Quality of life in schizophrenia: a grounded theory approach

Research into health related quality of life (HRQoL) in schizophrenia has predominantly been conducted using lengthy interviewer administered questionnaires, many of which have not been validated for use with schizophrenic samples. The present study seeks to address the dearth of qualitative research by conducting a small-scale qualitative exploration of the impact of schizophrenia on HRQoL.

The study was conducted using the qualitative approach of grounded theory. Six individuals with a diagnosis of schizophrenia participated (3 men, 3 women). Mean age of participants was 33.3 years (range 20-55), mean length of illness was 12 years (range 2-38 years) and average length of interviews was 47 minutes (range 20-70).

Ten HRQoL domains were identified as being important: (1) barriers placed on relationships; (2) reduced control of behaviours and actions; (3) loss of opportunity to fulfil occupational roles; (4) financial constraints on activities and plans; (5) subjective experience of psychotic symptoms; (6) side effects and attitudes to medication; (7) psychological responses to living with schizophrenia; (8) labelling and attitudes from others; (9) concerns for the future and (10) positive outcomes from experiences.

Domains identified by participants encompassed a wide range of factors that may be expected to contribute generally to engaging in a positive quality of life. Participants identified that it was the loss of these things as a direct consequence of having schizophrenia that influenced their HRQoL. It would appear that in the main, factors that are secondary to the experience of schizophrenia are of most importance to participants. Suggestions are also made in the discussion for future research.