Faculty of Health, Arts and Design Swinburne University, Melbourne, Australia.
Division of Mood Disorders, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
Qual Life Res. 2018 Jun;27(6):1493-1500. doi: 10.1007/s11136-018-1811-x. Epub 2018 Feb 12.
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.
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.
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.
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.
生活质量（QoL）日益成为双相情感障碍（BD）干预的目标。虽然消费者的主观体验通常被认为是 BD 中 QoL 结构的核心，但该领域的有限研究意味着主观 QoL 仍未得到充分理解。本定性研究旨在通过调查 BD 患者在 QoL 自我管理干预背景下如何评价自己的生活质量来解决这一问题。
对 43 名参加过改善 BD 中 QoL 的自我管理干预的个体进行了半结构化访谈。询问了个体对干预的体验以及对其 QoL 的看法。采用主题分析方法探讨参与者对其 QoL 的评价。
一个总体主题涉及主观 QoL 的内在相对性：个体将 QoL 定位为相对于自我、他人和可能的未来。将与疾病相关的 QoL 参考点（“鉴于我的情况……”）纳入其中与改善 QoL 的感知有关。有意识地改变 QoL 的参考点被认为是自我同情的。
本研究提出了关于 BD 患者如何理解其 QoL 的新假设。数据表明，个体将其 QoL 定位在各种参考点上，并且这些参考点的使用是灵活的。与 QoL 的差距理论一致，个体接受疾病对生活质量的影响会改善主观生活质量感。个体体验到这些变化是适应性和积极的，而不是“满足于”较低的 QoL 标准。研究结果与 BD 中 QoL 的测量和改善有关。
