PURPOSE: Increasing the patient-centeredness of care can enhance quality of care and improve outcomes for persons with chronic illness. As a first step in improving the quality and client-centeredness of care for persons with chronic mental illness, this study elicited individual quality of life (QOL) indicators, measured QOL on those indicators, and compared the indicators to clinician-recorded treatment goals.

METHODS: 22 persons with mental illness residing in community Residential Care Facilities (RCFs) completed the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), generated 5 individual QOL indicators, rated the importance of each indicator, and rated their associated QOL. Investigators identified 9 domains of indicators in participants' responses: Interpersonal Relationships, Activities/Hobbies, Basic Living Needs, Money/Finances, Health, Spirituality/Religion, Identity/Values, Services/Treatment and Work/School. Treatment goals from participants' clinical records were categorized into the same domains and compared to participants' QOL indicators.

RESULTS: Participants' RCF tenure averaged 7 years. Their mean age was 49. 64% were male. 55% were white, 27% Asian-American and 14% African-American. 72 unique QOL indicators were elicited from participants. The most frequently elicited domains were Interpersonal Relationships (22%) and Activities/Hobbies (17%). The least frequently elicited domains were Services/Treatment (6%) and Work/School (6%). Domains were rated similarly in importance. On a 100-point scale, where 100 reflects the best possible QOL, mean QOL was highest for Identity/Values (82) and Health (75) and lowest for Interpersonal Relationships (53) and Spirituality/Religion (48). Participants' mean ratings of their overall QOL was 71. The domains most frequently observed in clinician-recorded treatment goals were Services/Treatment (28%) and Interpersonal Relationships (17%); the least frequent were Money/Finances (9%) and Activities/Hobbies (7%).

CONCLUSIONS: Participants rated their QOL relatively positively, but gave low ratings to their QOL in Interpersonal Relationships, the most frequently elicited domain. Participants' QOL indicators were not well represented in clinician-recorded treatment goals. Most notably, clinician-recorded goals emphasized the process of mental health treatment, while residents rarely identified treatment as a QOL indicator. Participants frequently identified activities and hobbies as a QOL indicator, but that domain was not common in clinician-recorded goals. Findings suggest that identifying client-specific QOL indicators and incorporating them in treatment planning could improve the quality and client-centeredness of care for persons with chronic mental illness.