The relationship of needs and quality of life in persons with schizophrenia living in the community. A Nordic multi-center study

Abstract

The relationship between needs for care and support and subjective quality of life was investigated in a cross-sectional multi-center study including 418 individuals with schizophrenia from 10 centers in Nordic countries. Needs in 22 domains were investigated by interviews with key workers and their patients using the Camberwell Assessment of Need scale, and quality of life by the Lancashire Quality of Life Profile. The results showed that key workers rated slightly more needs than patients. To have more unmet needs, as rated by both key workers and patients, were correlated to a worse overall subjective quality of life, while met needs showed no such association. A regression analysis, controlling for clinical and social characteristics of the patients, showed more unmet needs to be associated with a worse quality of life, accounting for 6% out of a total of 41% explained variance in subjective quality of life. Regression analyses of the relationship of unmet needs in specific life domains and overall quality of life showed that unmet needs in five domains as perceived by patients accounted for 17% of the explained variance in overall quality of life. More than half of this variance was related to an unmet need in the domain of social relationships. It is concluded that unmet needs are of specific importance in needs assessment and that attention must be paid to separate met needs for care and services from unmet needs, since the latter seem more important to consider in order to improve outcome of interventions with regard to quality of life. Specific attention should in this context also be paid to unmet needs concerning social relationships and problems with accommodation.

The interrelation of needs and quality of life in first-episode schizophrenia

“…Cross-sectional studies [3,9,10,32,35,39] have confirmed the interrelation between unmet needs and quality of life including patients with high, medium, and low levels of functioning [3]. For met needs, the interrelation with quality of life was less consistent.…”

“…For met needs, the interrelation with quality of life was less consistent. Some studies found a negative association (the more met needs the lower the quality of life) [32,39], others did not find such an association [10]. The assumption that more met needs would be associated with higher quality of life was not confirmed.…”

Components Associated with Adequacy of Help for Consumers with Severe Mental Disorders

“…Consumers with more service contacts (Lasalvia et al 2000) or who receive assertive case management (Gallagher and Teesson 2000) generally report a higher total numbers of needs. Finally, several studies have found a strong association between the number of unmet needs and poor quality of life (BengtssonTopps and Hansson 1999;Hansson et al 2003;Slade et al 2004;Van Busschbach and Wiersma 2002;Wiersma and van Busschbach 2001).…”

Are factors associated with subjective quality of life in people with severe mental illness consistent over time? — A 6-year follow-up study

“…This hypothesis has been investigated in rather few, mainly cross-sectional studies, showing an robust association between more unmet needs and a worse subjective quality of life (4)(5)(6)(7).…”