Abstract
Background: Mental healthcare needs person-tailored interventions. Experience Sampling Method (ESM) can provide daily life monitoring of personal experiences. This study aims to operationalize and test a measure of momentary reward-related Quality of Life (rQoL). Intuitively, quality of life improves by spending more time on rewarding experiences. ESM clinical interventions can use this information to coach patients to find a realistic, optimal balance of positive experiences (maximize reward) in daily life. rQoL combines the frequency of engaging in a relevant context (a ‘behavior setting’) with concurrent (positive) affect. High rQoL occurs when the most frequent behavior settings are combined with positive affect or infrequent behavior settings co-occur with low positive affect.Methods: Resampling procedures (Monte Carlo experiments) were applied to assess the reliability of rQoL using various behavior setting definitions under different sampling circumstances, for real or virtual subjects with low-, average- and high contextual variability. Furthermore, resampling was used to assess whether rQoL is a distinct concept from positive affect. Virtual ESM beep datasets were extracted from 1,058 valid ESM observations for virtual and real subjects.Results: Behavior settings defined by Who-What contextual information were most informative. Simulations of at least 100 ESM observations are needed for reliable assessment. Virtual ESM beep datasets of a real subject can be defined by Who-What-Where behavior setting combinations. Large sample sizes are necessary for reliable rQoL assessments, except for subjects with low contextual variability. rQoL is distinct from positive affect.Conclusion: rQoL is a feasible concept. Monte Carlo experiments should be used to assess the reliable implementation of an ESM statistic. Future research in ESM should asses the behavior of summary statistics under different sampling situations. This exploration is especially relevant in clinical implementation, where often only small datasets are available.
Highlights
Mental health care is becoming more patient-centered
In a shared decision process, patients and clinicians select rewarding situations and explore how to increase the occurrence of well-being in daily life. Can these situations be detected and personal profiles computed? When applied in clinical practice, does this improve the subject’s overall well-being? This paper describes the development of a reward-related Quality of Life (QoL) function and the proof of concept of its applicability
Twenty-seven patients with a severe mental illness were included in the Experience Sampling Method (ESM) baseline measurement of the D-STIGMI study
Summary
Mental health care is becoming more patient-centered. Clinicians should focus less on group characteristics and more on the individual’s daily adaptation strategies and need for care (van Os, 2014). The main purpose of mental health care is to improve functioning as well as quality of life, in an empowering way. This study aims to operationalize and test a measure of momentary reward-related Quality of Life (rQoL). Quality of life improves by spending more time on rewarding experiences. ESM clinical interventions can use this information to coach patients to find a realistic, optimal balance of positive experiences (maximize reward) in daily life. RQoL combines the frequency of engaging in a relevant context (a ‘behavior setting’) with concurrent (positive) affect. High rQoL occurs when the most frequent behavior settings are combined with positive affect or infrequent behavior settings co-occur with low positive affect
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