Quality of Life and Functioning of People With Mental Disorders Who Underwent Deinstitutionalization Using Assisted Living Facilities: A Cross-Sectional Study

Abstract

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, through interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’s t-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n = 65.8; 95%CI, 63.5–68.1 vs. n = 73.9; 95%CI, 67.5–80.3; p = 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n = 10.9; 95%CI, 9.6–12.2 vs. n = 5.1; 95%CI, 2.5–7.7; p = 0.01). A weak negative correlation (r = 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile.

Health related quality of life among people with mental illness: The role of socio-clinical characteristics and level of functional disability

“…Similar to previous studies (58, 59), in this study, the HRQoL of people with mental illness was negatively associated to their level of functioning/disability status, which might be represented in low employment rates and social interactions. Researchers have discovered that a worse HRQoL is connected with the incapacity to perform functional life tasks, such as activities of daily living such as bathing, dressing and instrumental activities of daily living like driving, budgeting (31, 60).…”

“…Researchers have discovered that a worse HRQoL is connected with the incapacity to perform functional life tasks, such as activities of daily living such as bathing, dressing and instrumental activities of daily living like driving, budgeting ( 31 , 60 ). Disability associated with mental illness can cause impairments, limitations, and restrictions to activities and participation in relation to the environment which may compromise HRQoL ( 59 ). This suggests that HRQoL and functioning can be employed as essential parameters in the creation of mental healthcare strategies, health condition monitoring, and social reintegration of these persons, hence helping the introduction of new assisted living facilities and enhancing the existing one.…”

Editorial: New Horizons in Health-Promoting: From Methods to Implementation Science

“…Switching between second-generation antipsychotics (SGA) is a common clinical practice in the treatment of schizophrenia and schizoaffective disorders due to differences in the tolerability and safety profiles of the different anti-psychotics (Leucht et al, 2013;Huhn et al, 2019;Fulone et al, 2021b), as well as the challenge of obtaining an ideal response (Fulone et al, 2016;Mayer et al, 2021). Data were obtained from a pharmaceutical assistance program, by using an administrative database.…”