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The authors declare that they have no competing interests.
JC, primary researcher, screened titles and abstracts, reviewed included papers, conducted additional searches, developed the conceptual framework, analysed the data, and drafted the manuscript. JB, principal investigator, reviewed included papers, reviewed and advised on the conceptual framework. AOC, co-investigator, reviewed included papers, reviewed and advised on the conceptual framework. MLJ, co-investigator, screened titles and abstracts, reviewed included papers, and developed the conceptual framework. SP developed the search strategy, conducted the electronic database searches and drafted the related section of the manuscript. All authors reviewed and revised drafts and approved the final manuscript.
To identify the domains of quality of life important to people with mental health problems.
A systematic review of qualitative research undertaken with people with mental health problems using a framework synthesis.
We identified six domains: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; and hope and hopelessness. Firstly, symptoms or ‘ill-being’ were an intrinsic aspect of quality of life for people with severe mental health problems. Additionally, a good quality of life was characterised by the feeling of being in control (particularly of distressing symptoms), autonomy and choice; a positive self-image; a sense of belonging; engagement in meaningful and enjoyable activities; and feelings of hope and optimism. Conversely, a poor quality life, often experienced by those with severe mental health difficulties, was characterized by feelings of distress; lack of control, choice and autonomy; low self-esteem and confidence; a sense of not being part of society; diminished activity; and a sense of hopelessness and demoralization.
Generic measures fail to address the complexity of quality of life measurement and the broad range of domains important to people with mental health problems.