Abstract
BackgroundQuality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients’ satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment.AimThis is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction. Methods: In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined.ResultsAnalyses revealed a highly significant medium-sized effect (r = .30, p < .001) for the associations of QoL and service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs.ConclusionAssociations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients’ perception of the service adequacy for achieving QoL enhancement into account.
Highlights
Associations with subjective Quality of life (QoL) remained largely robust when accounting for moderating variables, there was a trend of stronger associations for outpatients compared to inpatients
Our findings suggest that agents responsible for service
The World Health Organization proposed within the framework of the Quality of Life Project [4] that health and social services should incorporate the enhancement of quality of life in their list of desired outcomes
Summary
Mental disorders are responsible for approximately 12–15% of the world’s total disability, imposing an enormous cost to patients, families, and society [1] and having a constantly growing impact on the patients’ daily life [2,3]. The importance of quality of life improvement in psychotic patients has been receiving increasing attention from psychosocial services, because in more recent years a paradigmatic shift from only treating psychopathological symptoms towards more holistic treatments has taken place. Research efforts evaluating the effectiveness of psychosocial services by their ability to ameliorate the patients’ quality of life have increased [5,6,7]. Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients.
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