| Background and objectives. There have been no systematic studies of the impact of de-institutionalization on psychiatric patients' quality of life (QOL) in Chinese culture. The objectives of this study were: (1) To explore the effects of living in community residences on QOL of Chinese chronic schizophrenic patients in Hong Kong; (2) To identify factors predicting subjective well-being of Chinese chronic schizophrenic patients, particularly during their resettlement in community-based residences.;Methods. The study consisted of two phases. Phase I compared the QOL of well-matched groups of patients living in hospitals (N = 67) and two community residences [Long stay care home (LSCH) (N = 69) and halfway house (HWH) (N = 68)], and attempted to identify the factors predicting subjective well-being. Phase II aimed to follow-up 25 hospitalized patients discharged to HWH. Multiple measures were used to assess QOL.;Results. In Phase I, significant differences in objective QOL indices were found between subjects staying in hospital and those in community-based residences. However, no significant differences were observed in subjective well-being. Residents in LSCH had significantly higher life satisfaction scores compared to HWH residents. Predictors of subjective well-being were educational level, negative life events and certain psychiatric symptoms. The impact of negative life events on subjective well-being decreased over time indicating that subjective well-being could adapt to changing living circumstances.;In Phase II, significant improvement in objective QOL indices was found after the subjects' discharge to HWH over a 12-month-follow-up. However, a significant decrease in the satisfaction with "environment" domain was detected. The decrease might be related to the influence of Chinese values and the stress of living in the community. Moreover, the qualitative analysis suggested that a number of factors interacted with each other to contribute to the fluctuation in subjective well-being after the subjects' discharge to HWH.;Conclusions. Both Phase I and II showed that community residential services positively influenced objective QOL indices, but not subjective well-being. Factors predicting subjective well-being were negative life events, certain psychiatric symptoms and socio-demographic characteristics of patients. Moreover, the qualitative analysis suggested a number of interacting factors contributing to the fluctuation in subjective well-being in patients during their resettlement in HWH. |
