Does Meeting Needs Improve Quality of Life?

Mike Slade · Morven Leese · Mirella Ruggeri · Elizabeth Kuipers · Michele Tansella · Graham Thornicroft

167 citations0/0 files storedPsychotherapy and Psychosomatics

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Psychiatric care and mental health services Schizophrenia research and treatment Mental Health and Patient Involvement

Abstract

BACKGROUND: This study investigated the relationship between patient-rated unmet needs and subjective quality of life using routine outcome data. METHODS: 265 mental health service patients from South Verona were assessed using the Camberwell Assessment of Need, the Lancashire Quality of Life Profile, and other standardised assessments of symptoms, disability, function and service satisfaction. At 1-year follow-up, 166 patients were still in contact, of whom 121 patients (73%) were re-assessed. RESULTS: Higher baseline quality of life was associated with being male, a diagnosis of psychosis, higher disability, higher satisfaction with care, fewer staff-rated or patient-rated unmet needs, and fewer patient-rated met needs (accounting for 40% of the variance). Specifically, fewer baseline patient-rated unmet needs were cross-sectionally associated with a higher quality of life (B = -0.08, 95% CI -0.12 to -0.04). Apart from its baseline value, the only baseline predictor of follow-up QoL was patient-rated unmet need (B = -0.08, 95% CI -0.21 to -0.09), accounting for 58% of the variance in follow-up quality of life. Graphical chain modelling confirmed this association. CONCLUSIONS: The association between high numbers of unmet needs and low subjective quality of life appears increasingly robust across several studies. Future research will need to investigate whether changes in needs precede changes in quality of life. This study provides further evidence that a policy of actively assessing and addressing patient-rated unmet needs may lead to improved quality of life.

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References

1991Structural Equations with Latent Variables.1976The Global Assessment Scale 1995The Camberwell Assessment of Need: The Validity and Reliability of an Instrument to Assess the Needs of People with Severe Mental Illness 1993Training and quality assurance with the Brief Psychiatric Rating Scale: "The drift busters."1998Crossnational Differences in Happiness: Economic and Cultural Factors Explored 1996The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill 1993The development and use of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals 1998A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis

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2005Listening to patients' needs to improve their subjective quality of life 2008Better Mental Health Care 2011Lessons learned in developing community mental health care in Europe 2007Development and Evaluation of a Patient-rated Version Of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS-P)

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