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

BACKGROUND: As 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...

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Autores principales: Cardoso, Graça, Papoila, Ana, Tomé, Gina, Killaspy, Helen, King, Michael, Caldas-de-Almeida, José Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761132/
https://www.ncbi.nlm.nih.gov/pubmed/26897745
http://dx.doi.org/10.1186/s12888-016-0743-7
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author Cardoso, Graça
Papoila, Ana
Tomé, Gina
Killaspy, Helen
King, Michael
Caldas-de-Almeida, José Miguel
author_facet Cardoso, Graça
Papoila, Ana
Tomé, Gina
Killaspy, Helen
King, Michael
Caldas-de-Almeida, José Miguel
author_sort Cardoso, Graça
collection PubMed
description BACKGROUND: As 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. METHODS: All 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. RESULTS: Most (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. CONCLUSIONS: Investing in better quality, community based mental health facilities is associated with better outcomes for service users who require longer term support.
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spelling pubmed-47611322016-02-21 Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study Cardoso, Graça Papoila, Ana Tomé, Gina Killaspy, Helen King, Michael Caldas-de-Almeida, José Miguel BMC Psychiatry Research Article BACKGROUND: As 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. METHODS: All 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. RESULTS: Most (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. CONCLUSIONS: Investing in better quality, community based mental health facilities is associated with better outcomes for service users who require longer term support. BioMed Central 2016-02-20 /pmc/articles/PMC4761132/ /pubmed/26897745 http://dx.doi.org/10.1186/s12888-016-0743-7 Text en © Cardoso et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Cardoso, Graça
Papoila, Ana
Tomé, Gina
Killaspy, Helen
King, Michael
Caldas-de-Almeida, José Miguel
Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title_full Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title_fullStr Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title_full_unstemmed Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title_short Living conditions and quality of care in residential units for people with long-term mental illness in Portugal – a cross-sectional study
title_sort living conditions and quality of care in residential units for people with long-term mental illness in portugal – a cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761132/
https://www.ncbi.nlm.nih.gov/pubmed/26897745
http://dx.doi.org/10.1186/s12888-016-0743-7
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