Effectiveness and patient experience of a day rehabilitation ward in China: a mixed-methods study

This study explored the objective effectiveness of treatment and the subjective experiences of patients with schizophrenia spectrum disorders (SSD) and mood disorders (MD) in a day rehabilitation ward. A mixed-methods design was employed. Patients meeting the ICD-10 criteria for SSD or MD were enrolled. Standardised scales (BPRS, HAMD, MRSS) were used to assess symptom and functional changes in 377 patients; semi-structured interviews were conducted with 27 purposively sampled patients, and the data were analyzed using content analysis. Quantitative findings showed that, after treatment, patients with SSD had significantly lower BPRS total scores (Z=-2.929, P = 0.003), including lower factor scores for hostile suspiciousness (Z=-3.225, P = 0.001) and thought disturbance (Z=-2.412, P = 0.016). The MRSS total score (Z=-2.031, P = 0.042) and dependency subscale score (Z=-2.045, P = 0.041) were also significantly lower. For patients with MD, HAMD total score (Z=-4.188, P < 0.001) and the factor scores for anxiety/somatisation (Z=-3.604, P < 0.001), cognitive disturbance (Z=-3.385, P < 0.001), retardation (Z=-4.208, P < 0.001), sleep disturbance (Z=-2.842, P = 0.004), and hopelessness (Z=-2.448, P = 0.014) were significantly reduced. MRSS total score (Z=-2.294, P = 0.022) and inactivity subscale score(Z=-2.276, P = 0.023) were likewise significantly lower. Qualitative findings indicated that patients perceived positive changes in symptoms and illness status, personal growth, interpersonal communication, life fulfillment, and social integration. Reported challenges included difficulty in keeping up with and integrating into the courses, rehabilitation plateaus, and insufficient social support. Our findings suggest that patients with both SSD and MD experienced symptomatic improvement after treatment in the day rehabilitation ward. Changes in social functioning require further investigation. In addition, patients continued to face difficulties and challenges during day treatment.