Community based service and its effect on the quality of life of chronic psychiatric patients
Holt, Ruth N.
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This study explored the effectiveness of community based services to chronic psychiatric patients in improving their quality of life. The exploration aimed at shedding light on the nature and extent of such quality of life improvements, and on which of the services such improvements depend. Certain general expectations guided this Study: (a) that community based therapeutic services offered in typical day treatment programs do have a positive effect on their patients' quality of life; (b) that the patients' own reports on the utility of the services and on their quality of life provide valid data. There was limited prior research supporting either of these expectations. Therefore this Study dealt with validity as well as effectiveness issues. The Study limited itself to a single community based service system which is part of a community hospital. The day treatment services offered were found to conform to widely accepted norms. Therefore the results of the Study were generalizable to some degree. Quality of life data were collected from patients, before and after treatment, using a quality-of-life questionnaire which has a published record of previous use. Two other types of data were collected: service utility evaluations by patients, and patient improvement evaluations by their therapists. This was accomplished with questionnaires designed as part of this Study. It was found that before to after treatment changes in patients' quality of life reports were significantly correlated with their evaluations of service utilities, giving support to the validity of both types of data. The exploration also provided evidence for the existence of specific sources of error --such as the patients' tendency towards emotional fluctuations due to their pathology. Validity of the therapists' evaluations of patient improve-ment was not supported. Comparisons with a control group combined with the previously mentioned cor-relations provided exploratory evidence for the effectiveness of the day treatment program. The areas of the patients' lives most affected were family and social relations. All aspects of the program seemed to combine in producing improvement.
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