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Subjective Health-Related Quality of Life in Homeless and Vulnerably Housed Individuals and Its Relationship with Self-Reported Physical and Mental Health Status

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Abstract

Although the association between homelessness and objective indicators of poor health is well-established, little research has focused on the subjective health-related quality of life of homeless and vulnerably housed (HVH) individuals. This study examined the subjective health-related quality of life of HVH individuals, using the Multiple Discrepancies Theory (MDT) Scale for Health of the Quality of Life for Homeless and Hard-to-House Individuals (QoLHHI) Inventory, and its association with self-reported functional health status, as measured by the SF-12, and self-reported physical and mental health conditions in a sample of 100 HVH individuals recruited in Vancouver, Toronto and Ottawa. Our findings indicate that physical and mental health conditions are highly prevalent among HVH individuals and that the SF-12 Physical and Mental Component Summary scores are substantially lower compared to US population norms. The MDT Health items were not statistically significantly associated with physical or mental health conditions and only showed correlations of small to moderate magnitude with the SF-12 Component Summary Scales. These findings suggest that the QoLHHI MDT Scale for Health can provide information about HVH individuals’ subjective health experiences that is different from, and can serve as a valuable complement to, health status information for use in research and evaluation studies, as well as for policy purposes to make informed decisions based on subjective health-related quality of life data from HVH individuals.

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References

  • Anderson, K. L., & Burkhardt, C. S. (1999). Conceptualization and measurement of quality of life as an outcome variable for health care intervention and research. Journal of Advanced Nursing, 29, 298–306.

    Article  Google Scholar 

  • Binik, Y. M., & Devins, G. M. (1986–1987). Transplant failure does not compromise quality of life in end-stage renal disease. International Journal of Psychiatry in Medicine, 16, 281–292.

    Google Scholar 

  • Breakey, W. R., Fischer, P. J., Kramer, M., Nestadt, G., Romanoski, A. J., Ross, A., et al. (1989). Health and mental health problems of homeless men and women in Baltimore. Journal of the American Medical Association, 262, 1352–1357.

    Article  Google Scholar 

  • Canadian Institute for Health Information. (2007). Improving the health of Canadians: Mental health and homelessness. Ottawa, ON: Canadian Institute for Health Information.

    Google Scholar 

  • Cheung, A. M., & Hwang, S. W. (2004). Risk of death among homeless women: A cohort study and review of the literature. Canadian Medical Association Journal, 170, 1243–1247.

    Article  Google Scholar 

  • de Haes, J. C. J. M., & Van Knippenberg, F. C. E. (1985). The quality of life of cancer patients: A review of the literature. Social Science and Medicine, 20, 809–817.

    Article  Google Scholar 

  • Fischer, P. J., & Breakey, W. R. (1991). The epidemiology of alcohol, drug, and mental disorders among homeless persons. American Psychologist, 46, 1115–1128.

    Article  Google Scholar 

  • Frankish, C. J., Hwang, S. W., & Quantz, D. (2005). Homelessness and health in Canada: Research lessons and priorities. Canadian Journal of Public Health, 96(Suppl2), S23–S29.

    Google Scholar 

  • Gill, T. M., & Feinstein, A. R. (1994). A critical appraisal of the quality of quality-of-life measurements. Journal of the American Medical Association, 272, 619–626.

    Article  Google Scholar 

  • Hubley, A. M., Rusell, L. B., Palepu, A., & Hwang, S. W. (2012). Subjective quality of life among individuals who are homeless: A review of current knowledge. Social Indicators Research,. doi:10.1007/s11205-012-9998-7.

    Google Scholar 

  • Hubley, A. M., Russell, L. B., Gadermann, A. M., & Palepu, A. (2009). Quality of Life for Homeless and Hard-to-House Individuals (QOLHHI) Inventory: Administration and scoring manual. Vancouver, BC: Authors.

    Google Scholar 

  • Hwang, S. W. (2000). Mortality among men using homeless shelters in Toronto, Ontario. Journal of the American Medical Association, 283, 2152–2157.

    Article  Google Scholar 

  • Hwang, S. W. (2001). Homelessness and health. Canadian Medical Association Journal, 164, 229–233.

    Google Scholar 

  • Hwang, S. W., Wilkins, R., Tjepkema, M., O’Campo, P. J., & Dunn, J. R. (2009). Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study. British Medical Journal, 339, b4036.

    Article  Google Scholar 

  • Johnson, J. P., McCauley, C. R., & Copley, J. B. (1982). The quality of life of hemodialysis and transplant patients. Kidney International, 22, 286–291.

    Article  Google Scholar 

  • Kertesz, S. G., Larson, M. J., Horton, N. J., Winter, M., Saitz, R., & Samet, J. H. (2005). Homeless chronicity and health-related quality of life trajectories among adults with addictions. Medical Care, 43(6), 574–585.

    Article  Google Scholar 

  • Kushel, M. B., Vittinghoff, E., & Haas, J. S. (2001). Factors associated with the health care utilization of homeless persons. Journal of the American Medical Association, 285, 200–206.

    Article  Google Scholar 

  • Laird, G. (2007). Shelter. Homelessness in a growth economy: Canada’s 21st century paradox. Sheldon Chumir Foundation for Ethics in Leadership, Calgary.

  • Larson, C. O. (2002). Use of the SF-12 instrument for measuring the health of homeless persons. Health Services Research, 37, 733–750.

    Article  Google Scholar 

  • Lehman, A. F. (1983). The well-being of chronic mental patients. Archives of General Psychiatry, 40, 369–373.

    Article  Google Scholar 

  • Lehman, A. F., Ward, N. C., & Linn, L. S. (1982). Chronic mental patients: The quality of life issue. American Journal of Psychiatry, 139, 1271–1276.

    Google Scholar 

  • Luo, X., Lynn George, M., Kakouras, I., Edwards, C. L., Pietrobon, R., Richardson, W., et al. (2003). Reliability, validity and responsiveness of the short form 12-item survey (SF-12) in patients with back pain. Spine, 28, 1739–1745.

    Google Scholar 

  • Mayer, T., & Andrews, H. B. (1981). Changes in self-concept following a spinal cord injury. Journal of Applied Rehabilitation Counseling, 12, 135–137.

    Google Scholar 

  • Michalos, A. C. (1985). Multiple discrepancies theory (MDT). Social Indicators Research, 16, 37–413.

    Article  Google Scholar 

  • Michalos, A. C. (2004). Social indicators research and health-related quality of life research. Social Indicators Research, 65, 27–72.

    Article  Google Scholar 

  • Michalos, A. C. (in press). Multiple discrepancies theory. In A. C. Michalos (Ed.), Encyclopedia of quality of life research. New York: Springer.

  • Moons, P., Budts, W., & De Geest, S. (2006). Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches. International Journal of Nursing Studies, 43, 891–901.

    Article  Google Scholar 

  • Muldoon, M. F., Barger, S. D., Flory, J. D., & Manuk, S. B. (1998). What are quality of life measurements measuring? British Medical Journal, 316, 542–545.

    Article  Google Scholar 

  • Palepu, A., Hubley, A. M., Russell, L. B., Gadermann, A. M., & Chinni, M. (2012). Quality of life themes in Canadian adults and street youth who are homeless or hard-to-house: A multi-site focus group study. Health and Quality of Life Outcomes, 10, 1–11.

    Article  Google Scholar 

  • Research Alliance for Canadian Homelessness, Housing, and Health (REACH3). (2010). Housing vulnerability and health: Canada’s hidden emergency. Toronto: Research Alliance for Canadian Homelessness, Housing, and Health (REACH3).

  • Salyers, M. P., Bosworth, H. B., Swanson, J. W., Lamb-Pagone, J., & Osher, F. C. (2000). Reliability and validity of the SF-12 health survey among people with severe mental illness. Medical Care, 2000(38), 1141–1150.

    Article  Google Scholar 

  • Smith, K. W., Avis, N. E., & Assmann, S. F. (1999). Distinguishing between quality of life and health status in quality of life research: A meta-analysis. Quality of Life Research, 8, 447–459.

    Article  Google Scholar 

  • Sun, S., Irestig, R., Burström, B., Beijer, U., & Burström, K. (2012). Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006. Scandinavian Journal of Public Health, 40(2), 115–125.

    Article  Google Scholar 

  • Tsui, J. I., Bangsberg, D. R., Ragland, K., Hall, C. S., & Riley, E. D. (2007). The impact of chronic Hepatitis C on health-related quality of life in homeless and marginally housed individuals with HIV. AIDS and Behavior, 11(4), 603–610.

    Article  Google Scholar 

  • Ware, J. E. J., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

    Article  Google Scholar 

  • Weissman, J. S., Cleary, P. D., Seage, G. R., I. I. I., Gatsonis, C., Haas, J. S., Chasan-Taber, S., et al. (1996). The influence of health-related quality of life and social characteristics on hospital use by patients with AIDS in the Boston Health Study. Medical Care, 34(10), 1037–1056.

    Article  Google Scholar 

  • Wen, C., Hudak, P., & Hwang, S. (2007). Homeless people’s perceptions of welcomeness and unwelcomeness in healthcare encounters. Journal of General Internal Medicine, 22, 1011–1017.

    Article  Google Scholar 

  • WHOQOL Group. (1995). The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Social Science and Medicine, 41, 1403–1409.

    Article  Google Scholar 

  • Wright, S. J. (1985). Health satisfaction: A detailed test of the multiple discrepancies theory Model. Social Indicators Research, 17, 299–313.

    Article  Google Scholar 

Download references

Acknowledgments

This project was supported by an operating grant from the Canadian Institutes of Health Research to Dr. Anita Hubley and Dr. Anita Palepu. Dr. Anne Gadermann also gratefully acknowledges support from the Michael Smith Foundation for Health Research.

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Authors and Affiliations

  1. Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, University of British Columbia, 620B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Anne M. Gadermann & Anita Palepu

  2. Department of ECPS, University of British Columbia, 2125 Main Mall, Vancouver, BC, V6T 1Z4, Canada

    Anita M. Hubley & Lara B. Russell

Authors
  1. Anne M. Gadermann
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  2. Anita M. Hubley
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  3. Lara B. Russell
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  4. Anita Palepu
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Correspondence to Anne M. Gadermann.

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Gadermann, A.M., Hubley, A.M., Russell, L.B. et al. Subjective Health-Related Quality of Life in Homeless and Vulnerably Housed Individuals and Its Relationship with Self-Reported Physical and Mental Health Status. Soc Indic Res 116, 341–352 (2014). https://doi.org/10.1007/s11205-013-0302-2

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