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

TLDR

In a cross‑sectional multi‑center study of 418 individuals with schizophrenia, the relationship between care needs and subjective quality of life was investigated. The authors aimed to determine whether unmet needs are associated with poorer quality of life. They assessed 22 need domains using the Camberwell Assessment of Need scale and quality of life with the Lancashire Quality of Life Profile, interviewing key workers and patients across 10 Nordic centers. Key workers reported more needs than patients, and unmet needs—especially in social relationships and accommodation—were significantly associated with poorer quality of life, explaining 6–17% of its variance, whereas met needs showed no such association.

Abstract

AbstractThe 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.