Abstract
BackgroundQuality of life (QoL) is an established outcome measure of substance use disorder treatment. The WHOQOL-BREF is the gold standard tool, but its appropriateness for particularly vulnerable patient populations must be further explored. This article examines the scaling qualities of the WHOQOL-BREF in a Norwegian substance use disorder population, and explores relationships with social and health variables.Methods107 participants in a larger national treatment study provided data during structured interviews. Item responses, responsiveness, and domain scaling qualities are reported. General linear models identified correlates of impaired QoL.ResultsThree out of four domains exhibited acceptable scaling qualities, while the social relationships domain had low internal validity. 59% of the variance in physical health QoL was explained in our model by the negative main or interaction effects of depression, unemployment, social isolation, smoking, residential treatment, and weight dissatisfaction. 52% of the variance in psychological health QoL was explained by depression and being single. Depression also had significant main effects in social relationships QoL (R2 = .27) and environment QoL (R2 = .39), and social isolation and exercise had further interaction effects in environment QoL.ConclusionsAfter one year in treatment, the impact of low social contact in reducing QoL, rather than specific substance use patterns, was striking. The social relationships domain is the shortest in the WHOQOL-BREF, yet social variables were important in other areas of QoL. Social support could benefit from more attention in treatment, as a lack of social support seems to be a strong risk factor for poor QoL in various domains. The WHOQOL-BREF exhibits otherwise satisfactory measurement characteristics and is an appropriate tool among this population.
Highlights
Quality of life (QoL) is an established outcome measure of substance use disorder treatment
Participants’ characteristics Table 1 displays the demographic, substance, health, and social variables of the 107 participants included in this analysis
Sixty-five participants had entered into OMT (60.7%) and 42 had begun residential treatment (39.3%) at study inclusion
Summary
Quality of life (QoL) is an established outcome measure of substance use disorder treatment. Qualitative research has shown people with SUDs consider social factors such as enough relationships and contact, a supportive network, and social inclusion as necessary components to good QoL [11,12,13]. These social settings may influence the development and Muller et al BMC Medical Research Methodology (2019) 19:44 trajectory of SUDs in general to a far greater extent than other chronic diseases, as substance use in a person’s network impacts their own access to both substances and, later, to treatment [14,15,16]
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