ABSTRACT
BACKGROUND: A growing number of severely ill patients require long-term care in non-hospital residential facilities (RFs). Despite the magnitude of this development, longitudinal studies surveying fairly large resident samples and yielding important information on this population have been very few. AIMS: The aims of the study were (1) to describe the socio-demographic, clinical, and treatment-related characteristics of RF patients during an index period in 2010; (2) to identify predictors and characteristics associated with discharge at the 1-year follow-up; (3) to evaluate clinicians' predictions about each patient's likelihood of home discharge (HD). METHODS: A prospective observational cohort study was conducted involving all patients staying in 23 medium-long-term RFs of the St John of God Order with a primary psychiatric diagnosis. A comprehensive set of socio-demographic, clinical, and treatment-related information was gathered and standardized assessments (BPRS, HONOS, PSP, PHI, SLOF, RBANS) were administered to each participant. Logistic regression analyses were run to identify independent discharge predictors. RESULTS: The study involved 403 patients (66.7% male), with a mean age of 49 years (SD = 10). The participants' average illness duration was 23 years; median value for length of stay in the RF was 2.2 years. The most frequent diagnosis was schizophrenia (67.5%). 104 (25.8%) were discharged: 13.6% to home, 8.2% to other RFs, 2.2% to supported housing, and 1.5% to prison. Clinicians' predictions about HD were generally erroneous. CONCLUSIONS: Very few patients were discharged to independent accommodations after 1 year. The main variables associated with a higher HD likelihood were: illness duration of <15 years and effective social support during the previous year. Lower severity of psychopathology and higher working skill levels were also associated with a significantly greater HD likelihood.
Subject(s)
Length of Stay/statistics & numerical data , Mental Disorders/epidemiology , Mental Disorders/therapy , Patient Discharge/statistics & numerical data , Residential Facilities/organization & administration , Adolescent , Female , Follow-Up Studies , Humans , Italy/epidemiology , Logistic Models , Long-Term Care , Male , Mental Disorders/classification , Mental Health Services/organization & administration , Middle Aged , Multivariate Analysis , Predictive Value of Tests , Prospective Studies , Socioeconomic Factors , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The World Health Organisation defines health as "a state of complete physical, mental and social well-being, not merely the absence of disease or infermity". In May 1984 the spiritual dimension became part of WHO Member States' strategies for health. The WHO defines quality of life as "individuals' perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns." PURPOSE: To test health workers' quality of life (QOL) with regard to their spirituality. METHODS: The WHOQOL SRPB-domain 6 was used. It denotes an individual's perception of quality of life, as far as spirituality is concerned. The sample was formed by 116 health workers from three wards of three Rehabilitation Hospitals owned by the Brothers of Saint John of God, in Northern Italy. RESULTS: The sample shows means above the mid-point in all facets denoting reasonably good quality of life in the domain of spirituality. The most significative variables are: health conditions (p = .001*), religiousness (p < or = .0005**), personal creed (p < or = .0005**). IMPLICATIONS: The sample's quality of life in the domain of spirituality is reasonably good. Our findings suggest that spirituality is associated with the subjective perception of people's health status.
