ABSTRACT – The aim of this study was to evaluate the impact of a sailing rehabilitation program on the quality of life (QoL) in a sample of patients with severe mental disorders. The study adopted a randomized, crossover, waiting-list controlled design. The participants enrolled in the study were outpatients diagnosed with severe chronic mental disorders. The participants (N=40) exposed to rehabilitation with sailing took part in a series of supervised cruises near the gulf of Cagliari, South Sardinia, and showed a statistically significant improvement of their quality of life compared to the control group. This improvement was comparable to the improvement in psychopathologic status and social functioning as shown in a previous report of the same research project. The improvement was maintained at follow-up only during the trial and for a few months later: after 12 months, patients returned to their baseline values and their quality of life showed a worsening trend. This is the first study to show that rehabilitation with sailing may improve the quality of life of people with severe chronic mental disorders. In all likelihood, a program grounded on learning how to manage a sailing vessel – during which patients perform cruises that emphasize the exploration of the marine environment by sailing – might be interesting enough and capture the attention of the patients so as to favour greater effectiveness of standard rehabilitation protocols, but this should be specifically tested.
INTRODUCTION
The construct of the quality of life (QoL) deals with subjective well-being and includes somatic and psychological components such as emotional well-being, awareness of one’s skills and disability, possibility of satisfactory sleep and rest, energy and vitality, and general satisfaction about one’s life [1, 2]. In a person suffering from a chronic disorder, QoL is influenced by severity and duration of illness, the side effects of medication, and the stressful events that interfere with the course of the illness [3, 4]. The subjective perception of the quality of life is now considered a construct of relevance for measuring the outcome of chronic disease [5], particularly for those having a great impact on the daily life of individuals and their relatives [6]. Consequently QoL has become central to evaluate the efficacy of treatments [7].
The most severe psychiatric disorders are chronic; these include several factors that can potentially impair the quality of life. Moreover the disorder-related stigma influences subjective QoL more than in other diseases [8]. One of the most stigmatizing elements in psychiatric disorders is the feeling that not only is the subject incurable, but also that his/her disabilities are irreversible, such belief having been found deeply rooted in public opinion but also in caregivers [9]. Sport is socially accepted and doing sports is collectively seen as a symbol of physical and psychological wellbeing. This is why it could serve as a strong antidote against the stigma [10]. Physical exercise and sports activities have often been used as a tool for the rehabilitation of patients with severe psychiatric disorders [11] but never before our research project [12] were they investigated through a randomized controlled trial by means of standardized assessment tools. In a previous study we have shown how a program of learning to sail and practicing improved the clinical symptoms and social skills of a group of patients with chronic psychosis [12]. The purpose of this paper is to illustrate how this same program has also improved some components of the quality of life, a construct linked to a modern vision of recovery, in people with severe psychosis [13].
