medigraphic.com
ISSN 0185-3325 (Print)
Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2002, Number 4

<< Back Next >>

Salud Mental 2002; 25 (4)

Autodeterminación y calidad de vida en salud mental: dos conceptos emergentes

Verdugo MA, Martín M

Language: Spanish
References: 93
Page: 68-77
PDF size: 380.86 Kb.


ABSTRACT

Self-determination and quality of life are two concepts that in recent years have been submitted to numerous studies in order to find relationships between them with the aim of improving the quality of life of mental illnesses patients and their families. Starting with the psychiatric reform, people began to see from the patients’ perspective the necessity to improve their quality of life by increasing their participation in mental health services and in the decisions and planning of the treatment.
The evaluation of patients’ satisfaction with the services provided by social programs shows the necessity to improve their autonomy. To achieve this objective, their opinions, desires, and necessities were kept in mind as well as promoting their integration into the community. The patients’ perception about their quality of life and their own reality is a factor that is already a part of many psychosocial rehabilitation programs designed in recent years.
The models of quality of life, where more importance has been given to the concept of self-determination, have been the ones focusing on the community, together with the framework proposed by Schalock and validated by the literature published in the 1985-1999 period. These multidimensional models consider that the patients’ subjective perception should be kept in mind in designing the different interventions or rehabilitation programs under way.
The concept of self-determination was initially used in the evaluation of programs as a principle to guarantee well-being and quality of life. Beginning with the psychiatric reform, it was used first as an indicator in community models, and is currently applied as an important dimension inside the programs of psychosocial rehabilitation. Due to the paradigm change, the attention in mental health was focused on the users and family rather than on the professionals. This change was reflected in the use of longitudinal, quantitative and qualitative evaluation designs.
The objective of this article is to analyze the impact of the concepts of quality of life and self-determination in mental health. To do this, we focus on the existing research on quality of life and self-determination during the 1985-1999 period, showing when, why, and how both concepts began to be used. Next, we analyze their use in professional practices and their influence in the paradigm change. To conclude, we propose several future directions and performance rules, directed at people interested in improving the quality of life and selfdetermination in mental health.


REFERENCES

  1. ANGERMEYER MC, KILIAN R: Theoretical models of quality of life for mental disorders. En: Katschning H, Freeman H, Sartorius N (eds.). Quality of Life in Mental Disorders. John Wiley and Sons, pp.19-30, Chichester, 1997.

  2. ANTHONY WA, FARKAS M: A client-outcome planning model for assessing psychiatric rehabilitation interventions. Schizophrenia Bulletin, 8:13-38, 1982.

  3. ATKINSON JM, COIA DA, HARPER-GILMOUR W, HARPER JP: The impact of education groups for people with schizophrenia on social functioning and quality of life. Brit J Psychi, 168:199-204, 1996.

  4. ATKINSON MJ, CALDWELL L: The differential effects of mood on patients’ ratings of life quality and satisfaction with their care. J Affect Disorders, 44:169- 175, 1997.

  5. ATKINSON MJ, ZIBIN S, CHUANG H: Characterizing Quality of Life Among Patients With Chronic Mental Illness: A Critical Examination of the Self Report Methodology. American J Psychiatry, 154(1):99-105, 1997.

  6. BAKER F, INTAGLIATA J: Quality of life in the evaluation of community support systems. Evaluation Program Planning, 5:69-79, 1982.

  7. BARCIA D, AYUSO JL, HERRAIZ ML, FERNANDEZ A: Quality of life of patients treated with risperidone. An Psiquiatria, 12:134-141, 1996.

  8. BECKER M, DIAMOND R, SAINFORT F: A new patient focused index for measuring quality of life in persons with severe and persistent mental illness. Quality Life Research, 2:239-251, 1993.

  9. BECKER M, DIAMOND R: New developments in quality of life measurement in schizophrenia. En: Katschning H, Freeman H, Sartorius N (eds.). Quality of Life in Mental Disorders. John Wiley and Sons, pp. 119-133, Chichester, 1997.

  10. BENGTSSON-TOPS A, HANSSON L: Subjective quality of life in schizophrenic patients living in the community. Relationship to clinical and social caracteristics. European Psychiatry, 14: 256- 263, 1999.

  11. BIGELOW DA, BRODSKY G, STEWART L, OLSON M: The concept and measurement of quality of life as a dependent variable in evaluation of mental health services. Innovative Approaches to Mental Health Evaluation. Academic Press, pp. 349-351, Nueva York, 1982.

  12. BLACK DW, BELSARE G, SCHLOSSER S: Clinical features, psychiatric comorbidity, and health-related quality of life in persons reporting compulsive computer use behavior. J Clinical Psychiatry, 60(12):839-844, 1999.

  13. BOBES J, GONZALEZ, MP, BOUSOÑO, M, SAIZ PA: Calidad de Vida y Salud Mental. Aula Médica, Madrid, 1997.

  14. BOEKAERTS M, RÖDER I: Stress, coping, and adjustment in children with a chronic disease: a review of the literature. Disability Rehabilitation, 21(7):311- 337, 1999.

  15. BURT MR, DUKE AE, HARGREAVES WA: The Program Environment Scale: Assessing client perceptions of community-based programs for the severely mentally ill. American J Community Psychology, 26(6):853-879, 1998.

  16. CASS AR, VOLK RJ, NEASE DE: Health-related quality of life in primary care patients with recognized and unrecognized mood and anxiety disorders. International J Psychiatry Medicine, 29(3):293-309, 1999.

  17. CLARK R, TEAGE G: Cost-effectiveness of assertive community treatment versus standard case management for persons with co-ocurring severe mental illness and substance use disorders. Health Services Research, 33(5): 1285-1307, 1998.

  18. CHANDLER D, SPICER G, WAGNER M, HARGREAVES W: Cost-effectiveness of a capitated assertive community treatment program. Psychiatric Rehabilitation J, 22(4):327-336, 1999.

  19. DENNIS ML, FETTERMAN DM, SECHREST L: Integrating qualitative and quantitative evaluation methods in substance abuse research. Evaluation Program Planning, 17(4):419-427, 1994.

  20. DICKENS P: Tools and techniques of human service quality 3: Involving workers and consumers: quality circles and consumer views. En: Dickens P (ed). Quality and Excellence in Human Services. John Wiley y Sons, pp. 131-146, Chichester, 1994a.

  21. DICKENS P: Quality systems in human services. En: Dickens P (ed.). Quality and Excellence in Human Services. John Wiley y Sons, pp. 147-176, Chichester, 1994b.

  22. DRAKE RE, MCHUGO GJ, CLARK RE, TEAGUE GB, XIE H, MILESi K, ACKERSON TH: Assertive community treatment for patients. American J Orthopsychiatry, 68(2):201-215, 1998.

  23. ESTROFF SE: Self, identity, and subjective experiences of schizophrenia: In search of the subject. Schizophrenia Bull, 15:189-196, 1989.

  24. FABIAN E: Supported employment and the quality of life: Does a job make a difference? Rehabilitation Counseling Bull, 36(2):84-97, 1992.

  25. FAIRWEATHER GW, SANDERS DH, MAYNARD H, CRESSLER DL: Community Life for the Mentally Ill. An Alternative to Institutional Care. Aldine Publishing, Chicago, 1969.

  26. FELTON CJ, STASTNY P, SHERN DL, BLANCK A, DONAHVE SA, KNIGHT E, BROWN C: Consumers as peer specialists on intensive case management teams: Impact on client outcomes. Psychiatric Services, 46:1037-1044, 1995.

  27. FETTERMAN DM: Steps of empowerment evaluation. Evaluation Program Planning, 17(3):305-313, 1994.

  28. FISHMAN DB: An introduction to the experimental versus the pragmatic paradigm in evaluation. Evaluation Program Planning, 14:353-363, 1991.

  29. FRISTAD MA, STEPHEN M, GAVAZZI SM, SOLDADO KW: Psychoeducation: A Promising intervention Strategy for families of Children and adolescents with mood disorders. Family Therapy, 18(3):371-383, 1996.

  30. GERBER GJ, COLEMAN GE, JOHNSTON L, LAFAVE HG: Quality of life of people with psychiatric disabilities 1 and 3 years after discharge from hospital. Quality Life Research, 3:379-383, 1994.

  31. GJAERUM B, HEYERDAHL S: Assessment of the mental state in medically ill children and adolescents. Current Opinion in Psychiatry, 11:635-641, 1998.

  32. HAGNER D, HELM DT, BUTTERWORTH JTH: Esta es tu sesión: Un estudio cualitativo de la planificación centrada en la persona. Siglo Cero, 27(6):5-15, 1996.

  33. HOFFMANN FL, LECKMAN E, RUSSO N, KNAUF L: In it for the long haul: the integration of outcomes assessment, clinical services, and management decision-making. Evaluation Program Planning, 22:211-219, 1999.

  34. HOLLOWAY F, CARSON J: Intensive case management for the severely mentally ill: Controlled trial. Brit J Psychiatry, 172:19-22, 1998.

  35. ISO A, SEPPO E, PARK CHJ: Leisure-related social support and self-determination as buffers of stressillness relationship. J Leisure Research, 28(3):169-187, 1996.

  36. JANIKOWSKI T, BORDIERI J, MUSGRAVE J: Dimensions of client satisfaction with vocational evaluation services. Vocational Evaluation Work Adjustment Bulletin, 24(2):43-48, 1991.

  37. JAREMA M, BURY L, KONIECZYNSKA Z, ZABOROWSKI B, CIKOWSKA G, KUNICKA A, BARTOSZEWICZ J, MURASZKIEWICZ L: Comparison of quality of life of schizophrenic patients in different forms of psychiatric care. Psychiatria Polska, 32:107-115, 1998.

  38. JUNG K: Effective strategies for stress management in everyday life. En: Warburton DM, Sherwood N (eds.). Pleasure and Quality of Life. John Wiley and Sons, pp. 59-66, Chichester, 1996.

  39. KAPLAN RM: Health-related quality of life in mental health services evaluation. En: Miller NE, Magruder KM (eds.). Cost effectiveness of psychotherapy: A guide for practitioners, Researchers, and Policymakers. Oxford University Press, pp. 160-173, Nueva York, 1999.

  40. KATSCHNIG H: How useful is the concept of quality of life in psychiatry? En: Katschnig H, Freeman H Sartorius N (eds.). Quality of Life in Mental Disorders. John Wiley and Sons, pp. 3-16, Chichester, 1997.

  41. KNIGHT E: Self-directed rehabilitation. Empowerment, 2:1-3, 1991.

  42. LAMB HR: Lessons learned from desinstitutionalisation in the US. Brit J Psychiatry, 162:587-592, 1993.

  43. LANG MA, DAVIDSON L, BAILEY P, LEVINE MS: Clinicians’ and clients’ perspectives on the impact of assertive community treatment. Psychiatric Services, 50(10):1331-1340, 1999.

  44. LEFF JP, O’DRISCOLL C, DAYSON D, WILLS W, ANDERSON J: The TAPS Project. 5: The structure of social-network data obtained from long-stay patients. Brit J Psychiatry, 157: 848-852, 1990.

  45. LEHMAN AF, WARD NC, LINN LS: Chronic mental patients: The quality of life issue. Am J Psychiatry, 139(10):1271-1276, 1982.

  46. LEHMAN AF: The well-being of chronic mental patients: Assessing their quality of life. Arch Gen Psychiatry, 40:369-373, 1983a.

  47. LEHMAN AF: The effects of psychiatric symptoms on quality of life assessments among the chronically mentally ill. Evaluation Program Planning, 6:143-151, 1983b.

  48. LEHMAN AF, POSSIDENTE S, HAWKER F: The quality of life of chronic patients in a state hospital and in community residences. Hosp Community Psychiatry, 37(9):901-907, 1986.

  49. LIPSEY MW, POLLARD JA: Driving toward theory in program evaluation: more models to choose from. Evaluation Program Planning, 12:317-328, 1989.

  50. MASLOW AH: Motivation and Personality. Harper and Row. Nueva York, 1954.

  51. McLENAN A: Empowerment and the psychiatric consumer ex-patient movement in the United States: Contradictions, crisis and change. Social Science Medicine, 40:1053-1071, 1995.

  52. MACNEIL RD, ANDERSON SC: Leisure and persons with developmental disabilities: Empowering selfdetermination through inclusion. En: Retish P, Reiter S (eds.). Adults With Disabilities: International Perspectives in the Community. Lawrence Erlbaum Associates, Inc., Publishers, 125-143, xiv, 353, Mahwah, 1999.

  53. MELTZER HY, BURNETT S, BASTANI B, RAMIREZ LF: Effects of six months of clozapine treatment on the quality of life of chronic schizophrenic patients. Hospital Community Psychiatry, 150:1630-1638, 1990.

  54. MERCIER C, TEMPIER R, RENAUD C: Services communautaires et qualité de la vie: une étude d´impact en région éloignée. (Community services and quality of life: An outcome study in a outlying area). Canadian J Psychiatry/Revue Canadienne Psychiatrie, 37(8):553-563, 1992.

  55. NABER D: A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. International Clinical Psychopharmacology, 10 (supl.3):133-138, 1995.

  56. NIKKEL RE, SMITH G, EDWARDS P: A consumer operated case management project. Hospital and Community Psychiatry, 43:577-579, 1992.

  57. O’DONNELL M, PARKER G, PROBERTS M, MATTHEWS R, FISHER D, JOHNSON B, HADZI PD: A study of client-focused case management and consumer advocacy: The Community and Consumer Service Project. Australian New Zealand J Psychiatry, 33(5):684-693, 1999.

  58. OLIVER J, HUXLEY P, BRIDGES K, MOHAMAD H: Quality of Life and Mental Health Services. Londres, 1996.

  59. PELLETIER LG, VALLERAND RJ, GREEN-DEMERS I, BRIERE NM: Leisure and mental health: Interactions between motivation for leisure activities and psychological well-being. Canadian J Behavioural Science, 27(2):140-156, 1995.

  60. PICKNEY AA, GERBER GJ, LAFAVE HG: Quality of life after psychiatric rehabilitation: the clients’perspective. Acta Psychiatrica Scandinavica, 83:86-91, 1991.

  61. PRILLELTENSKY I, PEIRSON L, GOULD J, NELSON G: Planning mental health services for children and youth: Part I-A value-based approach. Evaluation Program Planning, 20(2):163-172, 1997.

  62. RACINO JA, WALKER P, O’CONNOR S, TAYLOR S: Housing, support and, community. Choices and Strategies for Adults with Disabilities. Vol. 2. Paul H. Brookes, Baltimore, 1992.

  63. REVICKI DA, SIMON GE, CHAN K, KATON W, HEILIGENSTEIN J: Depression, health related quality of life, and medical cost outcomes of receiving recommended levels of antidepressant treatment. J Family Practice, 47(2):446-452, 1998.

  64. ROSENFIELD S, SHEREE NEESE-TODD: Why model programs work: factors predicting the subjective quality of life of the chronic mentally ill? Hospital Community Psychiatry, 44:76-78, 1993.

  65. ROSENFIELD S: Labeling mental illness: the effects of received services and perceived stigma on life satisfaction. Am Sociological Review, 62(4):660-672, 1997.

  66. ROSS J: Social phobia: the consumer’s perspective. J Clinical Psychiatry, 54(supl. 12):5-9, 1993.

  67. RYAN RM, DECI EL: Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Ame Psychologist, 55(1):68-78, 2000.

  68. SAINFORT F, BECKER M, DIAMOND R: Judgements of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectives. Am J Psychiatry, 153:497-502, 1996.

  69. SARTORIUS N: Quality of life and mental disorders: A global perspective. En: Katsching H, Freeman H, Sartorius N (eds.). Quality of Life in Mental Disorders. John Wiley and Sons, pp. 319- 328, Chichester, 1997.

  70. SCHALOCK RL: Outcome-based Evaluation. Plenum Publishing Corporation, Nueva York, 1995.

  71. SCHALOCK RL: (ed.): Quality of life. Vol. 1: Its Conceptualization, Measurement and Use. American Association on Mental Retardation, Washington, 1996.

  72. SCHALOCK RL: (ed.): Quality of Life. Vol. II: Application to Persons with Disabilities. American Association on Mental Retardation, Washington, 1997.

  73. SCHALOCK RL, NELSON G, SUTTON S, HOLTAN S, SHEEHAN M: Evaluación multidimensional del estado actual y la calidad de vida de los receptores de servicios de salud mental. Siglo Cero, 28(4):5-12, 1997.

  74. SCHALOCK RL, VERDUGO MA: The Concept of Quality of Life in Human Services: a Handbook for Human Service Practitioners. American Association on Mental Retardation, Washington,(2002).

  75. SHERWOOD N: Pleasure, choice and the quality of everyday life. En: Warburton DM, Sherwood N (eds). Pleasure and Quality of Life. John Wiley and Sons, pp. 275- 280, Chichester - New York - Brisbane - Toronto - Singapore, 1996a.

  76. SHERWOOD N: Stressors, product use and everyday skills. En: Warburton DM, Sherwood N (eds.). Pleasure and Quality of Life. John Wiley y Sons, pp. 89-96, Chichester, 1996b.

  77. SKANTZE K: Subjective quality of life and standard of living: a 10 year follow up of out patients with schizophrenia. Acta Psychiatrica Scandinavica, 98:390-399, 1998.

  78. SMITH MK: Empowerment evaluation: Theoretical and methodological considerations. Evaluation Program Planning, 21(3):255-261, 1998.

  79. STANARD RP: The effect of training in a strengths model of case management on client outcomes in a community mental health center. Community Mental Health J, 35(2):169-179, 1999.

  80. STANCLIFFE RJ: Proxy respondents and the reliability of the Quality of Life Questionnaire Empowerment factor. J Intellectual Disability Research, 43(3):185-193, 1999.

  81. STASTNY P, AMERING M: Integrating consumer perspectives on quality of life in research and service planning. En: Katschnig H, Freeman H, Sartorius N (eds.). Quality of Life in Mental Disorders. John Wiley and Sons, pp. 261-269, Chichester, 1997.

  82. STEIN LI, TEST MA: Alternatives to Mental Hospital Treatment. En: Stein LI, Test MA (eds.). Plenum Press, Nueva York, Londres, 1978.

  83. STEIN LI, TEST MA: Alternatives to mental hospital treatment: I. Conceptual model, treatment program, and clinical evaluation. Arch Gen Psychiatry, 37:392-397, 1980.

  84. TAYLOR RE, LEESE M, CLARKSON A, HOLLOWAY F, THORNICROFT G: Quality of life outcomes for intensive versus standard community mental health services: PRiSM Psychosis Study 9. Brit J Psychiatry, 173:416-422, 1999.

  85. THOMSON DA: New direction. Psychosocial Rehabilitation J, 15(3):105-109, 1992.

  86. VAN NIEUWENHUIZEN G, SCHENE AH: Measuring the quality of life of clients with severe mental illness: A review of instruments. Psychiatric Rehabilitation J, 20(4):33-42, 1997.

  87. VERDUGO MA: Integración social del deficiente psíquico adulto: Programas de entrenamiento prevocacional y vocacional. Siglo Cero, 107:12-17, 1986.

  88. VERDUGO MA: Programas Conductuales Alternativos: I. Habilidades Sociales. MEPSA, Madrid, 1989a.

  89. VERDUGO MA: La Integración Personal, Social, Vocacional de los Deficientes Psíquicos Adolescentes. Elaboración y Aplicación Experimental de un Programa Conductual. Ministerio de Educación y Ciencia, CIDE, Madrid, 1989b.

  90. VERDUGO MA: POT. Programa de Habilidades de Orientación al Trabajo. (Programas Conductuales Alternativos). Amarú, Salamanca, 1996.

  91. VERDUGO MA: PHS. Programa de Habilidades Sociales. (Programas Conductuales Alternativos). Amarú, Salamanca, 1997.

  92. VERDUGO MA: PVD. Programa de Habilidades de la Vida Diaria. (Programas Conductuales Alternativos). Amarú, Salamanca, 2000.

  93. VERDUGO MA, SCHALOCK RL: El concepto de calidad de vida en los servicios humanos. En: Verdugo MA, Jordán de Urries B (eds.). Apoyos, Autodeterminación y Calidad de Vida. Amarú, 105-112, Salamanca, 2001.




2020     |     www.medigraphic.com