Quality of life: a basis for clinical decision-making in community psychiatric care

This descriptive study used grounded theory methodology to illuminate how the concept of quality of life influences the practice of community psychiatric nurses caring for individuals with serious mental illnesses. In-depth interviews captured the practice wisdom of expert nurses. Data were verified through focus groups, member checks and peer debriefing. The constant comparative method was used to categorize data and identify key themes and concepts. Informants regarded the concept of quality of life as central to nursing practice. They cited examples of how it serves as a goal and philosophy of care, a basis for forming relationships, and a lens through which the nursing role becomes clearer. Quality of life is acknowledged to be a subjective concept. It is assessed in light of the individual's hopes, dreams and values, and within the context of his or her whole life. A quality of life focus is supported by the philosophies of holism and empowerment. Nurses promote quality of life through symptom management, educating and advocating for clients. Minimizing barriers to quality of life and helping the individual to have a broader vision of what his or her life could be, are also central to the psychiatric nursing role.