scholarly journals The effect on subjective quality of life of occupational therapy based on adjusting the challenge–skill balance: a randomized controlled trial

2019 ◽  
Vol 33 (11) ◽  
pp. 1732-1746
Author(s):  
Ippei Yoshida ◽  
Kazuki Hirao ◽  
Ryuji Kobayashi
Keyword(s):  
Quality Of Life ◽  
Occupational Therapy ◽  
Controlled Trial ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Rehabilitation Process ◽  
And Control

Objective: To verify the effect of adjusting the challenge–skill balance with respect to rehabilitation process. Design: A single-blind, two-arm, parallel-group, randomized controlled trial. Setting: Recovery rehabilitation unit of Harue Hospital, Japan. Subjects: The trial included 72 clients (mean (SD): age, 74.64 (9.51) years; Functional Independence Measure score, 98.26 (15.27)) with cerebral or spinal disease or musculoskeletal disease. Interventions: Clients were randomly divided into two groups: the experimental group, who received occupational therapy with adjustment of the challenge–skill balance, and the control group who received conventional occupational therapy. Time from admission to discharge was considered the implementation period; the final evaluation was conducted at three months after discharge. Main measures: The primary outcome was subjective quality of life (Ikigai-9). Secondary outcomes were the health-related quality of life (EuroQol–5 Dimensions, Five Levels (EQ-5D-5L)), the Flow State Scale for Occupational Tasks, and the Functional Independence Measure. A cost-effectiveness analysis was conducted using total cost and quality-adjusted life-year based on the EQ-5D-5L. Results: Significant differences were observed between the experimental and control groups with respect to the Ikigai-9 score ( P = 0.008) and EQ-5D-5L ( P = 0.038), and the effect sizes were 0.76 (95% confidence interval [CI]: 0.27–1.24) and 0.62 (95% CI: 0.14–1.10), respectively. No significant between-group differences in other outcomes were observed, for example, the Functional Independence Measure score improved in both experimental and control groups (119.80 (5.50) and 118.84 (6.97), respectively. The incremental cost-effectiveness ratio was US$5518.38. Conclusions: Adjusting the challenge–skill balance may be a useful approach to improve the participant’s subjective quality of life in the rehabilitation process.

scholarly journals Structured patient–clinician communication and 1-year outcome in community mental healthcare

2007 ◽  
Vol 191 (5) ◽  
pp. 420-426 ◽  
Author(s):  
Stefan Priebe ◽  
Rosemarie McCabe ◽  
Jens Bullenkamp ◽  
Lars Hansson ◽  
Christoph Lauber ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Treatment Satisfaction ◽  
Unmet Needs ◽  
Controlled Trial ◽  
Mental Healthcare ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Needs For Care ◽  
Clinician Communication

BackgroundPatient–clinician communication is central to mental healthcare but neglected in research.AimsTo test a new computer-mediated intervention structuring patient–clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care.MethodIn a cluster randomised controlled trial, 134 keyworkers in six countries were allocated to DIALOG or treatment as usual; 507 people with schizophrenia or related disorders were included. Every 2 months for 1 year, clinicians asked patients to rate satisfaction with quality of life and treatment, and request additional or different support. Responses were fed back immediately in screen displays, compared with previous ratings and discussed. Primary outcome was subjective quality of life, and secondary outcomes were unmet needs and treatment satisfaction.ResultsOf 507 patients, 56 were lost to follow-up and 451 were included in intention-to-treat analyses. Patients receiving the DIALOG intervention had better subjective quality of life, fewer unmet needs and higher treatment satisfaction after 12 months.ConclusionsStructuring patient–clinician dialogue to focus on patients' views positively influenced quality of life, needs for care and treatment satisfaction.

Patterns and predictors of trajectories for subjective quality of life in patients with early psychosis: Three-year follow-up of the randomized controlled trial on extended early intervention

2021 ◽  
pp. 000486742110096
Author(s):  
Candice Tze Kwan Kam ◽  
Wing Chung Chang ◽  
Vivian Wing Yan Kwong ◽  
Emily Sin Ki Lau ◽  
Gloria Hoi Kei Chan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Early Intervention ◽  
Controlled Trial ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Randomized Controlled ◽  
Life Trajectory

Objective: Subjective quality of life is an important outcome of psychotic disorders. However, longitudinal course of subjective quality of life in the early illness stage is under-studied. We aimed to investigate the patterns and baseline predictors of subjective quality of life trajectories over 3 years in early psychosis patients, utilizing growth mixing modeling analysis, in the context of a 3-year follow-up of a randomized controlled trial comparing 1-year extension of early intervention with step-down psychiatric care for first-episode psychosis. Method: One hundred sixty Chinese patients were recruited from specialized early intervention program for first-episode psychosis in Hong Kong after they had completed this 2-year early intervention service, and underwent 1-year randomized controlled trial as well as 2-year post–randomized controlled trial follow-up (i.e. 3-year follow-up). Assessments on premorbid adjustment, onset profile, psychopathology, functioning and treatment characteristics were conducted. Individual class membership of subjective quality of life trajectory derived from growth mixing modeling was based on the 36-Item Short Form Health Survey mental component summary scores measured at four different time-points (baseline, 1, 2 and 3 years) among 142 participants across 3-year follow-up. Results: Three distinct subjective quality of life trajectories were identified including higher-improving (68.3%, n = 97), lower-stable (24.6%, n = 35) and deteriorating (7%, n = 10) trajectories. Age of onset; duration of untreated psychosis; depressive, positive and negative symptoms; and intervention condition were significantly different between good (higher-improving trajectory) and poor (combined lower-stable and deteriorating trajectories) trajectory groups. Multiple regression analysis revealed that younger age of onset, more severe depression and receipt of step-down care independently predicted poor subjective quality of life trajectory. Conclusion: Approximately one-third of patients displayed poor subjective quality of life trajectory in the early phase of psychotic illness. Our results affirm depression as a critical determinant of prospective subjective quality of life and underscores positive effect of extended early intervention on sustained subjective quality of life improvement. Further longitudinal research is warranted to facilitate better characterization of subjective quality of life course patterns and development of targeted intervention to optimize subjective quality of life in patients with early psychosis.

Cognitive determinants of community functioning and quality of life in homeless adults with mental illness: 6-year follow-up from the At Home/Chez Soi Study Toronto site

2021 ◽  
pp. 1-9
Author(s):  
K. M. Gicas ◽  
C. Mejia-Lancheros ◽  
R. Nisenbaum ◽  
R. Wang ◽  
S. W. Hwang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Functional Outcomes ◽  
Verbal Learning ◽  
Subjective Quality ◽  
Subjective Quality Of Life ◽  
Homeless Adults ◽  
Community Functioning ◽  
At Home

Abstract Background High rates of physical and mental health comorbidities are associated with functional impairment among persons who are homeless. Cognitive dysfunction is common, but how it contributes to various functional outcomes in this population has not been well investigated. This study examines how cognition covaries with community functioning and subjective quality of life over a 6-year period while accounting for the effects of risk and protective factors. Methods Participants were 349 homeless adults (mean age = 39.8) recruited from the Toronto site of the At Home/Chez Soi study, a large Canadian randomized control trial of Housing First. Participants completed up to four clinical evaluations over 6 years. Factor scores were created to index verbal learning and memory (vLM) and processing speed-cognitive flexibility (PSCF). The primary outcomes were community functioning and subjective quality of life. Risk factors included lifetime homelessness, mental health diagnoses, medical comorbidity, and childhood adversity. Linear mixed-effects models were conducted to examine cognition-functional outcome associations over time, with resilience as a moderator. Results Better vLM (b = 0.787, p = 0.010) and PSCF (b = 1.66, p < 0.001) were associated with better community functioning, but not with quality of life. Resilience conferred a protective effect on subjective quality of life (b = 1.45, p = 0.011) but did not moderate outcomes. Conclusions Our findings suggest a need to consider the unique determinants of community functioning and quality of life among homeless adults. Cognition should be prioritized as a key intervention target within existing service delivery models to optimize long-term functional outcomes.

Existential/spiritual resources and the subjective quality of life experiences among elderly adults

2015 ◽  
Vol 13 (4) ◽  
pp. 123-168 ◽  
Author(s):  
Magdalena Kapała
Keyword(s):  
Quality Of Life ◽  
The Elderly ◽  
Subjective Quality ◽  
Modern World ◽  
Life Questionnaire ◽  
Elderly Adults ◽  
Subjective Quality Of Life ◽  
Spiritual Resources ◽  
Two Phases

AbstractMy paper presents the results of a research study on the relationship between existential/spiritual resources, that is, spiritual sensitivity (a disposition to experience spirituality, manifested in the embracement of the nature of things in the transcendent and final perspective, in moral sensitivity, and the ability to find meaning in paradoxical and limiting situations), spiritual sensitivity components and subjective quality of life (a generalized attitude to one’s own life mode, in the four existential dimensions: psychophysical, psycho-social, subjective, and metaphysical). Study subjects were older adults (60+, n = 522) living in the current, dynamic, uncertain and fluid modern world conditions. The study had two phases – quantitative and qualitative (narrative interviews). To measure the phenomena, the Spiritual Sensitivity Inventory (Straś-Romanowska, Kowal, & Kapała, 2013) and the Quality of Life Questionnaire (Straś-Romanowska, Oleszkowicz, & Frąckowiak, 2004) were used. The results obtained confirmed a strong mutual relationship between spiritual resources and quality of life, also providing an answer to some questions about the nature of spiritual sensitivity, and its integrating, pro-development and pro-health role in the elderly adults’ life in the post-modern era.

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