Abstract
The quality of life in persons with severe and persistent mental illness is often poor. Most treatment programmes have the goal of increasing quality of life. Unfortunately, existing methods to assess qualtiy of life are cumbersome and oriented towards research rather than clinical settings. This study describes preliminary steps in the development, testing and application of a new patient focused index for measuring quality of life in persons with severe mental illness. The Quality of Life Index for Mental Health (QLI-MH) differs from existing instruments in that it is based on an easy to use, self-administered questionnaire that assesses nine separate domains that together encompass quality of life. Each domain can be individually weighted depending on its relative importance to the patient. Different parts of the instrument solicit information from the patient, the primary clinician and, when available, the family. The instrument and its scoring system address limitations of previous approaches to quality of life measurement.
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Avison, WR. Speechley, KN. The discharged psychiatric patient: A review of social, social-psychological and psychiatric correlates of outcome. Am J Psychiatr 1987; 144: 10–18.
Tantam, D. Review article: Quality of life and the chronically mentally ill. Int J Social Psychiat 1988; 34: 243–247.
Revicki, DA. Health-related quality of life in the evaluation of medical therapy for chronic illness. J Family Practice 1989; 29: 377–380.
Baker, F, Intagliata, J. Quality of life in the evaluation of community support systems. Evaluation Program Planning 1982; 5: 69–79.
Lehman, AF. The effects of psychiatric symptoms on quality of life assessments among the chronic mentally ill. Evaluation and Program Planning 1983; 6: 143–151.
Najman, JM, Levine, S. Evaluating the impact of medical care and technologies on the quality of life: A review and critique. Social Sci Med 1981; 15F: 107–115.
Lehman, AF, Ward, NC, Linn, LS. Chronic mental patients: The quality of life issue. Am J Psychiatr 1982; 139: 1271–1276.
Diamond, R. Drugs and the quality of life: The patient's point of view. J Clin Psychiatr 1985; 46: 29–35.
Jaeschke, R, Guyatt, GH, Cook, D. Quality of life instruments in the evaluation of new drugs. PharmacoEconomics 1992; 2: 84–94.
Spilker, B. Introduction. In: Spilker, B, ed. Quality of Life Assessment in Clinical Trials. New York: Raven Press, 1990; 3–9.
Lehman, AF. A quality of life interview for the chronically mentally ill. Evaluation and Program Planning 1988; 11: 51–62.
Heinrichs, DW, Hanlon, TE, Carpenter, WT. The quality of life scale: An instrument for rating the schizophrenic deficit syndrome. Schizophrenia Bull 1984; 10: 388–398.
Malm, U, May, P, Dencker, SJ. Evaluation of the quality of life of the schizophrenic outpatient: A checklist. Schizophrenia Bull 1981; 7: 477–487.
Rosen, A, Hadzi-Pavlovic, D, Parker, G. The life skills profile: A measure assessing function and disability in schizophrenia. Schizophrenia Bull 1989; 15: 325–337.
Revicki, DA, Turner, R, Brown, R, Martindale, JJ. Reliability and validity of a health-related quality of life battery for evaluating outpatient antidepressant treatment. Quality Life Res 1992; 1: 257–266.
Levitt, AJ, Hogan, TP, Bocosky, CM. Quality of life in chronically mentally ill patients in day treatment. Psychol Med 1990; 20: 703–710.
Bigelow, PA, Brodsky, G, Steward, L, Olson, M. The concept and measurement of quality of life as a dependent variable in evaluation of mental health services. In: Stahler, GJ, Tarsh, WR, eds. Innovative Approaches to Mental Health Evaluation. New York: Academic Press, 1982; 345–366.
Hornquist, JO. The concept of quality of life. Scand J Social Med 1982; 10: 57–61.
Larson, R. Thirty years of research on the subjective well-being of older Americans. J Gerontol 1978; 1: 109–125.
Ferrans, CE. Quality of life: Conceptual issues. Seminars Oncol Nurs 1990; 6: 248–254.
Ferrans, CE, Powers, MJ. Psychometric assessment of the quality of life index. Res Nurs Health 1992; 15: 29–38.
Nayfield, SG, Ganz, PA, Moinpour, CM, Cella, DF, Hailey, BJ. Report from a national cancer institute (USA) workshop on quality of life assessment in cancer clinical trials. Quality Life Res 1992; 1: 203–210.
Mor, V, Guadagoli, E. Quality of life measurement: a Psychometric Tower of Babel. J Clin Epidemiol 1988; 41: 1155–1158.
Andrews, FM, Withey, SB. Social Indicators of Well-Being: America's Perception of Life Quality New York: Plenum Press, 1976.
Campbell, A, Converse, P, Rogers, W. The Quality of American Life 1976. New York: Russell Sage Foundation, 1976.
Campbell A. Subjective measures of well-being. Am Psychol 1976; (February): 117–124.
Zautra, A, Goodhart, D. Quality of life indicators: A review of the literature. Commun Mental Health Rev 1979; 4: 1–10.
Patrick, DL, Deyo, RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989; 27: S217-S231.
Ware JE. The use of health status and quality of life measures in outcomes and effectiveness research. Paper presented at the National Agenda Setting Conference on Outcomes and Effectiveness Research, Agency for Health Care Policy and Research, Alexandria, VA, April, 1991.
Ware, JE. Measuring functioning, well-being, and other generic health concepts. In: Osoba, D. ed. Effect of Cancer on Quality of Life. Boca Raton, FI: CRC Press, 1991; 7–23.
Breier, A, Strauss, JS. The role of social relationships in the recovery from psychotic disorders. Am J Psychiat 1987; 141: 947–955.
Strauss, JS, Carpenter, WT. The prediction of outcome in schizophrenia: II. Relationships between predictor and outcome variables: A report from the WHO international pilot study of schizophrenia. Arch Gen Psychiatr 1974; 31: 37–42.
Feinstein, AR. Clinimetrics. New Haven, CT; Yale University Press, 1987.
Ryff, CD. Happiness is everything, or is it? Explorations on the meaning of psychological well-being. J Personality Social Psychol 1989; 57: 1–13.
Bradburn NM. The Structure of Psychological Well Being. Chicago, IL: Aldine.
Watson, D. Intraindividual and interindividual analyses of positive and negative affect: Their relation to health complaints, perceived stress, and daily activities. J Personality Social Psychol 1988; 54: 1020–1030.
Spitzer, WO, Dobson, A, Hall, J, et al. Measuring the quality of life of cancer patients: A concise QL-index for use by physicians. J Chronic Dis 1981; 34: 585–597.
Wood-Dauphinee, S, Williams, JI. The Spitzer quality-of-life-index: Its performance as a measure. In: Osoba, D, ed. Effect of Cancer on Life. Boca Raton, FL: CRC Press, 1991; 169–184.
Rosenfield, S. Factors contributing to the subjective quality of life of the chronic mentally ill. J Health Social Behav 1992; 33: 299–315.
Link, BG. Mental patient status, work, and income: An examination of the effects of a psychiatric label. Am Sociol Rev 1983; 47: 202–215.
Dohrenwend, BP, Dohrenwend, BS. Social Status and Psychological Disorder: A Casual Inquiry. New York: John Wiley & Sons, 1969.
Overall, JE, Gorham, DR. The brief psychiatric rating scale. Psychol Rep 1962; 10: 799–812.
Overall, JE. The brief psychiatric rating scale in psychopharmacology research. Mod Prob Pharmacol 1974; 7: 67–78.
Hedlund, JL, Vieweg, BW. The brief psychiatric rating scale (BPRS): A comprehensive review. J Operational Psychiatr 1980; 11: 48–65.
Mike, V. Quality of life research and the ethics of evidence. Quality Life Res 1992; 1: 273–276.
Feinstein, AR. Benefits and obstacles for development of health status assessment measures in clinical settings. Med Care 1992; 30: MS50-MS56.
Ruehlman, LS, Wolchik, SA. Personal goals and interpersonal support and hindrance as factors in psychological distress and well-being. J Personality Social Psychol 1988; 55: 293–301.
Spitzer, RL, ed. Diagnostic and Statistical Manual of Mental Disorders. Third Edition-Revised, American Psychiatric Association, Washington, D.C. 1987.
Becker M. The Development and Use of Quality of Life Indicators in Mental Health Research and Evaluation. Paper presented at the Midwest Nursing Research Society, Chicago, IL. March, 1992.
Carmines, EG, Zeller, RA. Reliability and Validity Assessment. Newbury, CA: Sage Publications, Inc, 1979.
Ware, JE, Sherbourne, D. The MOS 36-Item Short Form Health Survey (SF-36). Med Care 1992; 30: 473–483.
Pearlin, LI, Schooler, C. The structure of coping. J Health Social Behav 1978; 19: 2–21.
Evans, R. The relationship of two measures of perceived control to depression. J Personality Assess 1981; 45: 66–70.
Hanestad, BR. Errors of measurement affecting reliability and validity of data acquired from self-assessed quality of life. Scand J Caring Sci 1990; 4: 29–34.
Moum, T. Yea-saying and mood-reported quality of life. Soc Indicators Res 1988; 20: 117–139.
VanDam, FSAM, Somers, R, VanBeek-Couzijn, AL. Quality of life: Some theoretical issues. J Clin Pharmacol 1981; 21: 166–168.
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Becker, M., Diamond, R. & Sainfort, F. A new patient focused index for measuring quality of life in persons with severe and persistent mental illness. Qual Life Res 2, 239–251 (1993). https://doi.org/10.1007/BF00434796
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DOI: https://doi.org/10.1007/BF00434796