Abstract
Subjective quality of life (QOL) has often been assessed through questionnaires or structured interviews focusing on the person's satisfaction with various life domains. In particular, most QOL instruments for psychiatric patients are based on this concept. We report on a study casting some doubts on the rationale of this approach. We investigated the QOL of 48 chronic schizophrenic outpatients with a long-term disease history (at least 20 years) using a German version of the Lancashire QOL Profile. The interrelations between general life satisfaction, satisfaction with specific life domains, psychological well-being and psychopathology were studied using correlation analysis and multiple linear regression. Of the life domains assessed, only two, namely social relations and health, contributed significantly to the patients' general life satisfaction, while the others (including work, leisure, family relations and housing) did not. The subscales on psychological well-being (self-esteem, affective state) as well as psychopathology were found to be more closely associated with general life satisfaction than almost all life domains considered. The findings are discussed with regard to the specific situation of the group of patients investigated. They give indications that the life domain approach to measuring QOL has its limitations, in particular when applied to patients having adapted to a very restricted everyday life.
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References
Fabian ES. Quality of life: a review of theory and practice implications for individuals with long-term mental illness. Rehabilitation Psychology 1990; 35: 161-170.
Revicki DA, Murray M. Assessing health-related quality of life outcomes of drug treatments for psychiatric disorders. CNS Drugs 1994; 1: 465-476.
Oliver J, Huxley P, Bridges K, Mohamad H. Quality of Life and Mental Health Services. London, UK: Routledge, 1996.
Becker M. Quality of life instruments for severe chronic mental illness. Pharmacoeconomics 1995; 7: 229-237.
Lehman AF, Burns BJ. Severe mental illness in the community. In: Spilker B, ed. Quality of Life and Pharmacoeconomics in Clinical Trials. Philadelphia, PA (USA): Lippincott-Raven, 1996: 919-924.
Lehman AF, Ward NC, Linn LS. Chronic mental patients: the quality of life issue.AmJ Psychiatr 1982; 139: 1271-1276.
Lehman AF. Aquality of life interview for the chronically mentally ill. Evaluation Program Planning 1988; 11: 51-62.
Oliver JPJ. The social care directive: development of a quality of life profile for use in community services for the mentally ill. Soc Work Soc Sci Rev 1991; 3: 5-45.
Becker M, Diamond R, Sainfort F. A new patient focused index for measuring quality of life in persons with severe and persistentmental illness.Qual Life Res 1993; 2: 239-251.
Baker F, Intagliata J. Quality of life in the evaluation of community support systems. Evaluation Program Planning 1982; 5: 69-79.
Cantril H. The Pattern of Human Concerns. New Brunswick, New York (USA): Rutgers University Press, 1965.
Campbell A, Converse PE, Rodgers WL. The Quality of American Life.New York, NY (USA): Russell Sage Foundation, 1976.
Andrews FM, Withey SB. Social Indicators of Well-being. New York, NY (USA): Plenum Press, 1976.
Lehman AF. Convergent validation of quality of life assessments for persons with severe mental illnesses. Qual Life Res 1993; 2: 327-333.
Hinterhuber H, Schwitzer J, Kemmler G, Neudorfer C, Holzner B, Schifferle I, Meise U. Long-term course and quality of life of schizophrenic patients: a prospective study. Neurol Psychia Brain Res 1995; 3: 201-210.
Kay SR, Fiszbein LA, Opler A. The Positive and Negative Symptoms Scale (PANSS) for schizophrenia. Schiz Bull 1987; 13: 261-276.
Priebe S, Gruyters T, Heinze M, Hoffmann C, Jäkel A. Subjektive Evaluationskriterien in der psychiatrischen Versorgung - Erhebungsmethoden für Forschung und Praxis. Psychiatrische Praxis 1995; 22: 140-144.
Kaiser W, Priebe S, Hoffmann K, Isermann M. Subjektive Lebensqualität bei Patienten mit chronischer Schizophrenie. Nervenarzt 1996; 67: 572-582.
Rosenberg M. Society and the Adolescent Self-image. Princeton, NJ (USA): Princeton University Press, 1965.
Bradburn N. The Structure of Psychological Well-being. Chicago, IL (USA): Aldine Publishing Co., 1969.
Steel RG, Torrie JH. Principles and Procedures of Statistics, Second Edition. London, UK: Mc Graw Hill, 1981: 280-282.
Dillon WR, Goldstein M. Multivariate analysis. Methods and Applications. New York, NY (USA): Wiley, 1984: 271-280.
Lehman AF. The well-being of chronic mental patients— assessing their quality of life. Arch Gen Psychiatry 1983; 40: 369-373.
Ciompi L, Müller C. Lebensweg und Alter der Schizophrenen. Eine katamnestische Langzeitstudie bis ins Senium.Berlin, Heidelberg, Germany: Springer, 1976.
Maslow AH. Motivation and Personality. New York, NY (USA): Harper and Row, 1954.
Bigelow DA, 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, Tash WR, eds. Innovative Approaches toMentalHealth Evaluation. New York, NY (USA): Academic Press, 1982; 345-366.
Kilian R. Ist Lebensqualität meßbar? Probleme der quantitativen und Möglichkeiten der qualitativen Erfassung von Lebensqualität in der Psychiatrie. Psychiatrische Praxis 1995; 22: 97-101.
Angermeyer MC, Kilian R. Theoretical models of quality of life for mental disorders. In: Katschnig H, Freeman H, Sartorius N, eds. Quality of Life In Mental Disorders. Chichester, UK: Wiley (in print).
Krause NM, Jay GM. What do global self-rated health items measure? Med Care 1994; 32: 930-942.
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Kemmler, G., Holzner, B., Neudorfer, C. et al. General life satisfaction and domain-specific quality of life in chronic schizophrenic patients. Qual Life Res 6, 265–273 (1997). https://doi.org/10.1023/A:1026466906643
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DOI: https://doi.org/10.1023/A:1026466906643