the efficacy of interventions aiming to improve QOL in caregivers of patients with schizophrenia.
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