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Erschienen in: Quality of Life Research 6/2018

12.02.2018

The ‘new normal’: relativity of quality of life judgments in individuals with bipolar disorder—a qualitative study

verfasst von: Emma Morton, Erin Michalak, Rachelle Hole, Simone Buzwell, Greg Murray

Erschienen in: Quality of Life Research | Ausgabe 6/2018

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Abstract

Purpose

Quality of life (QoL) is increasingly a target of interventions for bipolar disorders (BD). While the subjective experience of consumers is often elevated as central to the construct of QoL in BD, limited investigation in this area means subjective QoL remains poorly understood. The present qualitative study seeks to address this by investigating how people with BD appraise the quality of their lives in the context of a QoL self-management intervention.

Methods

Semi-structured interviews were conducted with 43 individuals who had participated in a self-management intervention for improving QoL in BD. Individuals were questioned about experiences of the intervention and perceptions of their QoL. Thematic analysis was used to explore participants’ appraisal of their QoL.

Results

An overarching theme concerned the intrinsic relativity of subjective QoL: individuals located QoL as relative to self, others and possible futures. Incorporating illness-related reference points for QoL (‘given my circumstances…’) was associated with perceptions of improved QoL. Deliberately modifying reference points for QoL was perceived as self-compassionate.

Conclusion

The present study generates novel hypotheses about how individuals with BD make sense of their QoL. Data suggest that individuals located their QoL relative to a variety of reference points, use of which was flexible. In accord with gap theories of QoL, individuals experienced acceptance of illness impacts as improving subjective sense of QoL. Rather than ‘settling for’ a lower standard of QoL, individuals experienced these changes as adaptive and positive. Findings are discussed in relation to the measurement and amelioration of QoL in BD.

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Literatur
1.
Zurück zum Zitat Murray, G., & Michalak, E. E. (2012). The quality of life construct in bipolar disorder research and practice: Past, present, and possible futures. Bipolar Disorders, 14(8), 793–796.CrossRefPubMed Murray, G., & Michalak, E. E. (2012). The quality of life construct in bipolar disorder research and practice: Past, present, and possible futures. Bipolar Disorders, 14(8), 793–796.CrossRefPubMed
2.
Zurück zum Zitat Morton, E., Michalak, E. E., & Murray, G. (2017). What does quality of life refer to in bipolar disorders research? A systematic review of the construct’s definition, usage and measurement. Journal of Affective Disorders, 212, 128–137.CrossRefPubMed Morton, E., Michalak, E. E., & Murray, G. (2017). What does quality of life refer to in bipolar disorders research? A systematic review of the construct’s definition, usage and measurement. Journal of Affective Disorders, 212, 128–137.CrossRefPubMed
3.
Zurück zum Zitat Ware, J. E. (1995). The status of health assessment. Annual Review of Public Health, 16, 327–354.CrossRefPubMed Ware, J. E. (1995). The status of health assessment. Annual Review of Public Health, 16, 327–354.CrossRefPubMed
4.
Zurück zum Zitat Gitlin, M. J., & Miklowitz, D. J. (2017). The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment. Journal of Affective Disorders, 209, 147–154.CrossRefPubMed Gitlin, M. J., & Miklowitz, D. J. (2017). The difficult lives of individuals with bipolar disorder: A review of functional outcomes and their implications for treatment. Journal of Affective Disorders, 209, 147–154.CrossRefPubMed
5.
Zurück zum Zitat Sachs, G. S., & Rush, A. J. (2003). Response, remission, and recovery in bipolar disorders: What are the realistic treatment goals? Journal of Clinical Psychiatry, 64(Suppl 6), 18–22.PubMed Sachs, G. S., & Rush, A. J. (2003). Response, remission, and recovery in bipolar disorders: What are the realistic treatment goals? Journal of Clinical Psychiatry, 64(Suppl 6), 18–22.PubMed
6.
Zurück zum Zitat McIntyre, R. S. (2009). Understanding needs, interactions, treatment, and expectations among individuals affected by bipolar disorder or schizophrenia: The UNITE global survey. Journal of Clinical Psychiatry, 70(Suppl 3), 5–11.CrossRefPubMed McIntyre, R. S. (2009). Understanding needs, interactions, treatment, and expectations among individuals affected by bipolar disorder or schizophrenia: The UNITE global survey. Journal of Clinical Psychiatry, 70(Suppl 3), 5–11.CrossRefPubMed
7.
Zurück zum Zitat Eiring, Ø, Nylenna, M., & Nytrøen, K. (2016). Patient-important outcomes in the long-term treatment of bipolar disorder: A mixed-methods approach investigating relative preferences and a proposed taxonomy. Patient, 9(2), 91–102.CrossRefPubMed Eiring, Ø, Nylenna, M., & Nytrøen, K. (2016). Patient-important outcomes in the long-term treatment of bipolar disorder: A mixed-methods approach investigating relative preferences and a proposed taxonomy. Patient, 9(2), 91–102.CrossRefPubMed
8.
Zurück zum Zitat Haarig, F., Berndt, C., Kühnert, M., Fuchs, S., Bräunig, P., & Mühlig, S. (2016). What is important to patients? Determination of patient-centered therapeutic goals in the treatment of bipolar disorders. Zeitschrift fur Psychiatrie, Psychologie und Psychotherapie, 64(2), 111–120.CrossRef Haarig, F., Berndt, C., Kühnert, M., Fuchs, S., Bräunig, P., & Mühlig, S. (2016). What is important to patients? Determination of patient-centered therapeutic goals in the treatment of bipolar disorders. Zeitschrift fur Psychiatrie, Psychologie und Psychotherapie, 64(2), 111–120.CrossRef
9.
Zurück zum Zitat Maczka, G., Siwek, M., Skalski, M., & Dudek, D. (2009). Patients’ and doctors’ attitudes towards bipolar disorder—Do we share our beliefs? Psychiatria Polska, 43(3), 301–312.PubMed Maczka, G., Siwek, M., Skalski, M., & Dudek, D. (2009). Patients’ and doctors’ attitudes towards bipolar disorder—Do we share our beliefs? Psychiatria Polska, 43(3), 301–312.PubMed
10.
Zurück zum Zitat Sajatovic, M., Jenkins, J. H., Cassidy, K. A., & Muzina, D. J. (2009). Medication treatment perceptions, concerns and expectations among depressed individuals with type I bipolar disorder. Journal of Affective Disorders, 115(3), 360–366.CrossRefPubMed Sajatovic, M., Jenkins, J. H., Cassidy, K. A., & Muzina, D. J. (2009). Medication treatment perceptions, concerns and expectations among depressed individuals with type I bipolar disorder. Journal of Affective Disorders, 115(3), 360–366.CrossRefPubMed
12.
Zurück zum Zitat Murray, G., Leitan, N. D., Thomas, N., Michalak, E. E., Johnson, S. L., Jones, S., et al. (2017). Towards recovery-oriented psychosocial interventions for bipolar disorder: Quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. Clinical Psychology Review, 52, 148–163.CrossRefPubMed Murray, G., Leitan, N. D., Thomas, N., Michalak, E. E., Johnson, S. L., Jones, S., et al. (2017). Towards recovery-oriented psychosocial interventions for bipolar disorder: Quality of life outcomes, stage-sensitive treatments, and mindfulness mechanisms. Clinical Psychology Review, 52, 148–163.CrossRefPubMed
13.
Zurück zum Zitat Michalak, E. E., Yatham, L. N., Kolesar, S., & Lam, R. W. (2006). Bipolar disorder and quality of life: A patient-centered perspective. Quality of Life Research, 15(1), 25–37.CrossRefPubMed Michalak, E. E., Yatham, L. N., Kolesar, S., & Lam, R. W. (2006). Bipolar disorder and quality of life: A patient-centered perspective. Quality of Life Research, 15(1), 25–37.CrossRefPubMed
14.
Zurück zum Zitat Michalak, E. E., & Murray, G. (2010). Development of the QoL.BD: A disorder-specific scale to assess quality of life in bipolar disorder. Bipolar Disorders, 12(7), 727–740.CrossRefPubMed Michalak, E. E., & Murray, G. (2010). Development of the QoL.BD: A disorder-specific scale to assess quality of life in bipolar disorder. Bipolar Disorders, 12(7), 727–740.CrossRefPubMed
15.
Zurück zum Zitat Michalak, E. E., Morton, E. M., Barnes, S. J., Hole, R., CREST.BD, & Murray, G. (2018). If you build it, will they come? A mixed-methods study of online knowledge translation strategies for bipolar disorder (in preparation) Michalak, E. E., Morton, E. M., Barnes, S. J., Hole, R., CREST.BD, & Murray, G. (2018). If you build it, will they come? A mixed-methods study of online knowledge translation strategies for bipolar disorder (in preparation)
16.
Zurück zum Zitat Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15, 398–405.CrossRefPubMed Vaismoradi, M., Turunen, H., & Bondas, T. (2013). Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study. Nursing and Health Sciences, 15, 398–405.CrossRefPubMed
17.
Zurück zum Zitat Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd edn.). Thousand Oaks, CA: SAGE. Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd edn.). Thousand Oaks, CA: SAGE.
18.
Zurück zum Zitat Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.CrossRef Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.CrossRef
20.
Zurück zum Zitat Michalos, A. C. (1985). Multiple discrepancies theory (MDT). Social Indicators Research, 16(4), 347–413.CrossRef Michalos, A. C. (1985). Multiple discrepancies theory (MDT). Social Indicators Research, 16(4), 347–413.CrossRef
21.
Zurück zum Zitat Rapkin, B. D., & Schwartz, C. E. (2004). Toward a theoretical model of quality-of-life appraisal: Implications of findings from studies of response shift. Health and Quality of Life Outcomes, 2(1), 14.CrossRefPubMedPubMedCentral Rapkin, B. D., & Schwartz, C. E. (2004). Toward a theoretical model of quality-of-life appraisal: Implications of findings from studies of response shift. Health and Quality of Life Outcomes, 2(1), 14.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Evans, S., & Huxley, P. (2005). Adaptation, response-shift and quality of life ratings in mentally well and unwell groups. Quality of Life Research, 14(7), 1719–1732.CrossRefPubMed Evans, S., & Huxley, P. (2005). Adaptation, response-shift and quality of life ratings in mentally well and unwell groups. Quality of Life Research, 14(7), 1719–1732.CrossRefPubMed
23.
Zurück zum Zitat Mechanic, D. (2006). Organisation of care and quality of life of persons with serious and persistent mental illness. In H. Katschnig, H. Freeman & N. Sartorius (Eds.), Quality of life in mental disorders (2nd edn., pp. 309–320). Chichester: Wiley. Mechanic, D. (2006). Organisation of care and quality of life of persons with serious and persistent mental illness. In H. Katschnig, H. Freeman & N. Sartorius (Eds.), Quality of life in mental disorders (2nd edn., pp. 309–320). Chichester: Wiley.
24.
Zurück zum Zitat Katschnig, H. (2006). How useful is the concept of quality of life in psychiatry? In H. Katschnig, H. Freeman & N. Sartorius (Eds.), Quality of life in mental disorders (2nd edn., pp. 3–17). Chichester: Wiley. Katschnig, H. (2006). How useful is the concept of quality of life in psychiatry? In H. Katschnig, H. Freeman & N. Sartorius (Eds.), Quality of life in mental disorders (2nd edn., pp. 3–17). Chichester: Wiley.
25.
Zurück zum Zitat Fayers, P. M., & Machin, D. (2016). Quality of life: The assessment, analysis and reporting of patient-reported outcomes (3rd edn.). Chichester: Wiley. Fayers, P. M., & Machin, D. (2016). Quality of life: The assessment, analysis and reporting of patient-reported outcomes (3rd edn.). Chichester: Wiley.
26.
Zurück zum Zitat Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford Press.
27.
Zurück zum Zitat Dowd, E. T., & Pace, T. M. (1989). The relativity of reality. In A. Freeman, K. M. Simon, L. E. Beutler & H. Arkowitz (Eds.), Comprehensive handbook of cognitive therapy (pp. 213–226). Boston: Springer.CrossRef Dowd, E. T., & Pace, T. M. (1989). The relativity of reality. In A. Freeman, K. M. Simon, L. E. Beutler & H. Arkowitz (Eds.), Comprehensive handbook of cognitive therapy (pp. 213–226). Boston: Springer.CrossRef
Metadaten
Titel
The ‘new normal’: relativity of quality of life judgments in individuals with bipolar disorder—a qualitative study
verfasst von
Emma Morton
Erin Michalak
Rachelle Hole
Simone Buzwell
Greg Murray
Publikationsdatum
12.02.2018
Verlag
Springer International Publishing
Erschienen in
Quality of Life Research / Ausgabe 6/2018
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-018-1811-x

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