The Quality Of Life And Its Correlation With Loneliness And Level Of Hope Among Long-term Hospitalized Schizophrenic Patients

Objective:The aims of the study were to investigate the current situation of quality of life among long-term hospitalization schizophrenia patients,and to explore the relationship between quality of life and level of loneliness and hope,so as to provide theoretical basis for finding intervention methods to improve patients’ quality of life from the perspective of positive psychology.Method:A total of 251 long-term hospitalized schizophrenic patients who met the inclusion criteria in a tertiary A mental health center of Shandong province were selected by convenient sampling method.Patients with schizophrenia were investigated by general data questionnaire,Quality of Life Scale for schizophrenics（SQLS）,Emotion-Social Loneliness Scale（ESLS）and Herth Hope Scale（HHI）.SPSS22.0 software was used for descriptive statistical analysis,one-way ANOVA,independent sample t test,Pearson correlation analysis and stratified regression analysis,etc.PROCESS plug-in was used for mediating effect analysis.Results:1.The socio-demographic and clinical dataThe age of 251 schizophrenic patients ranged from 18 to 69 years,with an average age of（42.92±12.25）years.Among them,167 patients（66.5%）were male;145 cases（57.8%）were urban patients;204 cases（81.3%）were unemployed before the disease;171 cases（68.1%）had normal family economic status.The total course of disease is between 0.5 and 46 years,with an average of（15.37±10.20）years.Among them,105 patients（41.8%）were diagnosed as paranoid schizophrenia,42 patients（16.7%）had a family history,and 113 patients（45.0%）were hospitalized for 1 to 5 years.2.Comparison of SQLS scores and its differences in socio-demographic and clinical data of long-term hospitalized schizophrenic patientsThe SQLS scores of 251 patients with schizophrenia ranged from 2 to 76,with an average of（32.96±16.33）,with the highest score in dynamic energy dimension（41.93±15.55）,followed by psychosocial dimension（32.89±20.03）,and the lowest score in symptom and side effect dimension（25.24 ± 19.15）.The results of independent sample t test and one-way AN OVA showed that there were significant differences in the total SQLS scores of schizophrenic patients in terms of family location,education level,occupation,family economy,total course of disease and length of hospitalization.Among them,the SQLS scores of patients from rural areas,with lower education level,unemployment before illness,poor family economy,longer total course of disease and longer hospital stay were higher,and the quality of life of patients was worse.3.Analysis of correlation between loneliness,hope level and SQLS score in patients with schizophreniaThe scores of loneliness and hope level of 251 patients with schizophrenia were 100.44（41.90±15.52）and 12.48（25.31 ±19.19）,respectively.Pearson correlation analysis showed that the total score and each dimension score of SQLS in long-term hospitalized schizophrenic patients were positively correlated with the score of loneliness（r=0.220～0.518,P<0.01）,and negatively correlated with the score of hope level（r=-0.477～-0.632,P<0.01）.The score of loneliness was negatively correlated with the score of hope level in long-term hospitalized schizophrenic patients（r=-0.563,P<0.01）.4.Stratified regression analysis of factors related to SQLS score in patients with schizophreniaTaking the total score of patients’ SQLS and the scores of three sub-dimensions as dependent variables,demographic and clinical variables with statistical differences in univariate analysis were included in the first layer of the regression equation as control variables,loneliness and hope level as independent variables were included in the second layer of the regression equation,respectively.The results show that loneliness can positively predict the total score of SQLS and the scores of the three sub-dimensions（β=0.401,0.404,0.499,0.501,all P<0.05）.The hope level could negatively predict the total score of SQLS and the scores of three sub-dimensions（β=-0.554,-0.495,-0.594,-0.610,all P<0.001）.5.Analysis of the mediating effect of hope level on the relationship between loneliness and SQLS score in patients with schizophreniaIn order to further explore the mediating effect of patients’ hope level on the relationship between loneliness and quality of life,the total score of SQLS and the scores of three sub-dimensions were taken as dependent variables,loneliness as independent variables and hope level as mediating variables.The demographic and clinical related variables with statistical differences in univariate analysis were taken as control variables,and the process plug-in was used for mediating effect analysis.Bootstrap operation results show that the intermediary effect value of hope level between loneliness and total SQLS score is 0.241,95%confidence interval is（0.166,0.331）,the intermediary effect value between loneliness and psychosocial dimension is 0.196,95%confidence interval is（0.118,0.287）,and the intermediary effect value between loneliness and dynamic energy dimension is 0.227,95%confidence interval is（0.158,0.304）,the mediating effect between loneliness and symptom side effects was 0.213,and 95%confidence interval was（0.139,0.302）.The above 95%confidence intervals were not across zero,indicating the mediating effect of hope level.Conclusion:1.The QoL of schizophrenic patients who come from rural areas,with lower education level,unemployed before the illness,poor family economy,longer total course of disease and longer hospital stay deserve more attention.2.The QoL of long-term hospitalized patients with schizophrenia was negatively correlated with loneliness and positively correlated with the level of hope.3.The hope level had mediating effect between loneliness and QoL in long-term hospitalized schizophrenic patients.