Abstract
Introduction: Measuring quality of life (QoL) is essential to understand how clients perceive their care. In practice, many instruments are in place to identify mental health diagnoses and measure treatment outcomes, but there are fewer standardized instruments to routinely collect information about self-reported QoL, especially across different mental health settings. Moreover, existing tools have been criticized for being built from the perspective of care professionals rather than the users' perspective. The 23-item Self-Reported interRAI-QoL Survey for Mental Health and Addictions (interRAI SQoL-MHA) tackles these issues, as it is based on self-reported measures and has proven validity across settings and countries.Objective: The aim of this study is to assess and compare QoL across settings and explore associations between dimensions of self-reported QoL and some items from the interRAI SQoL-MHA in a multinational sample.Settings: Inpatient and community mental health services.Methods: Data were collected from organizations in Belgium, Finland, Russia, Brazil, Rwanda, Canada and Hong Kong. Logistic regression models were constructed using each domain scale of the interRAI SQoL-MHA (relationship, support, hope, activities and relationship with staff) as dependent variables.Results: A total of 2,474 people (51.2% female, 56.7% of age 45 or older) were included in the study. A benchmark analysis showed the samples that performed above the benchmark line or below. The models yielded significant odds ratios among the domain scales, as well as for the items of the interRAI SQoL-MHA, with positive associations for the items “work and education opportunities” and “satisfied with services”, and inverse associations for the items “financial difficulties” and for the inpatient setting.Conclusion: The analysis of associations between the determinants offers relevant information to improve mental health care and clients' perceived quality of life. Information about the determinants can help policymakers to design interventions to improve care outcomes, as well as provide more possibilities for integration into the community. The interRAI SQoL-MHA is innovative, as it can be linked to the third generation interRAI MH and Community MH-instruments, to be used in different mental health care settings, combining the objective and subjective QoL domains.
Highlights
Measuring quality of life (QoL) is essential to understand how clients perceive their care
The sample consisted of a total of 2,474 people from seven countries: 623 (25.2%) users received inpatient care, 1,207 (48.8%) received community mental health services and a Canadian sample from the general population with a total of 644 people (26.0%) living in the community
The outpatient sample from Canada consisted of people of age 45 or older, contrasting with all interRAI Self-Reported Quality of Life other samples, especially with Finland and Rwanda which had the youngest distribution of the population
Summary
Measuring quality of life (QoL) is essential to understand how clients perceive their care. The definition put forward by Anthony (1993) was a key milestone for this shift, where recovery was described as “a deeply personal, unique process of changing one’s attitudes, values, feelings, goals, skills, and/or roles It is a way of living a satisfying, hopeful, and contributing life even with limitations caused by illness. According to Thornicroft and Slade [15], it is the point of view of the service users that counts most in deciding which outcomes should be assessed when evaluating mental health interventions They agree that quality of life is not closely related to users’ needs as rated by the staff, but is closely associated with unmet needs as rated by service users [16, 17]. This highlights the importance of users’ self-rated measures of QoL
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