| Summary: | 碩士 === 國立高雄醫學大學 === 公共衛生學研究所碩士在職專班 === 90 === The purpose of this study is to investigate the quality of life and family burden of the community-based service and hospital-based service for people with schizophrenia. Under the growing stress of fiscal problem of health insurance commpany in Taiwan that the longitudinal medical outcome study in mental health service, especially in the field of community support program versus to the standard, traditional service which is hospital-center program, is a crucial issue for the reform in mental health policy. Of the 52 schizophrenic patients studied, 27 were randomized as community-based ones and 25 were hospital-based treatment models.
The study duration was one year from Jan. 2001 to Dec. 2001 in the department of psychiatry of Koahsiung military general hospital where it has beening running an integrated delivery system of mental illness. Under the agreement of client and family caregiver after detailing informed consent that each cases were measured by three different stages with the Quality of Life by WHOQOL-BREF of Taiwan-version and the mental-ill QOL Rating Scale, Brief Psychiatric Rating Scale, Mental Status Examination, out-patient service, burden of relatives by Chinese Health Questionnaire, satisfaction of family and client, rate of lost to follow up, job or work condition, social function. The comparison of quality of life and family burden between the two group has been performed with the statistical method of descriptive analysis, data explore, independent-samples t test, and repeated measures ANOVA by using SPSS for Windows release 10.0 and GEE-I.
There were not any significant differences in the results of quality of life, family burden of Chinese Health Questionaire, and Brief Psychiatric Rating Scale between the two groups under control of the factors of sex, age, duration, FIQ, handicap level. The predicted factors of discharged setting are “duration and FIQ”, patient who has the higher FIQ predict the commninity setting, the longer duration predict the hospital setting.
In this study, there were no decreases of quality of life in hospital-based group and no increase of family burden in community-based group. The clinical implication shows that community-based care is more effective for schizophrenic patient under the finacial stress of National Health Insurance.
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