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Am J Psychiatry 1996; 153:497-502
Copyright © 1996 by American Psychiatric Association
Judgments of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectives
F Sainfort, M Becker and R Diamond
Center for Health Systems Research and Analysis, School of Medicine, University of Wisconsin, Madison, USA.
OBJECTIVE: This study was an investigation of judgments regarding quality
of life of individuals with severe mental disorders from two different
perspectives: patient self-report versus provider. METHOD: Judgments on
several dimensions of quality of life were collected from a convenience
sample of 37 schizophrenic patients and their primary clinicians by using
the well-known Quality of Life Index of Spitzer et al. and the more
recently developed Quality of Life Index-Mental Health. Both indexes
capture judgments on a number of dimensions. Patterns of concordance for
the patient-provider pairs were tested by using Cohen's kappa and Pearson
correlation coefficients. RESULTS: The results suggest that patients' and
providers' judgments are more likely to coincide on clinical aspects, such
as symptoms and function, than on social aspects. Specifically, there was
moderate agreement on symptoms and function, less agreement on physical
health, and little to no agreement on social relations and occupational
aspects of quality of life. CONCLUSIONS: Such differences support the
notion that treatment strategies and mental health services should address
a wide range of needs reflecting different aspects of quality of life
perceived as important by different patients.
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