Investigating Health Related Quality of Life in People with Schizophrenia

Abstract

Schizophrenia is a serious mental illness that significantly lessens health-related quality of life (HRQoL). A better understanding of HRQoL is needed to inform holistic and patient-centered treatments for schizophrenia. The purpose of this dissertation is to conduct an in-depth exploration of HRQoL in people with schizophrenia. The dissertation includes three components. The first component is an integrative literature review aimed at identifying factors associated with physical quality of life (QoL) in people with schizophrenia. The review reveals that symptoms of schizophrenia, depression, obesity or body mass index, and physical activity are associated with physical QoL in this population. The second and third components are based on illness narratives of 20 people with schizophrenia who had participated in a larger study of individuals diagnosed with serious mental illness. The second component of the dissertation is a qualitative descriptive study conducted to describe common HRQoL concerns in people with schizophrenia. The results indicate that these concerns were related to social relationships, psychiatric symptoms, psychiatric care, and employment. The third component of the dissertation is a parallel convergent mixed-methods study conducted to explore whether computerized lexical analysis (CLA) of illness narratives of people with schizophrenia can reveal their HRQoL concerns. CLA is an automatized process that counts words in text data and sorts them into pre-defined word categories. The results provide preliminary support for the potential use of CLA to efficiently assess HRQoL in people with schizophrenia as the CLA identified some of the HRQoL concerns that had been identified in the prior qualitative descriptive study. The results of the three studies reveal the complexity of the phenomenon of HRQoL in people with schizophrenia and can inform the development of strategies to identify and promote HRQoL in this population.