Journal of Psychiatric and Mental Health Nursing, 1999, 6, 71^72

Research in brief

Quality of life for people with severeand enduring mental illness in thecommunity: the issue of activity

Introduction

This study is concerned with examining quality of

life as an outcome measure for people with severe

and enduring mental illness in the community.

The results brie¯y reported here examine the

relationship between self-reported quality of life

and involvement in activities by people with

severe and enduring mental illness in the commu-

nity in Northern Ireland. A number of authors

including Sullivan et al. (1992) indicate that

patients with greater and more satisfactory social

activity tend to report that they have higher life

satisfaction.

Methodology

A random sample of 90 respondents who met the

criteria for severe and enduring mental illness as

de®ned by the House of Commons Health Com-

mittee (1994) were interviewed using a structured

interview approach. The interviews were struc-

tured using a quality of life pro®le developed

speci®cally for the study. The pro®le included

instruments designed to measure life satisfaction

(quality of life), activity levels, mastery, self-

esteem and mental health. This part of the study

was designed to answer the following research

questions:

1 To what extent do people who have severe and

enduring mental illness rate their quality of life

as satisfactory?

2 To what extent are people who have severe and

enduring mental illness involved in 14 common

activities of living, e.g. shopping, cooking and

social activities?

3 Is there a relationship between participation in

activities and life satisfaction for this client

group?

Life satisfaction was measured using a scale of

35 items which were subdivided into nine life

domains: ®nance, occupation, health, family rela-

tionships, social relationships, activities of living,

living situation, religion, and legal/safety issues.

The items have been used by other quality of life

researchers, e.g. Oliver et al. (1996). Participants

were asked to rate their satisfaction with each

item on a 6-point Likert scale. They also rated the

importance of each item to themselves on a 5-

point scale. Satisfaction scores were adjusted for

importance using the procedure suggested by

Ferrans & Powers (1985). A domain score was

calculated by taking the median score for the

items within that domain. An overall satisfaction

score was computed by summing the domain

scores. Respondents were also asked to indicate

which of the 14 listed activities of living they had

participated in during the previous month. An

activity score was calculated by summing the

number of activities participated in.

Results

Overall the respondents reported low life satisfac-

tion. The median score was 148.5 (range 70.5±

195.5) on a scale from 9 to 216. There was also

low participation in domestic and social activities.

Over half of participants indicated that they had

no structured activities in their lives. The activity

scores ranged from 0 to 13 with a median score of

7. An example of the low participation in social

activities can be highlighted by the fact that over

70% (70.7%, 65) of respondents had not attended

a social activity during the previous month.

The correlation between the activity score and

overall life satisfaction was found to be weak, but

statistically signi®cant (r = 0.17, P 5 0.05).

However, the correlation between satisfaction

with involvement in activities of living and

overall life satisfaction was considerably higher

(r= 0.5, P5 0.001). These ®ndings suggest that

involvement in activities and satisfaction with

# 1999 Blackwell Science Ltd 71

Editors:

Steve Tilley1 & Mary Chambers

Submissions address:1University of Edinburgh, Adam Ferguson Building,George Square, Edinburgh EH8 9LL, UK

that involvement are important contributory

factors to overall life satisfaction.

Conclusion

The data from this study do not explain the

reason for non-participation, however, it is likely

that a number of factors are involved: lack of skill;

lack of motivation in relation to activities of

living; and over protection by relatives. Whatever

the cause of under involvement in activities it

needs to be dealt with, given the relationship

between involvement in activities life satisfaction

(quality of life) indicated earlier. The three possi-

ble causative factors listed above would normally

be a therapeutic focus in a rehabilitation pro-

gramme.

The low levels of participation in activities of

living suggests that either the cohort has pro-

gressed as far as possible with rehabilitation or

that current rehabilitation practices may be failing

people with severe and enduring mental illness in

the community by either not achieving desired

outcomes or by not being accessible. The

approaches to rehabilitation used with the

respondents were not examined. This an area

that would require further investigation.

References

Ferrans C.E. & PowersM.J. (1985) Quality of Life Index.Development and Psychometric Properties. Advancesin Nursing Science 8, 15±24.

House of Commons Health Committee (1994) Better O�in the Community? Care of People Who Are SeriouslyMentally Ill, Volume 1. HMSO, London.

Oliver J., Huxley P., Bridges K. & Mohamad H. (1996)Quality of Life and Mental Health Services. Routle-dge, London.

Sullivan G., Wells K.B. & Leake B. (1992) Clinicalfactors associated with better quality of life in aseriously mentally ill population. Hospital and Com-munity Psychiatry 43, 794±798.

SEAN KELLY

Nurse Lecturer

School of Nursing and Midwifery

The Queen's University

Belfast

Research in brief

72 # 1999 Blackwell Science Ltd, Journal of Psychiatric and Mental Health Nursing 6, 71±72