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Associated and mediating variables related to quality of life among service users with mental disorders

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Abstract

Purpose

This study aimed to identify variables associated with quality of life (QoL) and mediating variables among 338 service users with mental disorders in Quebec (Canada). Data were collected using nine standardized questionnaires and participant medical records.

Methods

Quality of life was assessed with the Satisfaction with Life Domains Scale. Independent variables were organized into a six-block conceptual framework. Using structural equation modeling, associated and mediating variables related to QoL were identified.

Results

Lower seriousness of needs was the strongest variable associated with QoL, followed by recovery, greater service continuity, gender (male), adequacy of help received, not living alone, absence of substance use or mood disorders, and higher functional status, in that order. Recovery was the single mediating variable linking lower seriousness of needs, higher service continuity, and reduced alcohol use with QoL. Findings suggest that greater service continuity creates favorable conditions for recovery, reducing seriousness of needs and increasing QoL among service users. Lack of recovery-oriented services may affect QoL among alcohol users, as substance use disorders were associated directly and negatively with QoL.

Conclusions

Decision makers and mental health professionals should promote service continuity, and closer collaboration between primary care and specialized services, while supporting recovery-oriented services that encourage service user involvement in their treatment and follow-up. Community-based organizations should aim to reduce the seriousness of needs particularly for female service users and those living alone.

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Abbreviations

ACSS-MH:

Alberta continuity of services scale for mental health

AIC:

Akaike information criterion

AUDIT:

Alcohol use disorders identification test

CA:

Cronbach’s alpha

CFI:

Comparative fit index

DAST:

Drug abuse screening test

MANQ:

Montreal assessment of need questionnaire

MCAS:

Multnomah community ability scale

PCLOSE:

Process close

RAS:

Recovery assessment scale

QoL:

Quality of life

RMR:

Root mean square residual

RMSEA:

Root mean square error of approximation

SLDS:

Satisfaction with life domains scale

SPS:

Social provisions scale

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Acknowledgements

We gratefully acknowledge the support of the Fonds de la recherche en santé du Québec (FRSQ) for this study. As well, we would like to thank the advisory committee, co-investigators, research assistants, and service users who participated in this research.

Funding

This study was funded by the Fonds de la recherche en santé du Québec (FRSQ), Grant Number 22367, Prends soin de toi Program.

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Authors and Affiliations

  1. Department of Psychiatry, Douglas Hospital Research Centre, McGill University, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada

    Marie-Josée Fleury

  2. Douglas Hospital Research Centre, Montreal, QC, H4H 1R3, Canada

    Guy Grenier & Jean-Marie Bamvita

  3. Douglas Mental Health University Institute, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada

    Guy Grenier

Authors
  1. Marie-Josée Fleury
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  2. Guy Grenier
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  3. Jean-Marie Bamvita
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Correspondence to Guy Grenier.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study involving human subjects were in accordance with the ethical standards of the institutional committee, with the 1964 Helsinki declaration and later amendments, as well as comparable ethical standards.

Informed consent

Informed consent was obtained from all service users included in this study.

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Fleury, MJ., Grenier, G. & Bamvita, JM. Associated and mediating variables related to quality of life among service users with mental disorders. Qual Life Res 27, 491–502 (2018). https://doi.org/10.1007/s11136-017-1717-z

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  • DOI: https://doi.org/10.1007/s11136-017-1717-z

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