Q. I am a Mental Health Nurse working in an outpatient setting. With the switch to novel antipsychotics, I am looking for an outcome measurement tool to measure quality of life. The budget does not give much room for purchasing copyrights. What do you suggest?

A. There are several well-accepted quality of life (QOL) scales that you could use, including the MOS Short-form General Health Survey (SF-20) and the Wisconsin Quality of Life Index. For a reference to the SF-20, see the study by Spitzer et al in JAMA 274:1511-1517, 1995. But-you really don't need to get fancy unless you plan to publish this as a research study.

For everyday clinical practice, there are much simpler tools you can use as a measure of QOL. For example, the Global Assessment Scale (GAS) is sometimes used as one measure of QOL. A modified version of this-the GAF-is found on p. 32 of DSM-IV. You should not need any copyright permission simply to give patients a GAF score on a monthly basis.

Or, you could create your own QOL instrument by using some well-accepted dimensions, such as (1) Patient's relations with family members rated on a 5-point scale; (2) Enjoyment of recreational activities rated on a 5-point scale; (3) Occupational functioning in the previous month; (4) Performance of household duties, (5) Overall psychological functioning, etc. (See the article by Ho et al, in the May 2000 American Journal of Psychiatry, table 2, for more details on this). Good luck with your work!

July 2001

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