Measuring the quality of life of people with severe and enduring mental health problems in different settings

Abstract

Research has shown that quality of life (QOL) among people with severe and enduring mental health problems is better if they live in the community rather than in hospital. In the course of a study to replicate this result in one particular service, comparisons were made between different QOL measures in their suitability for routine clinical use. Forty-five hospital and community residents each took part in four out of six QOL assessments: the Life Experience Checklist (Ager, 1990) in user and keyworker report forms; the Quality of Life Questionnaire (Bigelow, McFarland & Olson, 1991); the Quality of Life Interview (Lehman, 1983); Values Satisfaction (Hartley, 1988) and Five Accomplishments (developed specifically for the study). Measures were also taken of adaptive behaviours and psychiatric symptomatology, as well as the practicalities of completion. The expected difference between hospital and community residents was found for three of the six measures (LEC-keyworker, Bigelow and Five Accomplishments), which were also strongly correlated with psychiatric symptomatology and adaptive behaviour scores. The measures differed considerably in the numbers of failures to complete, the percentage of missing data and the amount of face-to-face contact with service users required. The correlations between subscale scores on the different measures were generally low. The study raises questions about the robustness of the QOL construct, and its use as an outcome measure in mental health.