Background
Methods
Study design and users selection criteria
Data collection
Name | Description | Variables |
---|---|---|
Satisfaction with Life Domains Scale (SLDS) [6] | Assesses satisfaction in 20 life domains; seven-point Likert scale, questions; Cronbach alpha: 0.92 [60] | Subjective quality of life |
Montreal Assessment of Needs Questionnaire (MANQ) [61] | Derived from the Camberwell Assessment of Need (CAN) Assesses user needs in 26 needs areas; 11-point analog scales (0–10); Cronbach Alpha: 0.70 to 0.73 | Age |
Gender | ||
Civil status | ||
Education | ||
Employment | ||
Type of housing (autonomous/supervised) | ||
Nationality (Canadian/Others) | ||
Spoken language (French/Others) | ||
Importance attributed to spirituality | ||
Number of needs areas (26 in five categories: basic; health; functioning; social, services) | ||
Severity of need | ||
Amount of help received from relatives | ||
Amount of help received from services | ||
Adequacy of help received | ||
Social Provision Scale (SPS) [62] | Measures availability of social support in six dimensions; Cronbach Alpha: 0.92 [62] | Attachment, reassurance of worth, social integration, reliable alliance, guidance and nurturance |
Multnomah CommunityAbility Scale (MCAS) [63] | Assesses user’s functional ability in the community, e.g. obstacles to functioning, social competences; Cronbach Alpha: 0.87 [63] | Functional ability in the community |
Alcohol Use Disorders Identification Test (AUDIT) [64] | Measures alcohol consumption level and consequences; 10 items; yes/no questions; Cronbach Alpha: 0.88 [65] | Alcohol abuse |
Drug Abuse Screening Test (DAST-20) [66] | Measures user’s drug use and consequences; 20 items; yes/no questions; Cronbach Alpha: 0.74 [66] | Drug Abuse |
Alberta Continuity of Services Scale for Mental Health (ACSS-MH) [67] | Measures service continuity, e.g. system access and team function; Cronbach Alpha: 0.78 to 0.92 | Service continuity |
Service Utilization Questionnaire (SUQ) [68] | Derived from the Canadian Health Survey Questionnaire (CCHS) Evaluates types and frequency of professionals and services used | Visit to any healthcare professional or services |
Clinical records | Diagnoses | Schizophrenia |
Mood disorders | ||
Anxiety disorders | ||
Personality disorders | ||
Delusion and other psychotic disorders | ||
Schizophrenia spectrum disorders | ||
Number of mental disorders | ||
History of prior violence | ||
History of prior judiciary problems Being on medication |
Measurement instruments
Analysis and conceptual framework
Results
User sample
Categories | Sub-categories | Variables | n | % |
---|---|---|---|---|
Sociodemographic variables
|
Age [Mean (SD)]
| 48.5 | 10.4 | |
Gender
| Men | 153 | 51.5 | |
Women | 144 | 48.5 | ||
Spoken language
| French | 190 | 64.0 | |
English | 61 | 20.5 | ||
French/English | 7 | 2.4 | ||
Others | 37 | 12.5 | ||
Civil status
| Single/Never married | 224 | 75.4 | |
In a relationship/Married/Remarried | 33 | 11.1 | ||
Separated/Divorced/Widow | 40 | 13.5 | ||
Socio-economic variables
|
Type of housing
| Autonomous housing | 179 | 60.3 |
Supervised housing | 116 | 39.1 | ||
Education
| Primary/Secondary school | 185 | 62.3 | |
College/University | 110 | 37.0 | ||
Clinical variables
|
Severe mental health disorders
| Schizophrenia | 113 | 38.0 |
Mood disorders | 124 | 41.8 | ||
Schizophrenia spectrum disorders | 38 | 12.8 | ||
Delusional and other psychotic disorders | 28 | 9.4 | ||
Second diagnosis
| Anxiety disorders | 36 | 12.1 | |
Dependences and substance abuse | ||||
Drug | 16 | 5.4 | ||
Alcohol | 13 | 4.4 | ||
Multiple | 27 | 9.1 | ||
Personality disorders | 81 | 27.3 | ||
Moderate or mild mental retardation | 37 | 12.5 |
Categories | Areas | N | % | Severity Mean* | SD |
---|---|---|---|---|---|
Basic | Job integration | 101 | 34.0 | 7.50 | 2.504 |
Accommodation | 101 | 34.0 | 5.96 | 3.062 | |
Daytime activities | 98 | 33.0 | 5.52 | 2.729 | |
Food | 96 | 32.3 | 5.24 | 2.396 | |
Health | Psychological distress | 204 | 68.7 | 6.67 | 2.732 |
Stress adaptation | 182 | 61.3 | 6.30 | 2.599 | |
Physical health | 168 | 56.6 | 5.70 | 2.851 | |
Psychotic symptoms | 144 | 48.5 | 5.54 | 2.715 | |
Drugs | 99 | 33.3 | 7.44 | 3.035 | |
Safety to self | 58 | 19.5 | 6.00 | 2.853 | |
Alcohol | 31 | 10.4 | 5.10 | 2.371 | |
Safety to others | 22 | 7.4 | 5.77 | 3.206 | |
Functioning | Money | 140 | 47.1 | 6.84 | 2.904 |
Looking after the home | 99 | 33.3 | 5.69 | 2.448 | |
Self-care | 49 | 16.5 | 5.55 | 2.829 | |
Basic education | 42 | 24.1 | 5.79 | 3.000 | |
Childcare | 21 | 7.1 | 7.43 | 2.993 | |
Social | Sexual expression | 122 | 41.1 | 7.42 | 2.787 |
Company | 101 | 34.0 | 4.06 | 3.736 | |
Intimate relationships | 97 | 32.7 | 7.30 | 2.84 | |
Social exclusion | 95 | 32.0 | 6.16 | 2.841 | |
Services | Transportation | 65 | 21.9 | 7.12 | 3.059 |
Information about illness and treatment | 65 | 21.0 | 5.94 | 2.800 | |
Involvement in treatment decisions | 58 | 19.5 | 6.12 | 2.986 | |
Benefits | 30 | 10.1 | 6.87 | 3.126 | |
Telephone | 8 | 2.7 | 6.38 | 2.615 |
SQOL predictors
Sociodemographic variables | Clinical variables | Needs and functionaliy variables | Social support | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Predictors from baseline
|
β
|
P
|
β
|
P
|
β
|
P
|
β
|
t
|
P
|
95% CI
|
95% CI Colinearity statistics
| ||
LL | UL | Tolerance | VIF | ||||||||||
Type of housing (autonomous) | -.282 | .000 | -.199 | .001 | -.151 | .008 | -.160 | −2.937 | .004 | −10.713 | −2.116 | .787 | 1.271 |
Schizophrenia | .181 | .002 | .155 | .006 | .166 | 3.142 | .002 | 2.497 | 10.873 | .837 | 1.195 | ||
DAST-20 score | -.147 | .008 | -.074 | .157 | -.101 | −2.020 | .044 | −1.395 | -.018 | .934 | 1.071 | ||
Severity of needs | -.330 | .000 | -.272 | −5.176 | .000 | -.226 | -.101 | .847 | 1.180 | ||||
MCAS score | .111 | .036 | .079 | 1.566 | .118 | -.041 | .361 | .920 | 1.086 | ||||
Social integration | .196 | 3.472 | .001 | .942 | 3.410 | .732 | 1.366 | ||||||
Reassurance of worth | .136 | 2.397 | .017 | .255 | 2.597 | .721 | 1.386 | ||||||
Total variance explained (R2) | 8.0% | 12.9% | 24.7% | 32.6% | |||||||||
Goodness-of-fit | |||||||||||||
F | 25.518 | 14.523 | 19.133 | 19.940 | |||||||||
P | <0.001 | <0.001 | <0.001 | <0.001 |
Services | Functioning | Health | Basic | Social needs | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
b
|
P
|
b
|
P
|
b
|
P
|
b
|
P
|
b
|
t
|
P
|
95cpc CI
|
Colinearity statistics
| |||
LL | UL | Tolerance | VIF | ||||||||||||
Benefit | -.185 | .001 | -.191 | .001 | -.146 | .009 | -.126 | .020 | -.101 | −1.936 | .054 | −1.740 | .014 | .895 | 1.117 |
Involvement in treatment decisions | -.185 | .001 | -.177 | .002 | -.112 | .044 | -.082 | .131 | -.055 | −1.051 | .294 | −1.127 | .342 | .878 | 1.139 |
Self-care | -.122 | .029 | -.097 | .070 | -.064 | .222 | -.020 | -.382 | .703 | −1.014 | .685 | .902 | 1.109 | ||
Safety to self | -.205 | .000 | -.190 | .000 | -.155 | −2.940 | .004 | −1.878 | -.372 | .880 | 1.137 | ||||
Stress adaptation | -.173 | .002 | -.104 | .066 | -.030 | -.531 | .596 | -.753 | 433 | .757 | 1.320 | ||||
Drugs | .126 | .020 | .102 | .052 | .091 | 1.803 | .072 | -.042 | .952 | .950 | 1.052 | ||||
Daytime activities | -.251 | .000 | -.183 | −3.171 | .002 | −1.908 | -.447 | .736 | 1.358 | ||||||
Company | -.225 | −3.730 | .000 | −1.843 | -.570 | .673 | 1.486 | ||||||||
Social exclusion | -.113 | −2.057 | .041 | −1.312 | -.029 | .811 | 1.233 | ||||||||
Total variance explained (R2) | 8.2% | 9.7% | 19.4% | 24.6% | 30.0% | ||||||||||
Goodness-of-fit | |||||||||||||||
F | 13.107 | 10.467 | 11.664 | 13.503 | 13.646 | ||||||||||
P | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 |