Empirical evidence for using subjective quality of life as an outcome variable in clinical studies

Vatne, Solfrid; Bjørkly, Stål

doi:10.1016/j.cpr.2008.01.001

Cited by 33 publications

(15 citation statements)

References 82 publications

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“…A lack of or only a small association of sex and age on QoL in mentally ill populations has been found in our study as well as in several other studies and meta-analyses [ 82 , 83 ]. However, a Dutch study on QoL in psychiatric ambulatory care patients reported a higher QoL in women in the social relationships domain [ 67 ] and a decreasing QoL with increasing age in the social relationship and the physical health domains [ 84 ].…”

Section: Discussionsupporting

confidence: 56%

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

et al. 2020

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Purpose This study (a) assessed quality of life (QoL) in a patient sample with severe mental illness in an integrated psychiatric care (IC) programme in selected regions in Germany, (b) compared QoL among diagnostic groups and (c) identified socio-demographic, psychiatric anamnestic and clinical characteristics associated with QoL. Methods This cross-sectional study included severely mentally ill outpatients with substantial impairments in social functioning. Separate dimensions of QoL were assessed with the World Health Organisation’s generic 26-item quality of life (WHOQOL-BREF) instrument. Descriptive analyses and analyses of variance (ANOVAs) were conducted for the overall sample as well as for diagnostic group. Results A total of 953 patients fully completed the WHOQOL-BREF questionnaire. QoL in this sample was lower than in the general population (mean 34.1; 95% confidence interval (CI) 32.8 to 35.5), with the lowest QoL in unipolar depression patients (mean 30.5; 95% CI 28.9 to 32.2) and the highest in dementia patients (mean 53.0; 95% CI 47.5 to 58.5). Main psychiatric diagnosis, living situation (alone, partner/relatives, assisted), number of disease episodes, source of income, age and clinical global impression (CGI) scores were identified as potential predictors of QoL, but explained only a small part of the variation. Conclusion Aspects of health care that increase QoL despite the presence of a mental disorder are essential for severely mentally ill patients, as complete freedom from the disorder cannot be expected. QoL as a patient-centred outcome should be used as only one component among the recovery measures evaluating treatment outcomes in mental health care. Electronic supplementary material The online version of this article (10.1007/s11136-020-02470-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 56%

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

et al. 2020

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“…The intention of such a broad perspective is to evaluate a variety of life experiences that can affect the mental health service user’s sense of well-being—areas that, in Lehman’s words, may relate to the need for, and be affected by, the delivery of mental health services [2]. This is a response to deinstitutionalisation of people with mental illness, and the growing need for empirical evidence of QoL among mental health patients living in the community [3]. A subjective QoL approach emphasises the patients’ perspectives and their constant interaction with the environment, and differs from health-related QoL which focuses mainly on health state (physical and psychological) and the consequence of this state for the patient [4].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with mental illness frequently report poorer QoL than the general population [5], and patients in a hospital setting report poorer QoL than patients in community care settings [4]. Differences in subjective QoL between patients with severe mental illnesses (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) and non-severe mental diagnoses (such as depression and anxiety disorders)—referred to as SMI and non-SMI, are inconsistent [3]. Several studies show significantly better QoL among patients with SMI diagnoses than among those with non-SMI diagnoses [6–9].…”

Section: Introductionmentioning

confidence: 99%

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Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses

et al. 2018

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Purpose Our study investigated quality of life (QoL) in patients with severe or non-severe mental illness diagnoses (SMI and non-SMI) and the association between QoL and service satisfaction measured as patients’ perception of continuity of care (CoC), therapeutic relationship, and unmet service needs. Methods We conducted a national cross-sectional survey among 3836 mental health outpatients, of whom 1327 (34.6%) responded. We assessed QoL with the Manchester Short Assessment of Quality of Life (MANSA), CoC with the CONTINUUM, the therapeutic relationship with the Therapeutic Relationship in Community Mental Health Care (STAR-P) and developed a simple scale to measure unmet service needs. Results Outpatients with SMI ( n = 155) reported significantly better QoL than those with non-SMI ( n = 835) ( p = 0.003). In both groups, QoL was positively associated with cohabitation ( p = 0.007 for non-SMI and p = 0.022 for SMI), good contact with family and friends ( p < 0.001 for both) and positive ratings of CoC ( p < 0.001 for non-SMI and p = 0.008 for SMI). A positive association between QoL and therapeutic relationship ( p = 0.001) and a negative association between QoL and unmet needs for treatment ( p = 0.009) and activity ( p = 0.005) was only found in the non-SMI group. Conclusion Our study highlights the important differences between those with SMI and those with non-SMI in their reported QoL and in the relationship between QoL and service satisfaction, with only non-SMI patients’ QoL influenced by the therapeutic relationship and unmet needs for treatment and activity. It also shows the importance of continuity of care and social factors for good QoL for both groups.

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“…The exclusive focus on symptom reduction risks ignoring other potentially important clinical outcomes, such as functional impairment (Dobson & Beshai, 2013), despite the fact that functional concerns are a leading reason for individuals to seek treatment (Hunt & McKenna, 1993). Although symptom reduction and improvements in functioning are significantly correlated, there can be a mismatch after treatment (see Vatne & Bjorkly, 2008, for review). Thus, it is possible that a treatment is highly effective at reducing specific target symptoms, and yet the patient fails to achieve desired clinical outcomes such as improved social or occupational functioning.…”

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confidence: 99%

Empirically Supported Treatment: Recommendations for a New Model

Tolin

McKay

Forman

et al. 2015

Clin Psychol Sci Pract

136

229

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Over the 20 years since the criteria for empirically supported treatments (ESTs) were published, standards for synthesizing evidence have evolved and more systematic approaches to reviewing the findings from intervention trials have emerged. Currently, the APA is planning the development of treatment guidelines, a process that will likely take many years. As an intermediate step, we recommend a revised set of criteria for ESTs that will utilize existing systematic reviews of all of the available literature, and recommendations that address the methodological quality, outcomes, populations, and treatment settings included in the literature.

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Empirical evidence for using subjective quality of life as an outcome variable in clinical studies

Cited by 33 publications

References 82 publications

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

Quality of life in patients with severe mental illness: a cross-sectional survey in an integrated outpatient health care model

Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses

Empirically Supported Treatment: Recommendations for a New Model

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