Comparison Of QOL,Perceived Stigma And Medication Adherence Of Chinese People With Schizophrenia: A Follow-up Study

Objective This study aims to explore the difference of the quality of life, perceived stigma, and medication adherence among a Chinese population with schizophrenia prior to and one-month following discharge.Methods 128 Chinese people who are diagnosed of schizophrenia, clinically stabilized and plan to discharge by registered psychiatrist, were recruited via the purposely sample method and completed the self-report scales:the Schizophrenia Quality of Life Scale (SQLS), the Link’Stigma Scale, and the Morisky Medication Adherence Scale (MMAS-8) prior to and one-month after discharge. Data were analyzed using descriptive statistics, Pearson parametric correlations, step-wise multiple regressions and paired sample t-test.Results 146 people with schizophrenia before discharge have a comparatively better quality of life. SQLS and psychosocial domain, the dependent variables, were found significantly positive correlated with PDD (r= 0.189, P<0.05; r= 0.193, P<0.05); coping orientation of withdrawal (r= 0.197, P<0.05; r= 0.179, P<0.05); and different and ashamed stigma-related feeling (r= 0.243, P<0.01; r= 0.219, P<0.01) and misunderstood stigma-related feelings (r= 0.258, P<0.01; r= 0.284, P<0.05). SQLS and psychosocial domain found significantly negative correlated with age (r-0.192, P<0.05; r=-0.183, P<0.05), and medication adherence (r=-0.185, P<0.05; r=-0.196, P<0.05).The findings of SQLS demonstrate deterioration on psychosocial and motivation/energy domain (p<.001) accompanied by improvement of symptom/side effect (p<.05) after discharge. The scores of perceived stigma and actual stigma coping orientations after discharge were found to be significantly higher than that of before discharge (p<.001). Medication adherence was significantly poorer after discharge than before discharge (p<.001). The total score of SQLS and psychosocial subscale were found significantly positive correlated with perceived stigma (p<.05), coping orientation of withdrawal (p<.05), and different and ashamed stigma-related feeling (p<.01) and misunderstood stigma-related feelings (p<.05); and negative correlated with age and medication adherence (p<.05). The best predictors of QOL and psychosocial domain were stigma related feelings:misunderstood, difference/ashamed; and age.Conclusions The assumption that the quality of life of individuals with schizophrenia after discharge was challenged because community-based mental health services are not well-developed in China. Psychiatric professionals play a crucial role to assist the patients in establishing positive self-evaluation and effective coping strategies through variety of interventions. Strategies include provision for the psychosocial and educational rehabilitation program for individuals and family members who plan to discharge; in order to improve their coping strategies, caring capabilities and medication adherence, decrease their perceived stigma, to facilitate their QOL ultimately.