SOME ASPECTS OF QUALITY OF LIFE OF PEOPLE WITH MENTAL DISABILITIES – PERSPECTIVE OF CASE MANAGEMENT USERS AND PEOPLE IN MENTAL HEALTH FACILITIES

Ovaj rad bazira se na dvije perspektive osoba s duševnim smetnjama i njihovoj percepciji kvalitete života, te je tako glavni cilj ovoga rada dobiti uvid u pojedina obilježja kvalitete života osoba s duševnim smetnjama iz perspektive korisnika usluge case managementa i osoba smještenih u dom za odrasle na području grada Zagreba. Zanimalo nas je njihovo viđenje zdravstvenog aspekta kvalitete života, te socijalna i okolišna domena (fokusirajući se ovdje ponajviše na socijalne usluge), kao neke od dimenzija kvalitete života. Odabran je kvalitativni istraživački pristup, a podatci su prikupljeni kroz polustrukturirane intervjue. Sudionici ovog istraživanja bili su korisnici Doma za odrasle – Zagreb. Dom pruža uslugu case managementa u domovima korisnika te smo imali četiri sudionika iz skupine korisnika usluge case managementa i četiri koji su smješteni u spomenuti dom za odrasle. Rezultati pokazuju značajne razlike u socijalnom funkcioniranju, percepciji psihičkog zdravlja kao i u okolišnoj domeni, a idu u prilog korisnicima usluge case managementa. Domena fizičkog zdravlja percipirana je povoljnijom od strane korisnika doma.This paper presents two perspectives of people with mental disabilities on their perception of quality of life. Main aim of this paper was to develop a deeper knowledge about certain aspects of quality of life of people with mental health disabilities from the perspective of case management users and people in mental health facilities in the geographical area of Zagreb. Aspects of quality of life that we were interested in were: general health (physical and mental), social and environmental aspects (focusing on social transfers mostly). For this purpose, qualitative research approach was selected and data was collected through semi-structured interviews on the total sample of 8 users. Participants of this study were persons in direct contact with mental health facility »Dom za odrasle – Zagreb«. The mentioned mental health facility is providing case management program for their users, and therefore we had four participants from a case management group and four participants that were accommodated in the mental health facility. The results showed significant differences in social functioning, perception of mental health, as well as in environmental domain on behalf of case management users. Physical health is perceived better in mental health facilities

INFLUENCE OF BIOLOGICAL THERAPEUTICS ON PATIENT-REPORTED QUALITY-OF-LIFE OUTCOMES (WHOQOL-BREF), FUNCTIONAL SCORES AND DISEASE ACTIVITY AMONG CROATIAN PATIENTS WITH RHEUMATOID ARTHRITIS: OUR EXPERIENCE

Background: Rheumatoid arthritis (RA) is a chronic and disabling disease with a great impact on the quality of life (QOL). The aim of this study was to assess QOL and health in RA patients treated with biological disease-modifying drugs (bDMARDs) as opposed to those treated with conventional synthetic DMARDs (csDMARDs). We analysed four domains of QOL: physical health (D1), mental health (D2), social relationships (D3) and one\u27s surroundings (D4); as well as general quality of life (W1), general state of health (W2), and disease activity and physical disability. Subjects and methods: Seventy-seven RA patients (group A=29 on bDMARDs, group B= 48 on csDMARDs) were enrolled in the study. QOL was evaluated using WHO questionnaire (WHOQOL-BREF), disease activity using Disease ActivityScore28C-reactive protein (DAS28CRP) and functional status using Health Assessment Questionnaire (HAQ). Results: There was no statistically significant difference of mean values in the four domains of QOL, nor in the general QOL, between groups A and B. There was also no statistically significant difference regarding RA activity (3.51 vrs 3.54, p=0.56). However, we have found that the variable of the general state of health domain was statistically significantly higher in group B (2.66 vrs 2.89, p=0.001), while HAQ was statistically significantly higher in group A (1.19 vrs 1.07, p=0.018), as well as the duration of RA (6.25vrs 3.75 years, p=0.0006). Statistically significant correlation was found between HAQ and W2, disease duration and D3 in group A and DAS28CRP and D1, D2, W2 and HAQ and D1 and D2 in group B. Conclusion: These findings suggest that the inclusion of bDMARDs in the treatment regimen was overdue, with RA already advancing with developed functional disability, which prevented the achievement of the primary goals of treatment: low disease activity or remission and the improvement of patient\u27s QOL