Top

Quality of Life Research

Published in:

Open Access 01-03-2019

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

Authors: Marian Ådnanes, Jorid Kalseth, Solveig Osborg Ose, Torleif Ruud, Jorun Rugkåsa, Stephen Puntis

Published in: Quality of Life Research | Issue 3/2019

Abstract

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.

Available only for authorised users

Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11.CrossRef

Lehman, A. F. (1988). A quality of life interview for the chronically mentally ill. Evaluation and Program Planning, 11(1), 51–62. https://doi.org/10.1016/0149-7189(88)90033-X.CrossRef

Vatne, S., & Bjorkly, S. (2008). Empirical evidence for using subjective quality of life as an outcome variable in clinical studies: A meta-analysis of correlates and predictors in persons with a major mental disorder living in the community. Clin Psychol Rev, 28(5), 869–889. https://doi.org/10.1016/j.cpr.2008.01.001.CrossRefPubMed

Petkari, E., & Pietschnig, J. (2015). Associations of quality of life with service satisfaction in psychotic patients: A meta-analysis. PLoS ONE, 10(8), e0135267. https://doi.org/10.1371/journal.pone.0135267.CrossRefPubMedPubMedCentral

Kaiser, W., Priebe, S., Barr, W., Hoffmann, K., Isermann, M., Roder-Wanner, U. U., et al. (1997). Profiles of subjective quality of life in schizophrenic in- and out-patient samples. Psychiatry Research, 66(2–3), 153–166.CrossRefPubMed

Catty, J., Cowan, N., Poole, Z., Clement, S., Ellis, G., Geyer, C., et al. (2013). Continuity of care for people with non-psychotic disorders. International Journal of Social Psychiatry, 59(1), 18–27. https://doi.org/10.1177/0020764011421442. doi.CrossRefPubMed

Catty, J., White, S., Clement, S., Cowan, N., Geyer, C., Harvey, K., et al. (2011). Continuity of care for people with psychotic illness: Its relationship to clinical and social functioning. International Journal of Social Psychiatry, 59(1), 5–17. https://doi.org/10.1177/0020764011421440.CrossRefPubMed

Hansson, L., Middelboe, T., Merinder, L., Bjarnason, O., Bengtsson-Tops, A., Nilsson, L., et al. (1999). Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicentre study. International Journal of Social Psychiatry, 45(4), 247–258. https://doi.org/10.1177/002076409904500403.CrossRefPubMed

Priebe, S., Reininghaus, U., McCabe, R., Burns, T., Eklund, M., Hansson, L., et al. (2010). Factors influencing subjective quality of life in patients with schizophrenia and other mental disorders: A pooled analysis. Schizophrenia Research, 121(1–3), 251–258. https://doi.org/10.1016/j.schres.2009.12.020.CrossRefPubMed

10.

Tansella, M., & Thornicroft, G. (1998). A conceptual framework for mental health services: The matrix model. Psychological Medicine, 28(3), 503–508.CrossRefPubMed

11.

Puntis, S., Rugkasa, J., Forrest, A., Mitchell, A., & Burns, T. (2015). Associations between continuity of care and patient outcomes in mental health care: A systematic review. Psychiatric Services, 66(4), 354–363. https://doi.org/10.1176/appi.ps.201400178.CrossRefPubMed

12.

Haggerty, J. L., Reid, R. J., Freeman, G. K., Starfield, B. H., Adair, C. E., & McKendry, R. (2003). Continuity of care: A multidisciplinary review. BMJ: British Medical Journal, 327(7425), 1219–1221.CrossRefPubMedPubMedCentral

13.

Sweeney, A., Rose, D., Clement, S., Jichi, F., Jones, I. R., Burns, T., et al. (2012). Understanding service user-defined continuity of care and its relationship to health and social measures: A cross-sectional study. BMC Health Services Research, 12, 145. https://doi.org/10.1186/1472-6963-12-145.CrossRefPubMedPubMedCentral

14.

McGuire-Snieckus, R., McCABE, R., Catty, J., Hansson, L., & Priebe, S. (2007). A new scale to assess the therapeutic relationship in community mental health care: STAR. Psychological Medicine, 37(01), 85–95.CrossRefPubMed

15.

Johansson, H., & Eklund, M. (2003). Patients’ opinion on what constitutes good psychiatric care. Scandinavian Journal of Caring Sciences, 17(4), 339–346.CrossRefPubMed

16.

McCabe, R., & Priebe, S. (2003). Are therapeutic relationships in psychiatry explained by patients’ symptoms? Factors influencing patient ratings. European Psychiatry, 18(5), 220–225. https://doi.org/10.1016/S0924-9338(03)00061-0.CrossRefPubMed

17.

Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438–450.CrossRefPubMed

18.

Priebe, S., Richardson, M., Cooney, M., Adedeji, O., & McCabe, R. (2011). Does the therapeutic relationship predict outcomes of psychiatric treatment in patients with psychosis? A systematic review. Psychotherapy and Psychosomatics, 80(2), 70–77.CrossRefPubMed

19.

McCabe, R., & Priebe, S. (2004). The therapeutic relationship in the treatment of severe mental illness: A review of methods and findings. International Journal of Social Psychiatry, 50(2), 115–128. https://doi.org/10.1177/0020764004040959.CrossRefPubMed

20.

McCabe, R., Röder-Wanner, U.-U., Hoffmann, K., & Priebe, S. (1999). Therapeutic relationships and quality of life: Association of two subjective constructs in schizophrenia patients. International Journal of Social Psychiatry, 45(4), 276–283. https://doi.org/10.1177/002076409904500406.CrossRefPubMed

21.

Hansson, L., Sandlund, M., Bengtsson-Tops, A., Bjarnason, O., Karlsson, H., Mackeprang, T., et al. (2003). The relationship of needs and quality of life in persons with schizophrenia living in the community. A Nordic multi-center study. Nord J Psychiatry, 57(1), 5–11. https://doi.org/10.1080/08039480310000194.CrossRefPubMed

22.

Slade, M., Leese, M., Cahill, S., Thornicroft, G., & Kuipers, E. (2005). Patient-rated mental health needs and quality of life improvement. The British Journal of Psychiatry, 187(3), 256–261. https://doi.org/10.1192/bjp.187.3.256.CrossRefPubMed

23.

Ruggeri, M., Gater, R., Bisoffi, G., Barbui, C., & Tansella, M. (2002). Determinants of subjective quality of life in patients attending community-based mental health services. The South-Verona Outcome Project 5. Acta Psychiatrica Scandinavica, 105(2), 131–140. https://doi.org/10.1034/j.1600-0447.2002.01293.x.CrossRefPubMed

24.

Bengtsson-Tops, A., & Hansson, L. (2001). Quantitative and qualitative aspects of the social network in schizophrenic patients living in the community. Relationship to sociodemographic characteristics and clinical factors and subjective quality of life. International Journal of Social Psychiatry, 47(3), 67–77. https://doi.org/10.1177/002076400104700307. doi.CrossRefPubMed

25.

Priebe, S., Huxley, P., Knight, S., & Evans, S. (1999). Application and results of the Manchester Short Assessment of Quality of Life (MANSA). International Journal of Social Psychiatry, 45(1), 7–12. https://doi.org/10.1177/002076409904500102.CrossRefPubMed

26.

Björkman, T., & Svensson, B. (2005). Quality of life in people with severe mental illness. Reliability and validity of the Manchester Short Assessment of Quality of Life (MANSA). Nordic Journal of Psychiatry, 59(4), 302–306. https://doi.org/10.1080/08039480500213733.CrossRefPubMed

27.

Das-Munshi, J., Chang, C.-K., Dutta, R., Morgan, C., Nazroo, J., Stewart, R., et al. (2017). Ethnicity and excess mortality in severe mental illness: A cohort study. The Lancet Psychiatry, 4(5), 389–399, https://doi.org/10.1016/S2215-0366(17)30097-4.CrossRefPubMedPubMedCentral

28.

Rose, D., Sweeney, A., Leese, M., Clement, S., Jones, I. R., Burns, T., et al. (2009). Developing a user-generated measure of continuity of care: Brief report. Acta Psychiatrica Scandinavica, 119(4), 320–324. https://doi.org/10.1111/j.1600-0447.2008.01296.x.CrossRefPubMed

29.

Loos, S., Kilian, R., Becker, T., Janssen, B., Freyberger, H., Spiessl, H., et al. (2012). Psychometric properties of the German version of the scale to assess the therapeutic relationship in Community Mental Health Care (D-STAR). European Journal of Psychological Assessment, 28(4), 255–261. https://doi.org/10.1027/1015-5759/a000105.CrossRef

30.

White, I. R., Royston, P., & Wood, A. M. (2011). Multiple imputation using chained equations: Issues and guidance for practice. Statistics in Medicine. https://doi.org/10.1002/sim.4067.CrossRefPubMedPubMedCentral

31.

Plumpton, C. O., Morris, T., Hughes, D. A., & White, I. R. (2016). Multiple imputation of multiple multi-item scales when a full imputation model is infeasible. BMC Research Notes, 9(1), 45. https://doi.org/10.1186/s13104-016-1853-5.CrossRefPubMedPubMedCentral

32.

Von Hippel, P. T. (2007). Regression with missing Ys: An improved strategy for analyzing multiply imputed data. Sociological Methodology, 37(1), 83–117. https://doi.org/10.1111/j.1467-9531.2007.00180.x.CrossRef

33.

Atkinson, M., Zibin, S., & Chuang, H. (1997). Characterizing quality of life among patients with chronic mental illness: A critical examination of the self-report methodology. The American Journal of Psychiatry, 154(1), 99–105. https://doi.org/10.1176/ajp.154.1.99.CrossRefPubMed

34.

Bengtsson-Tops, A., & Hansson, L. (1999). Clinical and social needs of schizophrenic outpatients living in the community: the relationship between needs and subjective quality of life. Social Psychiatry and Psychiatric Epidemiology, 34(10), 513–518.CrossRefPubMed

35.

Caron, J., Lecomte, Y., Stip, E., & Renaud, S. (2005). Predictors of quality of lifein schizophrenia. Community Mental Health Journal, 41(4), 399–417. https://doi.org/10.1007/s10597-005-5077-8.CrossRefPubMed

36.

Palumbo, C., Volpe, U., Matanov, A., Priebe, S., & Giacco, D. (2015). Social networks of patients with psychosis: A systematic review. BMC Research Notes, 8, 560. https://doi.org/10.1186/s13104-015-1528-7.CrossRefPubMedPubMedCentral

37.

Eklund, M., & Hansson, L. (2007). Social network among people with persistent mental illness: Associations With sociodemographic, clinical and health-related factors. International Journal of Social Psychiatry, 53(4), 293–305. https://doi.org/10.1177/0020764006074540. doi.CrossRefPubMed

38.

Bengtsson-Tops, A. (2004). Mastery in patients with schizophrenia living in the community: Relationship to sociodemographic and clinical characteristics, needs for care and support, and social network. Journal of Psychiatric and Mental Health Nursing 11(3), 298–304. https://doi.org/10.1111/j.1365-2850.2003.00718.x.CrossRefPubMed

39.

Slade, M., Leese, M., Ruggeri, M., Kuipers, E., Tansella, M., & Thornicroft, G. (2004). Does Meeting Needs Improve Quality of Life? Psychotherapy and Psychosomatics, 73(3), 183–189.CrossRefPubMed

40.

Willems, S., De Maesschalck, S., Deveugele, M., Derese, A., & De Maeseneer, J. (2005). Socio-economic status of the patient and doctor–patient communication: Does it make a difference? Patient Education and Counseling, 56(2), 139–146. https://doi.org/10.1016/j.pec.2004.02.011.CrossRefPubMed

41.

Hansson, L. (2006). Determinants of quality of life in people with severe mental illness. Acta Psychiatrica Scandinavica, 113, 46–50. https://doi.org/10.1111/j.1600-0447.2005.00717.x.CrossRef

42.

Boyer, L., Lançon, C., Baumstarck, K., Parola, N., Berbis, J., & Auquier, P. (2013). Evaluating the impact of a quality of life assessment with feedback to clinicians in patients with schizophrenia: Randomised controlled trial. The British Journal of Psychiatry, 202(6), 447–453.CrossRefPubMed

43.

Reininghaus, U., McCabe, R., Burns, T., Croudace, T., & Priebe, S. (2012). The validity of subjective quality of life measures in psychotic patients with severe psychopathology and cognitive deficits: An item response model analysis. Quality of Life Research, 21(2), 237–246. https://doi.org/10.1007/s11136-011-9936-1.CrossRefPubMed

Title: Quality of life and service satisfaction in outpatients with severe or non-severe mental illness diagnoses
Authors: Marian Ådnanes
Jorid Kalseth
Solveig Osborg Ose
Torleif Ruud
Jorun Rugkåsa
Stephen Puntis
Publication date: 01-03-2019
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 3/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-018-2039-5

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2019

What matters most to sepsis survivors: a qualitative analysis to identify specific health-related quality of life domains

Assessing the measurement invariance of the RCADS-25 questionnaire across gender and child–parent dyads in the presence of multilevel data

Interpretation and use of patient-reported outcome measures through a philosophical lens

Early quality-of-life and psychological predictors of disease-free time and survival in localized prostate cancer

Apathy and health-related quality of life in nursing home residents

Predicting change in quality of life from age 79 to 90 in the Lothian Birth Cohort 1921