The role of life context and self-defined well-being in the outcomes that matter to people with a diagnosis of schizophrenia

Health Expect. 2017 Oct;20(5):1061-1072. doi: 10.1111/hex.12548. Epub 2017 Apr 3.

Abstract

Objective: Conduct a deep exploration of the outcomes that matter to people with a diagnosis of schizophrenia and understand from their perspective how these outcomes can be achieved.

Sample and methods: In-depth qualitative interviews were conducted with 22 people with a diagnosis of schizophrenia. Interviews were analysed using thematic frameworks, and a realist informed theories of change approach.

Results: Our study revealed the potential causal relationships between the context of a person's life, short-term goals and long-term outcomes. We provide a nuanced and detailed exploration of outcomes that matter for people with schizophrenia in relation to self-defined well-being. Achieving life milestones, feeling safe and outcomes related to improved physical health along with employment, a positive sense of self and psychosocial outcomes, were highly valued. For short- and long-term outcomes to be achieved, individuals required medication with minimal side-effects, cognitive behavioural therapy, family/social support and meaningful activities in their lives. Well-being was influenced by life context and short- and long-term outcomes, but in a circular nature also framed what short-term goals could be achieved.

Conclusions: Working with people with a diagnosis of schizophrenia to identify and achieve better outcomes will necessitate a person-centred approach. This will require an appreciation of the relationship between the statutory and non-statutory resources that are available and a consideration of an individual's current well-being status. This approach acknowledges personal strengths and encourages ownership of goals and supports self-management.

Keywords: Schizophrenia; goals; patient centred outcomes research; qualitative research.

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects
  • Cognition
  • Cognitive Behavioral Therapy / methods
  • Female
  • Goals
  • Health Knowledge, Attitudes, Practice
  • Health Status*
  • Humans
  • Interpersonal Relations
  • Interviews as Topic
  • Male
  • Mental Health*
  • Middle Aged
  • Patient Reported Outcome Measures*
  • Qualitative Research
  • Schizophrenia / therapy*
  • Schizophrenic Psychology*
  • Self Concept
  • Social Support

Substances

  • Antipsychotic Agents