Psychopathology, rehospitalization and quality of life among patients with schizophrenia under home care case management in Taiwan

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• 作者：Li-Ren Chang^a ; Yu-Hsuan Lin^a ; ^b ; Hung-Chieh Wu Chang^a ; Ying-Zai Chen^a ; Wei-Lieh Huang^a ; Chih-Min Liu^b ; ^c ; Chen-Chung Liu^b ; ^c ; ^{chchliu@ntu.edu.tw} ; Hai-Gwo Hwu^b ; ^c
• 关键词：EQ-5D ; nonintensive case management ; quality of life ; rehospitalization ; schizophrenia
• 刊名：Journal of the Formosan Medical Association
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：112
• 期：4
• 页码：208-215
• 全文大小：202 K

文摘

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Background/Purpose

To study the outcome of a group of patients with schizophrenia receiving community home care case management programs by delineating the relationship among their psychopathology, rehospitalization rates and health-related quality of life (HRQoL).

Methods

This is a cross-sectional study on HRQoL, functioning and associating factors and a retrospectivehistorical control study by comparing the frequency and duration of rehospitalization in a sample of 60 patients with schizophrenia under nonintensive case management (non-ICM) in Taiwan. All participants were assessed on the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) for psychopathology, on EuroQoL-5D (EQ-5D) and EQ visual analogue (EQ-VAS) for HRQoL, andGlobal Assessment of Functioning (GAF) for socio-occupational dysfunction. Other clinical characteristics are also gathered.

Results

Patients with schizophrenia treated with non-ICM had a significant reduction in admission frequency (?0.10?¡À?0.36 times per year, p?=?0.042) and length of inpatient stay (-27.8?¡À?78.0 days per year, p?=?0.008). Better EQ-5D and EQ-VAS are significantly associated with lower general psychopathology score, while better EQ-VAS is significantly associated with older age and higher negative symptoms subscale score. GAF is negatively associated with higher positive symptoms and negative symptoms subscale scores, while positively correlated with a greater reduction in number and frequency of admission.

Conclusion

Non-ICM can help to decrease rehospitalization of home care patients. HRQoL and functioning can be assessed by the three perspectives we used, and each measure was correlated to different dimensions of patient psychopathology. It will be better if we include baseline and post-intervention PANSS scores, HRQoL and functioning as outcome indicators.