Comparing quality of life using the World Health Organization Quality of Life measure (WHOQOL-100) in a clinical and non-clinical sample: Exploring the role of self-esteem, self-efficacy and social functioning

Abstract

Background: Quality of life assessments provide a measure of client-assessed wellbeing and help clinicians recognize issues of importance to clients. Comparing quality of life in individuals with a mental illness and individuals without mental illness would allow us to profile and understand the needs of individuals with mental illness understand the impact of stigma and narrow the treatment gap.

Aims: To compare quality of life in individuals with severe mental illness against a sample of the general population and to investigate the role of self-esteem, self-efficacy and social functioning.

Method: The World Health Organization Quality of Life measure (WHOQOL-100) along with the Rosenberg Self-Esteem Scale (RSE) and the Generalized Self Efficacy Scale (GSES) were administered to 104 individuals, 52 of whom were mental health service users with the remaining 52 participants sampled from the general population.

Results: Significant differences were found between clinical and non-clinical groups in four domains of the WHOQOL-100 and in a majority of the facets within domains. Two domains, Level of Independence and Social Relationships, were important differentiating aspects of QoL between the clinical and non-clinical sample as the highest significant differences were recorded there (t = 12.150, p < 0.001 and t = 7.252, p < 0.001 respectively). Lower self-esteem and self-efficacy scores were recorded for the clinical sample compared to the non-clinical sample.

Conclusions: The negative repercussions of mental illness encompassed almost all aspects of QoL that individuals had ascertained to be important for satisfaction and wellbeing in everyday life. Findings also indicated that individuals with mental illness have similar needs to a “normal” population in terms of social support and social networks and that inter-personal issues were probably more pervasive than intra-psychic events with regard to QoL. We conclude that the concept of QoL offers clinicians an increased awareness and greater concern for life issues for people who are mentally ill, helping us to develop collaborative relationships and provide effective interventions for individuals with mental illness.

Declaration of interest: None.

Keywords:

• Quality of life
• psychological well-being
• self-esteem
• self-efficacy
• social functioning

Notes

1 A stringent alpha level is applied for t-tests (p < 0.001) as Type 1 errors are uncorrected in the analysis.