Quality of services and quality of life from service providers' perspectives: analysis with focus groups.
Managers, professionals, and direct-care staff define quality of life and service quality differently—align them to improve client outcomes.
01Research in Context
What this study did
Peters et al. (2013) ran four focus groups with 27 staff who serve adults with intellectual disability. The groups were managers, professionals, and direct-care workers.
Each group talked about what quality of life and quality of service mean to them. The researchers compared the answers to see where views clash or match.
What they found
Only managers linked good service to real life gains for clients. Professionals cared most about therapy goals. Direct-care staff focused on safety and daily routines.
All groups used the words quality of life, but they defined it differently. This split can steer the same program in three directions at once.
How this fits with other research
Gonzalo et al. (2024) extends this idea to college. Their scoping review shows schools rarely apply the Quality of Life Supports Model even when they claim to. Both papers reveal a gap between talk and action.
Lin et al. (2005) is a predecessor that saw the same rift earlier. Directors of large facilities said health programs were very important yet most were not in place. Peters et al. (2013) now shows the split lives inside everyday teams, not just top brass.
Golubović et al. (2013) found parents and teens with ID also rate quality of life differently, especially on health. Together these studies prove disagreement is normal across families, staff levels, and settings.
Why it matters
If your team does not share a definition of quality, you will pull in different directions. Start each planning meeting by writing one sentence that links the service goal to a real life outcome the client wants. Make every role voice that link before moving on.
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02At a glance
03Original abstract
BACKGROUND: Concepts such as support, quality of life and quality of services are customary in services for people with intellectual disabilities. The identification of the different ways of conceiving, prioritising and implementing these concepts by service providers can help to drive changes to achieve better personal outcomes for this population. The current study aims to identify service providers' perceptions regarding the quality of life of their clients and the quality of services they provide. It also aims to identify similarities and differences of appraisals among professionals, and to identify associations between supports, quality of life and quality of services. METHOD: Data were collected from 22 service providers who attended three focus groups (professionals, direct support staff, and managers) from whom 424 comments were analysed. Service providers were asked about the required support for users, the meaning of quality of life for those users, and about features that should characterise quality services. Thematic analysis was employed and transcripts of the sessions were coded according to the dimensions of models on supports, quality of life and quality of services. Chi-squared tests were utilised to test for potential differences among groups. RESULTS: Each professional group has its own priorities concerning required supports. Among the organisation different and potentially conflicting perceptions regarding the meaning of experiencing quality of life coexist. Concerning quality of services, only managers mentioned personal outcomes. Finally, institutionalisation has a negative impact on supports, quality of life and quality of services. CONCLUSIONS: It is necessary to move beyond a shared awareness of the negative impact of institutionalisation towards the transformation of services in search of personal quality outcomes.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01548.x