The association between needs and quality of life in an epidemiologically representative sample of people with psychosis

Abstract

The impact of meeting needs on quality of life in the severely mentally ill is investigated in this study. An epidemiologically representative sample of 133 patients meeting ICD-10 criteria for psychosis completed standardized instruments for measuring needs and quality of life. Covariance structure modelling was used to investigate the extent to which latent factors of met and unmet need were associated with latent quality of life. Patients rated about 0.7 more total (met plus unmet) needs than staff, mainly due to differences in rating unmet need. Patient ratings were more reliable than ratings by others of unmet need and quality of life. Both underlying unmet need and met need were negatively associated with underlying quality of life, but unmet need was the stronger relationship. The patient's perspective on their difficulties (especially their unmet needs) must be central to mental health care.

Individual unmet needs for care: are they sensitive as outcome criterion for the effectiveness of mental health services interventions?

“…The prevalence rate of met and unmet needs in our study is in line with earlier research including the (significant) tendency towards lower numbers at follow-up [8,30]. Overall these findings are more or less consistent with the CAN literature.…”

“…higher in schizophrenia), and treatment setting (higher in inpatient care or among homeless people; [30,31]. Prevalence on total number of needs, met as well as unmet, appears to be quite stable on the population level, while any change (i.e.…”

“…Many needs are also unmet in community oriented settings with links to primary care, affecting at least 25-50% of the patient population. Unmet needs are a strong predictor of quality of life [9,30].…”

Does Meeting Needs Improve Quality of Life?

“…The UK700 study assessed staff-rated but not patient-rated needs, and found that patient-rated quality of life was predicted more by unmet needs than any other clinical or social variable [4]. A study from the PRiSM Psychosis Study compared the relative contribution of staff and patient assessments of needs, and found that number of unmet needs was inversely associated with quality of life (replicating the UK700 study), and that the association was more robust for patient ratings of need [5]. Current evidence therefore indicates that patient-rated unmet need may be particularly influential on quality of life.…”

Perception of unmet needs and association with benzodiazepine misuse among patients on a methadone maintenance treatment programme

“…21 Slade and colleagues asserted that patient ratings of need are more reliable than staff ratings. 22 The CANSAS-P assesses need on 22 items. The rater indicates any perceived need and determines whether this need is being met (0 = no need; 1 = not a serious problem because of help received, i.e.…”