Dewa Ayu putu Ratna Juwita, Cokorda Bagus Jaya Lesmana, I Made Ady Wirawan


There has been emphasis on de-institutionalization of psychiatric care with a focus on collaborative care model (CCM) as a bedrock improving quality of life. This study measures the association of CCM and quality of life in schizophrenia. Schizophrenia receiving CCM and usual care (UC), each group was 41 and chosen by systematic random sampling follow this cohort retrospective study in Denpasar and Badung, Bali Province on April-November 2020. The outcomes are QoL (assessed by WHOQOL-BREF), socio-demographic, clinical characteristic, family support using Friedman questionnaire, stressor using PSS, coping using BRIEF-COPE, and medical adherence using MARS. Data was analyzed using alpha 5%. The mean age was 40.43 years. Except for marital status (p=<0.000), the two groups did not differ significantly in term of other socio-demographic. There was difference in all domain of QoL except for physical health (p=0.219) in which CCM have quality of life 1.557 times than usual care (RR=1.577;95%CI 1.250-1.990, p=0.001). There was difference of QoL in both group (p<0.000) especially on social well-being (p<0.000), environmental well-being (p<0.000) and psychological health (p=0.026), relapse episode (0.049), medical adherence (p0.000) and family support (p0.026) especially informational support (p0.007) and appraisal support (p0.003). The component of CCM associated with good QoL were no relapse episode within a year (RR=1.264; 95%CI 0.960-1.663,p=0.046), informational support (RR=1.722; 95%CI 0.920-3.223,p=0.016), and appraisal support (RR=1.813;95%CI 1.134-2.896,p<0.001). CCM is associated with a good QOL in schizophrenia, especially in psychological health and social/environmental well-being. Schizophrenia could be well managed comprehensively at community psychiatric center as CCM.

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Keywords: collaborative care model; usual care;, quality of life, schizophrenia

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