Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study

BMC Psychiatry

Research Article

Graça Cardoso¹  José Miguel Caldas-de-Almeida¹  Gina Tomé¹  Michael King²  Helen Killaspy²  Ana Papoila³ 

[1] Chronic Diseases Research Center (CEDOC), NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056, Lisboa, Portugal;Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road,, W1T 7NF, London, UK;NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 130, 1169-056, Lisboa, Portugal;

关键词: Long-term;    Mental illness;    Quality of care;    Residential units;   

DOI  :  10.1186/s12888-016-0743-7

 received in 2015-08-04, accepted in 2016-02-12,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundAs in most European countries, mental health care has shifted from large hospitals to smaller community based settings in Portugal. Our study objectives were to determine: a) the characteristics of users of mental health residential facilities in Portugal; b) the quality of care provided comparing community and hospital units; and c) to investigate associations between quality of care, service and service users’ characteristics and experiences of care.MethodsAll longer term mental health units in Portugal providing on-site staffed support for at least 12 h per day were assessed with the Quality Indicator for Rehabilitative Care (QuIRC), a standardised tool completed by the unit manager. The QuIRC rates seven domains of care (Living Environment, Therapeutic Environment, Treatments and Interventions, Self/Management and Autonomy, Recovery Based Practice, Social Inclusion, and Human Rights). A random sample of service users were interviewed using standardised measures of autonomy, experiences of care and quality of life.ResultsMost (60 %) of the 42 units were in Lisbon and surrounding districts with 50 % based in the community and 50 % in hospital settings. They had a mean of 11.5 beds. Service users (n = 278) were mainly men (66.2 %), with a diagnosis of schizophrenia (72.7 %), and a mean age of 49.4 years. Community units scored higher than hospital units on the Living Environment, Treatments and Interventions, and Self-Management and Autonomy domains of the QuIRC. Increased service user age was negatively associated with all but one domain. All QuIRC domains were positively associated with service users’ autonomy and experiences of care.ConclusionsInvesting in better quality, community based mental health facilities is associated with better outcomes for service users who require longer term support.

【 授权许可】

CC BY   
© Cardoso et al. 2016