title: Toward meeting the needs of homeless people with schizophrenia: the validity of quality of life measurement.
abstract: OBJECTIVE
  To provide new evidence regarding the suitability of using quality of life (QoL) measurements in homeless people with schizophrenia, we assess the acceptability and psychometric properties of a specific QoL instrument (S-QoL 18) in a population of homeless people with schizophrenia, and we compare their QoL levels with those observed in non-homeless people with schizophrenia.
  
  
  METHODS
  This multi-centre prospective study was conducted in the following 4 French cities: Lille, Marseille, Paris and Toulouse. Two hundred and thirty-six homeless patients with schizophrenia were recruited over a 12 month-period. The S-QoL 18 was tested for construct validity, reliability, external validity and sensitivity to change. The QoL of the 236 homeless patients was compared with 236 French age- and sex-matched non-homeless patients with schizophrenia.
  
  
  RESULTS
  The eight-factor structure of the S-QoL 18 was confirmed by confirmatory factor analysis (RMSEA = 0.035, CFI = 0.95, GFI = 0.99 and SRMR = 0.015). Internal consistency, reliability and sensitivity to change were satisfactory. External validity was confirmed via correlations between S-QoL 18 dimension scores and SF-36, symptomatology and recovery scores. The percentage of missing data did not exceed 5%. Finally, homeless patients had significantly lower QoL levels than non-homeless patients with schizophrenia.
  
  
  CONCLUSIONS
  These results demonstrate the satisfactory acceptability and psychometric properties of the S-QoL 18, suggesting the validity of QoL measurement among homeless patients with schizophrenia. Our study also reported that QoL levels in homeless patients with schizophrenia were dramatically low, highlighting the need for new policies to eradicate homelessness and tackle poverty.
authors.affiliation: Aix-Marseille University, EA 3279 Research Unit, Marseille, France ; Department of Public Health, University Hospital, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Auquier
authors.forename: Aurelie
authors.initials: A
authors.lastname: Tinland
authors.forename: Cecile
authors.initials: C
authors.lastname: Fortanier
authors.forename: Anderson
authors.initials: A
authors.lastname: Loundou
authors.forename: Karine
authors.initials: K
authors.lastname: Baumstarck
authors.forename: Christophe
authors.initials: C
authors.lastname: Lancon
authors.forename: Laurent
authors.initials: L
authors.lastname: Boyer
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D006301:Health Services Needs and Demand; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012559:Schizophrenia / Q000453:epidemiology*