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Application and Results of the Manchester Short Assessment of Quality of Life (Mansa)

SAGE Publications Inc
International Journal of Social Psychiatry
Authors:
Stefan Priebe at Queen Mary University of London
Stefan Priebe
Peter J Huxley at Bangor University
Peter J Huxley
S. Knight
S. Knight
S. Knight
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Sherrill Evans at Swansea University
Sherrill Evans
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Abstract

Background Based on experiences and empirical evidence gained in studies using the Lancashire Quality of Life Profile (LQLP), the Manchester Short Assessment of Quality of Life (MANSA) has been developed as a condensed and slightly modified instrument for assessing quality of life. Its properties have been tested in a sample of community care patients. Method Fifty-five randomly selected patients on the Care Programme Approach were interviewed using the LQLP, the MANSA and the Brief Psychiatric Rating Scale. Results Correlations between subjective quality of life scores on MANSA and LQLP were all 0.83 or higher (0.94 for the satisfaction mean score). Cronbach's alpha for satisfaction ratings was 0.74, and association with psychopathology was in line with results for LQLP as reported in the literature. Conclusions The MANSA is a brief instrument for assessing quality of life focusing on satisfaction with life as a whole and with life domains. Its psychometric properties appear satisfactory.
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7-
APPLICATION
AND
RESULTS
OF
THE
MANCHESTER
SHORT
ASSESSMENT
OF
QUALITY
OF
LIFE
(MANSA)
S.
PRIEBE,
P.
HUXLEY,
S.
KNIGHT
&
S.
EVANS
SUMMARY
Background
Based
on
experiences
and
empirical
evidence
gained
in
studies
using
the
Lancashire
Quality
of
Life
Profile
(LQLP),
the
Manchester
Short
Assessment
of
Quality
of
Life
(MANSA)
has
been
developed
as
a
condensed
and
slightly
modified
instrument
for
assessing
quality
of
life.
Its
properties
have
been
tested
in
a
sample
of
community
care
patients.
Method
Fifty-five
randomly
selected
patients
on
the
Care
Programme
Approach
were
interviewed
using
the
LQLP,
the
MANSA
and
the
Brief
Psychiatric
Rating
Scale.
Results
Correlations
between
subjective
quality
of
life
scores
on
MANSA
and
LQLP
were
all
0.83
or
higher
(0.94
for
the
satisfaction
mean
score).
Cronbach’s
alpha
for
satisfaction
ratings
was
0.74,
and
association
with
psychopathology
was
in
line
with
results
for
LQLP
as
reported
in
the
literature.
Conclusions
The
MANSA
is
a
brief
instrument
for
assessing
quality
of
life
focusing
on
satisfaction
with
life
as
a
whole
and
with
life
domains.
Its
psychometric
properties
appear
satisfactory.
INTRODUCTION
In
the
last
10
years,
quality
of
life
in
people with
mental
illness
has
become
a
popular
construct
and
an
important outcome
criterion
in
evaluative
research.
Various
instruments
have
been
developed
for
measuring
it.
In
most
of
them,
satisfaction
with
life
in
general
and
with
life
domains
plays
a
central
role
and
is
assessed
on
Likert
type self
rating
scales
(Orley
et al.
1998).
Based
on
Lehman’s
original
work
in
the
US,
Oliver
et
al.
(1991/92)
established
the
Lancashire
Quality of
Life
Profile
(LQLP) which
has
been
widely used
in
Europe
(Priebe
et
al.
1995;
Oliver
et
czl.
1997).
Several
research
centres
now
have
huge
data
bases,
e.g.
in
Manchester,
Berlin, London
and
Verona.
In
samples
with
severe
mental
illness,
subjective
quality
of
life
ratings
obtained
by the
LQLP
have been
shown
to
be
sufficiently
reliable
(Kaiser
&
Priebe,
1998),
to
have
a
discriminative
ability
between
different
samples
and
treatment
settings
eft
al.
1997;
Kaiser
et
al.
1997;
Priebe
al.
1998a,b), and
to
be
sensitive
to
change (Holloway
&
Carson,
1998;
Hoffmann
et
al.
1998;
Priebe et
al.
in
press
a).
Yet,
research
has
also
revealed
some
shortcomings
of
the
LQLP:
Overall,
it
takes
approxi-
mately 30
minutes
to
administer
what
is
too
long for
some
purposes;
some
incorporated
parts
such
as
the
affect-balance-scale
assess
mainly
psychopathology
which
should
be
assessed
by
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8
specific
scales;
most
importantly,
there
are
many
items
in
the
LQLP
that
have
not
been
found
to
be
relevant
for
discriminating
between
samples
or
for
demonstrating
change.
Regarding
the
objective
variables,
there
are
various
items
with
insufficient
variance.
In
addition,
there
is
no
clear
way
to
sum
up
single
item
scores
for
each
domain
nor
has
an
overall
score
been
established.
Shortcomings
of
the
subjective
variables
in
the
LQLP
relate
to
inconsistency
in
the
language
used
i.e.
&dquo;how
do
you
feel
about ...?&dquo;
versus
’how
satisfied
are
you
with ...?&dquo;,
that
the
question
about
satisfaction
with
family
is
equivocal
because
it
is
unclear
which
part
of
the
family
is
referred
to
while
some
life
domains
are
assessed
by
one
question
and
others
by
more
than
one
question
which
complicates
statistical
analysis
and
interpretation
of
findings.
Finally,
it
was
widely
felt
that
a
question
on
the
domain
of
sexual
life
is
missing.
Based
on
experiences
gained
in
several
thousand
quality
of
life
interviews
and
on
the
results
of
systematic
studies,
we
therefore
developed
the
Manchester
Short
Assessment
of
Quality
of
Life
(MANSA),
a
brief
and
modified
version
of
the
LQLP
that
has
been
intended
to
take
into
account
all
of
the
above
mentioned
shortcomings
(see
Appendix
and
Priebe
et
al.
in
press
b).
Objective
questions
that
in
previous
studies
have
neither
discriminated
between
settings
or
groups
nor
have
been
sensitive
to
change,
were
eliminated.
Subjective
questions
were
reduced
to
one
item
per
life
domain
and
put
in
a
consistent
language
rating
patients’
satisfaction.
The
MANSA
consists
of
three
sections:
(1)
Personal
details
that
are
supposed
to
be
consistent
over
time
(date
of
birth,
gender,
ethnic
origin,
and
diagnosis).
(2)
Personal
details
that
may
potentially
vary
over
time
and
have
to
be
re-documented
if
change
has
occurred
(education;
employment
status
including
kind
of
occupation
and
working
hours
per
week;
monthly
income;
state
benefits;
living
situation
including
number
of
children,
people
the
patient
lives
with,
and
type
of
residence).
(3)
Only
16
questions
are
to
be
asked
every
time
the
instrument
is
applied.
Four
of
these
questions
are
termed
objective
and
to
be
answered
with
yes
or no.
Twelve
questions
are
strictly
subjective.
The
objective
items
assess
the
existence
of
a
&dquo;close
friend&dquo;,
number
of
contacts
with
friends
per
week,
accusation
of
a
crime
and
victimisation
of
physical
violence.
The
subjective
questions
obtain
satisfaction
with
life
as
a
whole,
job (or
sheltered
employ-
ment,
or
training/education,
or
unemployment/retirement),
financial
situation,
number
and
quality of
friendships,
leisure
activities,
accommodation,
personal safety,
people
that
the
patient lives
with
(or
living
alone),
sex
life,
relationship
with
family,
physical
health,
and
mental
health.
A
manual
outlines
explanation
of
questions and
their
operationalisation
(also
see
Priebe
et
czl.
in
press
b).
Like
in
the
LQLP,
satisfaction
is
rated
on
7-point
rating
scales
(
=
negative
extreme,
7 =
positive
extreme).
In
a
sample of
community
care
patients
we
applied
the
MANSA
and
examined
correlations
with
LQLP
scores
and
with
psychopathology.
METHOD
Data
was
collected
within
a
review
of
the
Care
Programme
Approach
and
care
management
by
the
School
of
Psychiatry
at
the
University
of Manchester.
Local
authorities
were
asked
to
select
at
random
approximately
20
patients
aged
between
18
and
65
who
are
on
the
Care
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9
Programme
Approach
and
receiving
services
under
the
Community
and
Mental
Health
legislation.
For
the
purpose
of
this
study,
quality
of
life
was
assessed
in
all
patients
who
were
interviewed
in
three
localities,
i.e.
two
inner
city
and
one
metropolitan
borough
using
the
LQLP
as
well
as
the
MANSA.
Psychopathology
was
assessed
on
the
24
item
version
of
the
Brief
Psychiatric
Rating
Scale
(BPRS;
Ventura et
al.
1993).
All
interviews
were
done
by
one
experienced
researcher
who
was
not
involved
in
the
patients’
care.
RESULTS
Fifty-five
patients
(19
women,
36
men)
were
interviewed.
Mean
(±
s.d.)
age
of
patients
was
40.9
±
14.9
years.
The
diagnosis
was
schizophrenia
in
38
patients,
bipolar-affective
psychosis
in 8
patients,
first
or
recurrent
episode
of
depression
in
6
patients,
obsessive
compulsive
disorder
in
2
patients,
and
anxiety
disorder
in
1
patient.
Mean
BPRS
total
score
was
33.4
±
7.4.
Twenty
patients
were
from
ethnic
minorities.
One
patient
was
employed,
47
unemployed
and
7
retired.
Administration
of
the
MANSA
took
between
3
and
5
minutes.
In the
MANSA,
33
patients
said
they
did
not
have
’a
close
friend&dquo;,
and
39
had
not
visited
or
been
visited
by
a
friend
within
the
last
week.
Two
patients
each
reported
having
been
accused
of
a
crime
or
having
been
victims
of
physical
violence
within
the
last
year.
Means
of
single
satisfaction
scores
varied
between
4.09
± 1.17
(life
as
a
whole
today)
and
5.18
z
0.82
(family).
The
mean
score
of
all
satisfaction
items
was
4.56
±
0.51.
Table
1
shows
Pearson’s
correlations
between
satisfaction
ratings
in
the
MANSA
and
the
LQLP.
All
coefficients
are
above
0.82,
including
those
regarding
domains
that
are
assessed
by
two
or
more
items
in
the
LQLP
and
by
only
one
in
the
MANSA.
,
Correlations
of
MANSA
subjective
quality
of
life
mean
score
with
BPRS
total
score
was
r
=
-0.49
(p
<
0.001)
and
with
the
BPRS
sub
score
anxiety/depression
r
=
-0.42
(p
<
0.01).
Cronbach’s
alpha
for
the
satisfaction
ratings
in
MANSA
was
0.74.
Table
1
Correlations
between
satisfaction
ratings
on
LQLP
and
on
MANSA
’mean of
two
items
in
LQLP,
Zmean of
six
items
in
LQLP,
*p
=<
0.001
for
each
correlation
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10
DISCUSSION
The
high
correlations
of
MANSA
and
LQLP
scores
suggest
a
concurrent
validity
for
the
MANSA
in
addition
to
a
face
and
construct
validity.
Internal
consistency
of
satisfaction
ratings
seems
reasonable,
and
associations
with
psychopathology
are
in
line
with
results
for the
LQLP
reported
in
the
literature
(Kaiser
et
at.
1997;
Priebe et
al.
1998a,b).
Thus,
the
MANSA
appears
a
viable
and
valid
instrument
to
obtain
condensed
and
accurate
quality
of
life
data,
and
it
is
brief
enough
to
be
included
in
a
minimum
data
set.
It
should
be
taken
into
account,
however,
that
the
MANSA
shares
conceptual
and
methodological
limitations
with
the
LQLP
and
other
similar
instruments.
Although
it
assesses
some
objective
indicators
of
quality
of
life,
its
focus
is
clearly
on
subjective
ratings.
The
underlying
concept
of
quality
of
life
is
a
generic
and
not
a
disease
specific
one.
All
questions
allow
comparisons
with
the
general
population,
and
are
not
specifically
illness
or
symptom
related.
If
in
research
or
routine
evaluation
the
interest
is
in
more
specific
symptom-related
measures,
other
scales
should
be
used
in
addition
to
or
instead
of
the
MANSA.
The
same
holds
true
if
other
related
but
nevertheless
distinct
constructs
such
as
social
functioning
are
to
be
assessed.
In
evaluative
studies,
psychopathology
should
be
assessed
and
controlled
for
as
an
influential
factor.
Mean
satisfaction
scores
may
serve
as
a
non-specific
outcome
criterion.
Satisfaction
ratings
with
single
life
domains
should
be used
for
testing
domain
specific
and
a
priori
stated
hypotheses,
and
for
generating
such
hypotheses
if
mean
scores
reveal
significant
differences.
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1
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Professor
Stefan
Priebe,
Department
of
Psychiatry,
St.
Bartholomew’s
and
the
Royal
London
School
of
Medicine
and
Dentistry,
Queen
Mary
&
Westfield
College,
University
of
London,
UK
Professor
Peter
Huxley,
The
Department
of
Psychiatric
Social
Work,
School
of
Psychiatry
and
Behavioural
Sciences,
University
of
Manchester,
UK
Susan
Knight,
The
Department
of
Psychiatric
Social
Work,
School
of
Psychiatry
and
Behavioural
Sciences,
University
of
Manchester,
UK
Sherrill
Evans,
The
Department
of
Psychiatric
Social
Work,
School
of
Psychiatry
and
Behavioural
Sciences,
University
of
Manchester,
UK
Correspondence
to
Professor
Priebe,
Academic
Unit
for
Social
&
Community
Psychiatry,
East
Ham
Memorial
Hospital,
London,
E7
8QR,
UK
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... A statistical analysis plan for the current analysis was developed before the analysis. We aimed to explore whether having a relapse during follow-up affected 24-month measures of the Social Functioning Scale (SFS), 28 the Manchester Short Assessment of Quality of Life (MANSA), 29 the total score on the Positive and Negative Syndrome Scale (PANSS) (sum of the subscales) 30 and employment status, categorised as being or not being in employment, education or training. ...
The association between relapse and the outcome of schizophrenia and recurrent psychotic disorders
Article
Full-text available
  • Apr 2025
  • BRIT J PSYCHIAT
Background Having a relapse of schizophrenia or recurrent psychosis is feared by patients, can cause social and personal disruption and has been suggested to cause long-term deterioration, possibly because of a toxic biological process. Aims To assess whether relapse affected the social and clinical outcomes of people enrolled in a 24-month randomised controlled trial of antipsychotic medication dose reduction versus maintenance treatment. Methods The trial involved participants with a diagnosis of schizophrenia or recurrent, non-affective psychosis. Relapse was defined as admission to hospital or significant deterioration (assessed by a blinded end-point committee). We analysed the relationship between relapse during the trial and social functioning, quality of life, symptom scores (Positive and Negative Syndrome Scale) and rates of being in employment, education or training at 24-month follow-up. We also analysed changes in these measures during the trial among those who relapsed and those who did not. Sensitivity analyses were conducted examining the effects of ‘severe’ relapse (i.e. admission to hospital). Results During the course of the trial, 82 out of 253 participants relapsed. There was no evidence for a difference between those who relapsed and those who did not on changes in social functioning, quality of life, symptom scores or overall employment rates between baseline and 24-month follow-up. Those who relapsed showed no change in their social functioning or quality of life, and a slight improvement in symptoms compared to baseline. They were more likely than those who did not relapse to have had a change in their employment status (mostly moving out of employment, education or training), although numbers changing status were small. Sensitivity analyses showed the same results for those who experienced a ‘severe’ relapse. Conclusions Our data provide little evidence that relapse has a detrimental effect in the long term in people with schizophrenia and recurrent psychosis.
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... Uno de ellos (6) utilizó el Inventario Breve de Síntomas (BSI) (Derogatis & Melisaratos, 1983), además midió el tiempo de participación en el SE en meses, como una variable contextual, así como resultados laborales utilizando una medida de resultado discreta y dicotómica. El otro (7), sin embargo, incluyó herramientas como el OQ, Índice de Participación del Inventario de Adaptabilidad de Mayo-Portaland (MPAI-4) (Malec & Lezak, 2008), MANSA (Manchester Short Assessment of Quality of Life) (Priebe et al., 1999) y RTI-E (The Routine Task Inventory Expanded) (Katz, 2006) entre otras herramientas. ...
Efectividad del empleo con apoyo en personas con trastorno mental grave
Article
Full-text available
  • Mar 2025
Resumen Introducción Las personas con trastornos mentales graves enfrentan altas tasas de desempleo, lo que ha impulsado intervenciones específicas en el área laboral. El empleo con apoyo, centrado en garantizar empleo competitivo con apoyo continuo, es más efectivo que la rehabilitación vocacional. Objetivo Explorar la eficacia de las intervenciones de terapia ocupacional que se centran en el empleo con apoyo, en la mejora de la inserción laboral de personas con trastorno mental grave. Metodología Se llevó a cabo una Revisión sistemática, siguiendo la declaración PRISMA. La búsqueda se realizó en las bases de datos: PubMed, Web of Science y Scopus, que arrojaron un total de 1.814 registros. Tras aplicar los criterios de inclusión y exclusión, se seleccionaron 7 artículos, publicados hasta abril de de 2024. El riesgo de sesgo se evaluó con las herramientas Review Manager Web y ROBINS-1. El protocolo de revisión se registró en PROSPERO: CRD42024536471. Resultados La muestra total fue de N= 866 (M=123,71, SD= 52,45). El rango de edad de los participantes osciló entre los 38 y 47 años, predominando el género masculino. Se evidenció que las intervenciones de empleo con apoyo, combinadas con intervenciones específicas como la Terapia Cognitivo-Conductual o la Remediación Cognitiva mejoran las tasas de empleo. Conclusión Se requieren estudios con mayor rigor metodológico para confirmar la efectividad de estos programas, que permitan orientar a los profesionales de la terapia ocupacional en la toma de decisiones enfocada a la práctica basada en la evidencia.
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... The Quality of Life Questionnaire (QOL.Q) (Schalock & Keith, 1993) was used in three studies, though the investigators from one study (Nadig et al., 2018) used an abridged version of the instrument that had not previously been validated. The Manchester Short Assessment for Quality of Life (MANSA) (Priebe et al., 1999) was used in two studies by investigators from the same group in Sweden (Sehlin et al., 2020;Wentz et al., 2012), though a question about sex life was removed as participants who could have been as young as age 15 were included in the study. Other instruments used were the EuroQoL-5 dimensions (EQ-5D) (Devlin & Brooks, 2017) and Quality of Life Inventory (QOLI) (Frisch et al., 2005). ...
Psychosocial Interventions and Quality of Life in Autistic Young Adults: A Systematic Review
Article
Full-text available
  • Mar 2025
Autistic young adults often experience challenges in the transition to adulthood, including loss of childhood services and difficulties managing the complexities of adult life. Additionally, quality of life (QoL) is generally lower in autistic adults. However, it is currently unclear what interventions improve QoL in autistic young adults. This systematic review evaluates the effect of psychosocial interventions on QoL in autistic young adults. Only four studies found interventions (two vocational interventions, one transition intervention, and one psychotherapy) that improved QoL. However, study quality was generally limited, and currently, no conclusions can be made about specific interventions that improve QoL in autistic young adults. There is clearly a pressing need for future research in this area.
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... The MANSA consists of 16 items, with participants rating their satisfaction across 12 life domains on a Likert scale ranging from 1 (totally dissatisfied) to 7 (totally satisfied). 19 Secondary outcome measures included depression and anxiety symptomology, as well as social outcomes. The Aga Khan University Depression and Anxiety Scale (AKUADS) is a 25-item screening tool designed and developed locally to assess symptoms of depression and anxiety in Pakistani populations. ...
Feasibility and acceptability of a solution-focused approach to strengthen lay counselling for common mental disorders (DIALOG+) in Pakistan: mixed methods study
Article
Full-text available
  • Mar 2025
Background Depression and anxiety are widespread globally, with significant treatment gaps in low-resource settings. In Pakistan, where prevalence is high and specialists are scarce, brief psychological interventions by trained lay counsellors show promise. DIALOG+ is a novel technology-assisted, solution-focused approach for leveraging resource-oriented approaches in routine community mental health treatment. Aims To explore the feasibility and acceptability of using DIALOG+ for community-based treatment of common mental disorders delivered by non-specialist lay counsellors in a low-resource setting (trial registration: ISRCTN14528579). Method An open, uncontrolled trial in community settings in Karachi, Pakistan, was conducted with 40 patients with depression and anxiety visiting two primary care clinics between June 2019 and February 2020. Patients were enrolled for monthly sessions delivered over 6 months by lay counsellors. Subjective quality of life along with symptoms of depression and anxiety were measured at baseline and endline (following the 6-month intervention) on the Manchester Short Assessment of Quality of Life (MANSA) and Aga Khan University Anxiety and Depression Scale (AKUADS). Changes in measures were evaluated before and after the intervention using a t -test analysis. Post-intervention, in-depth interviews were held with patients and lay counsellors to gather insights into their experience of the intervention. Results In total, 146 DIALOG+ sessions were conducted with 40 patients. At the 6-month post-intervention assessment, 33 patients showed improved subjective quality of life and reduced self-reported depression and anxiety scores. Patients reported that the intervention helped strengthen the therapeutic relationship with their lay counsellors, helped them track their progress through therapy and enhanced their self-management of negative emotions and behaviours. Conclusions Structured communication can help strengthen lay counsellors’ ability to improve therapeutic outcomes of people with common mental disorders in resource-constrained community settings. Future clinical trials are recommended to further evaluate the long-term impact of the DIALOG+ intervention on mental health outcomes.
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... Satisfaction with vocational status was assessed using a single item on the PROMs that originated from the Manchester Short Assessment of Quality of Life (39): "How satisfied are you with your vocational status?" The item was scored on a five-point Likert-type scale from 1 (not satisfied at all) to 5 (very much satisfied). ...
Predicting satisfaction with vocational status among people with serious mental illness in vocational services: the role of perceived skills and support
Article
Full-text available
  • Feb 2025
Background This study aimed to explore the role of perceived skills and support in satisfaction with vocational status to better address the vocational needs and recovery goals of individuals with serious mental illness (SMI). It focuses on three service types: individual placement and support (IPS), sheltered workshops, and vocational support centers. Method The study is a cross-sectional analysis of the nationwide Israeli PR-PROM project data. A sample of 2,968 participants diagnosed with SMI and their service providers self-reported their perceived skills, support, and satisfaction with vocational status. Results We found perceived skills and support to be primary predictors of vocational satisfaction across all groups. There were significant differences in satisfaction with vocational status among the three service types: IPS users reported higher satisfaction than sheltered workshop and vocational support center users. The service-provider evaluations reflected similar trends, with higher satisfaction ratings for more integrative services. Additionally, discrepancies were observed between participant and provider satisfaction ratings, varying by vocational service type. Discussion The study highlights the importance of perceived skills and support in enhancing satisfaction with vocational status for people with SMI regardless of the vocational service type. Whereas objective factors like employment status and salary contribute to vocational rehabilitation and quality of life, subjective perceptions of skills and support play a significant role in satisfaction with vocational status. The results suggest that vocational rehabilitation services should monitor consumers’ perceptions of skills and support to improve their vocational satisfaction, which can promote personal well-being and social integration.
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Precision Estimation of Rice Nitrogen Fertilizer Topdressing According to the Nitrogen Nutrition Index Using UAV Multi-Spectral Remote Sensing: A Case Study in Southwest China
Article
Full-text available
  • Apr 2025
The precision estimation of N fertilizer application according to the nitrogen nutrition index (NNI) using unmanned aerial vehicle (UAV) multi-spectral measurements remains to be tested in different rice cultivars and planting areas. Therefore, two field experiments were conducted using varied N rates (0, 60, 120, 160, and 200 kg N ha⁻¹) on two rice cultivars, Yunjing37 (YJ-37, Oryza sativa subsp. Japonica Kato., the Institute of Food Crops at the Yunnan Academy of Agricultural Sciences, Kunming, China) and Jiyou6135 (JY-6135, Oryza sativa subsp. indica Kato., Hunan Longping Gaoke Nongping seed industry Co., Ltd., Changsha, China), in southwest China. The rice canopy spectral images were measured by the UAV’s multi-spectral remote sensing at three growing stages. The NNI was calculated based on the critical N (Nc) dilution curve. A random forest model integrating multi-vegetation indices established the NNI inversion, facilitating precise N topdressing through a linear platform of NNI-Relative Yield and the remote sensing NNI-based N balance approaches. The Nc dilution curve calibrated with aboveground dry matter demonstrated the highest accuracy (R² = 0.93, 0.97 for shoot components in cultivars YJ-37 and JY-6135), outperforming stem (R² = 0.70, 0.76) and leaf (R² = 0.80, 0.89) based models. The RF combined with six vegetation index combinations was found to be the best predictor of NNI at each growing period (YJ-37: R² is 0.70–0.97, RMSE is 0.02~0.04; JY-6135: R² is 0.71–0.92, RMSE is 0.04~0.05). The RF surpassed BPNN/PLSR by 6.14–10.10% in R² and 13.71–33.65% in error reduction across the critical rice growth stages. The topdressing amounts of YJ-37 and JY-6135 were 111–124 kg ha⁻¹ and 80–133 kg ha⁻¹, with low errors of 2.50~8.73 kg ha⁻¹ for YJ-37 and 2.52~5.53 kg ha⁻¹ for JY-6135 in the jointing (JT) and heading (HD) stages. These results are promising for the precise topdressing of rice using a remote sensing NNI-based N balance method. The combination of UAV multi-spectral imaging with the NNI-nitrogen balance method was tested for the first time in southwest China, demonstrating its feasibility and offering a regional approach for precise rice topdressing.
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Outcomes on health, recovery and activity level for mental health service users attending a novel nature-based intervention: a prospective study
Article
  • Mar 2025
  • NORD J PSYCHIAT
Purpose: Mental illness due to longstanding stress is increasing. It has been shown that service users with mental illness may benefit from nature-based interventions (NBI), including equine-assisted therapy, to support their health, recovery, and activity level of daily life. However, the evidence base to support this is still weak. The aim was thus to evaluate and provide knowledge of the possible effects on health, recovery and activity level from participating in a novel nature-based intervention among mental health service users with mental illness due to longstanding stress. Materials and methods: Forty participants took part in the study, which had a single group pretest-post-test design. The program was delivered in groups at a farm-based rehabilitation centre in a southern part of Sweden. It consisted of 24 weeks in two 12-week phases. Data were collected using well-tested questionnaires reflecting health, clinical and personal recovery, and activity level. Results: The analysis showed an improvement with medium to large effect sizes over time according to outcomes on aspects of health, recovery and activity level with exception for self-mastery. All outcomes were statistically significant with p-values ≤.005. Conclusions: This novel nature-based program has the potential to be a recovery-oriented intervention that could enhance health, both clinical and personal recovery, as well as activity level for mental health service users. The intervention could thus also be a beneficial complement to current psychiatric care services. Keywords: Occupational therapy; equine-assisted therapy; nature- and animal-assisted interventions; psychiatry.
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Quality of Life in Mental Disorders
Chapter
  • Mar 2025
In the field of mental health, assessing quality of life may impact clinical care and policy decision-making as it indicates treatment efficacy. Despite the wide range of definitions of quality of life concept within the research field, quality of life instruments may be useful in quantifying and reducing the societal burden of mental disorders and planning clinical care at the individual level. The current chapter presents the most used theoretical frameworks and quality of life measures in mental health research. In addition, the findings of recent systematic reviews and meta-analyses on quality of life levels and effects of treatments on quality of life in adult patients are synthesized for several common and severe mental disorders. Research has shown that people with depression, anxiety disorders, posttraumatic stress disorder, and psychosis experience significantly lower quality of life than healthy controls, and have deficits in various quality of life domains. The results of systematic reviews and meta-analyses provide consistent support for the beneficial effects of psychological interventions on improving quality of life in individuals suffering from anxiety and depression. A manualized emotion regulation-based transdiagnostic intervention improved quality of life and functional impairment in individuals with internalizing disorders at post-intervention and six-month follow-up. In people with schizophrenia, more effort is needed to optimize psychological interventions in order to improve their quality of life. Future randomized clinical trials might include more quality of life measures and combine mindfulness-based stress reduction with physical exercise and other promising modern interventions to enhance their efficacy in improving patients’ quality of life.
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Heterogeneity in Item Content of Quality of Life Assessments Used in Depression Psychotherapy Research
Article
Quality of life (QOL) broadly encompasses constructs including health, well-being, life satisfaction, and psychosocial functioning. Depression, a major cause of global disability, is linked to lower QOL. Despite the rise of measurement-based care and patient-reported outcomes, there is no consensus on QOL definitions or models, resulting in varied assessments. This study aims to describe the item content overlap among commonly used QOL measures in depression research. We analyzed 10 QOL measures from a meta-analysis, calculating Jaccard indices to quantify overlap, and used two coding approaches: one for similarly worded items and another for exact word matches. We also categorized items into broader themes. At the most, average Jaccard similarity was M = 0.14 (SD = 0.12), indicating significant heterogeneity among QOL measures in depression. This suggests that QOL outcomes may not be reproducible across different scales. Future research should examine the relationships between the content assessed by various QOL measures.
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Zur Messung von Veränderungen der subjektiven Lebensqualität bei chronisch schizophrenen Patienten
Article
Full-text available
  • Mar 1998
Die subjektive Lebensqualität einer Gruppe chronisch schizophrener, ambulant behandelter Patienten wurde mit dem Berliner Lebensqualitätsprofil im Abstand von 11/2 Jahren (n=50) und von 4–6 Wochen (n=47) untersucht. Systematische therapeutische Interventionen fanden nicht statt. Stabilität und Konstanz der Werte entsprachen für den längeren Zeitraum Ergebnissen aus der Allgemeinbevölkerung. Die statistischen Kennwerte des kürzeren Intervalls belegten gute methodische Voraussetzungen für Veränderungsmessungen für den Summenscore des Profils und die allgemeine Lebenszufriedenheit. Im Gegensatz zu Querschnittsbefunden und dem längeren Bebachtungszeitraum finden sich für das kürzere Intervall keine bedeutsamen gemeinsamen Veränderungen in der psychopathologischen Bewertung und subjektiven Lebensqualität. Subjective quality of life in a group of chronic schizophrenia outpatients was assessed within 11/2 years (n=50) and 4–6 weeks (n=47) using the Berliner Lebensqualitätsprofil (German version of the Lancashire Quality of Life Profile). There had been no systematic therapeutic interventions meanwhile. Stability and constancy for the longer interval was similar to results in the general population. The statistics for the shorter interval justify in particular use of the profile’s total score and general well-being for the measurement of change. In contrast to cross-sectional data and the longer observation period, no significant common variation between psychopathological symptoms and subjective quality of life could be found for the shorter period.
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Intensive case management for the severely mentally ill - Controlled trial
Article
Full-text available
  • Jan 1998
The aim was to compare the efficacy of intensive clinical case management (ICM) with standard community care in the management of 'hard to treat' patients with a severe mental illness. A randomised controlled trial was carried out in East Lambeth, a deprived area of inner London. Seventy people with psychosis designated as 'hard to treat' by referring teams were included; 35 were randomised to ICM (case load eight patients per worker), and 35 to standard care, which offered follow-up by a community psychiatric nursing service (30 patients per worker). Outcome measures were admissions and hospital bed utilisation; contact with services; symptomatology; social behaviour; social functioning; quality of life; patients' satisfaction with care at 9 and 18 months. There were no differences in patients' symptoms, social behaviour or social functioning. Quality of life was significantly improved in patients receiving ICM at 9 months. Satisfaction with care was significantly greater among case-managed patients. All ICM patients remained in contact with services throughout the study, while six control patients were refusing all contact with services at 18 months. ICM failed to improve the clinical outcome of 'hard to treat' patients. The service was successful in maintaining contact with patients, was greatly appreciated and had a positive effect on their perceived quality of life.
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Measuring the quality of life of severely ill people using the Lancashire Quality of Life Profile
Article
Full-text available
  • Mar 1997
Quality of life (QOL) has become an important outcome measure for many disorders, including mental illness. The Lancashire Quality of Life Profile (LQOLP) was developed for use in operational contexts, and has been translated into several languages. It is in use in several European and North American community psychiatric services. The present paper addresses the questions: how easy is it to use?; how reliable is it?; do the results of the LQOLP vary by setting in a meaningful way?; how do the results co-vary with measures of clinical symptoms and social functioning?; how well does it measure change?; is it clinically useful? While most of the answers to these questions are favourable, there is a need for further research and development of the profile, in particular with reference to the consequences of the use of the profile as a routine monitoring instrument and the most appropriate form of statistical analysis in longitudinal data-sets.
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The Social Care Directive: development of a quality of life profile for use in community services for the mentally ill
Article
  • Jan 1970
Reports on the development of the Lancashire Quality of Life Profile by G. W. Torrance (1987) for evaluating services to the chronically mentally ill. The term "quality of life" is defined and its components enumerated. The process of questionnaire piloting is recounted, and the results of reliability and validity testing procedures are presented and discussed. The profile was found to be reliable and valid to acceptable levels, easy to administer, and well received by clients. However, problems have been encountered in worker compliance with routine evaluation within service settings that can affect implementation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Profiles of subjective quality of life in schizophrenic in- and out-patient samples
Article
  • Mar 1997
  • PSYCHIAT RES
For the use of subjective quality of life as an evaluation criterion, it should be known if measures are reliable, to what extent they are influenced by other variables and whether differences and similarities can be detected across treatment situations. Quality of life profiles (Berliner Lebensqualitätsprofil/Lancashire Quality of Life Profile) of 440 schizophrenic patients (from Berlin, Germany and from Wales, UK) were examined. Reliabilities differed between life domains and groups. The influence of other variables was moderate and varied between the groups. Several significant differences between subsamples could be shown between in-patients with a shorter present stay and out-patients. In addition, interesting similarities in profile patterns between in-patients with a longer stay (≥ 2 years) and out-patients can be found. Being admitted to a psychiatric hospital seems to have an influence on the level and structure of subjective quality of life for some time. Being in a psychiatric hospital for a longer time seems to coincide with a stabilization of level and structure of subjective quality of life. Future reports on subjective quality of life should include diagnostically homogeneous sampling and control the correlation with psychopathology. Further research is needed to clarify the impact of other variables (e.g. length of stay, cognitive variables, treatment features) on patients' satisfaction in different settings.
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Subjective criteria for evaluation of psychiatric care - Methods for assessment in research and routine care
Article
  • Aug 1995
Evaluation of psychiatric care is an important task in research and in routine conditions. It requires definition of criteria. Subjective criteria are, for different reasons, of increasing interest. Subjective quality of life, subjective needs for help and support and patients' assessment of psychiatric treatment are regarded as particularly relevant criteria. We present and briefly discuss instruments for assessment of these criteria, that are new at least in the German language. Results of a first cross-sectional study in a community care setting are reported. Regarding quality of life healthy groups were examined too. The findings suggest that the instruments are usefully applicable and that they may produce plausible results.
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The quality of life in patients with paranoid schizophrenia in London and Berlin
Article
  • Aug 1997
This study compared the subjective and objective quality of life and needs of patients with paranoid schizophrenia between inner city areas in Berlin (69 patients) and London (75 patients). Quality of life was assessed by means of the Lancashire Quality of Life Profile (German version Berliner Lebensqualitatsprofi), and need was quantified using the Camberwell Assessment of Need (German version Berliner Bedurfnisinventar). The hypotheses tested were that although Berlin patients may rate more highly on objective quality of life measures, the subjective quality of life would be similar as patients would judge their quality of life against their local expectations. The findings supported the first part of the hypothesis as on the objective measures the Berlin group was significantly better off financially and in living conditions, and had significantly fewer material needs. However, despite having more severe psychopathology, the Berlin groups' scores on global subjective quality of life were also higher. On particular life domains, subjective quality of life did not always reflect objective measures and sometimes went in the reverse direction. We concluded that the relationship between subjective and objective quality of life is complex, and great caution must be exercised in making quality of life comparisons between different cultures.
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[How does the quality of life of long-term hospitalized psychiatric patients change after their discharge into the community?]
Article
  • May 1998
In the Berlin deinstitutionalisation study, quality of life in 134 long-term hospitalised psychiatric patients was examined twice: Discharged patients were interviewed again one year after their return to the community, whereas patients who continued to be hospitalised were reinterviewed after 1(1/2)-2 years after the first interview. Quality of life was assessed by the Berlin Quality of Life Profile. Four groups were distinguished in the analysis: 1. patients who continued as inpatients in the same hospital, 2. patients who had been referred to other hospitals, 3. patients who had been discharged after less than one year of continuous inpatient care, and 4. patients discharged after more then one year of hospital care. The four groups differed significantly in several sociodemographic and illness-related variables. Regarding the objective quality of life data, the four groups differed significantly in respect of the spheres leisure, social contacts and safety at follow-up. Discharged patients had more leisure activities, more often a "good friend", and more frequent social contacts within the last week. They had been less often victim to a crime. In a cross-sectional analysis, the four groups showed significant differences regarding subjective quality of life in the spheres accommodation and safety. In a longitudinal analysis, no group showed any significant negative changes. Positive changes were found in the group of patients formerly hospitalised for more than a year most often: satisfaction with leisure activities, with the financial situation, and with accommodation improved significantly during the follow-up period. Results show a marked and significant improvement in the objective and subjective quality of life indicators in formerly long-term hospitalised patients after discharge.
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Do Different Subjective Evaluation Criteria Reflect Distinct Constructs?
Article
  • Aug 1998
Four subjective evaluation criteria--self-rated symptoms, subjective quality of life, self-rated needs, and patients' assessment of treatment--were examined to determine whether they reflect distinct constructs and to what extent they are correlated. The four criteria were assessed in 90 newly admitted schizophrenia patients, 170 long-term-hospitalized schizophrenia patients, 154 patients with alcoholism admitted for the short term, and 68 patients with alcoholism in long-term rehabilitation, using identical instruments. The four criteria show substantial intercorrelations, except for assessment of treatment in the two acute treatment groups. One general factor explains between 43% and 55% of the variance in each group. Factor scores are associated with observer-rated psychopathology and objective data. The four criteria overlap in different patient groups, except in the assessment of treatment in acute groups. The use of more than one subjective criterion should occur only with specific hypotheses. A better theoretical framework is needed to explain the differences between and interrelationships of subjective evaluation criteria.
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