Concept Of QOL Research Articles

“How long is life worth living for the horse?” A focus group study on how Austrian equine stakeholders assess quality of life for chronically ill or old horses

BackgroundQuality of life (QoL) provides a comprehensive concept underpinning veterinary decision-making that encompasses factors beyond physical health. It becomes particularly pertinent when seeking responsible choices for chronically ill or old horses that emphasise their well-being and a good QoL over the extension of life. How different stakeholders use the concept of QoL is highly relevant when considering the complexity of these decisions in real-life situations.MethodsSeven focus group discussions (N = 39) were conducted to gain insights into how stakeholders assess and use equine QoL in veterinary care decisions for chronically ill and/or old horses. The discussions included horse owners (n = 17), equine veterinarians (n = 7), veterinary officers (n = 6), farriers (n = 4), and horse caregivers (n = 5). The combination of deductive and inductive qualitative content analysis of the group discussions focused on identifying both similarities and differences in the views of these groups regarding QoL for old and/or chronically ill horses.ResultsFindings show agreement about two issues: the importance of the individuality of the horse for assessing QoL and the relevance of QoL in making decisions about veterinary interventions. We identified differences between the groups with respect to three issues: the time required to assess QoL, stakeholders’ contributions to QoL assessments, and challenges resulting from those contributions. While owners and caregivers of horses emphasised their knowledge of a horse and the relevance of the time they spend with their horse, the veterinarians in the study focused on the differences between their own QoL assessments and those of horse owners. In response to challenges regarding QoL assessments and decision-making, stakeholders described different strategies such as drawing comparisons to human experiences.ConclusionsDifferences between stakeholders regarding equine QoL assessments contribute to challenges when making decisions about the care of chronically ill or old horses. The results of this study suggest that individual and collaborative reflection about a horse’s QoL should be encouraged, for example by developing practicable QoL assessment tools that support relevant stakeholders in this process.

Concept of quality of life in health care research: a review

Quality of life (QoL) is the most studied concept in health care research. With an increase in life expectancy and consequently with more prevalence of chronic diseases, the QOL needs to be paid attention. It is a multifactorial concept and many tools are adopted to study QOL. The present article analyses the concept of QOL in the context of healthcare research. Articles for this were searched from PubMed, CINAHAL, Cochran and EBSCO. A detailed review of QoL in health care research including its components, models and various tools being used with their application are discussed in the current article.

Urban Quality of Life: Domains, Dimensions and Indicators for Indian Cities

The word “quality of life” has been used vigorously from everyday language to research studies. Often, it becomes challenging to differentiate between notions related to QoL, well-being, satisfaction, and happiness. UQoL is a notion that has been conversed in recent studies as a response to various urban issues and challenges. The paper aims to define the concept of QoL in urban context through a descriptive analytical approach and reviews various QoL models and approaches of QoL-studies and compares the number of indices measuring QoL at the national and city level to identify various dimensions and indicators. Finally, a conceptual model concluding the UQoL indicators have been deduced in the form of a matrix. These dimensions represent a guide for policymakers, Planners, Architects, and Designers.

Factor structure of the Japanese version of the Quality of Life in Alzheimer's Disease Scale (QOL-AD).

The Quality of Life in Alzheimer's Disease Scale (QOL-AD) developed by Logsdon et al. in1999 is believed to be useful for evaluating responses from both patients and their caregivers. We previously confirmed both the reliability and the validity of the Japanese version of the QOL-AD. However, the factor structure of this scale should be confirmed because the QOL-AD covers multiple facets of dementia patients' lives. Thus, we performed a factor analysis of the Japanese QOL-AD. Then, we examined the correlations between each of the identified QOL factor scores and the results of other scales. The Japanese version of the QOL-AD was given to 132 AD patients and 132 caregivers. Four other tests were also performed at the same time: the Mini-Mental State Examination, the Neuropsychiatric Inventory (NPI), the Hyogo Activities of Daily Living Scale (HADL), and the Short Memory Questionnaire. A factor analysis using Varimax rotation was used to examine the dimensions underlying the QOL-AD. In addition, we examined the Pearson correlations between each of the identified QOL factor scores and the results of the other four tests. Factor analyses of both versions of the Japanese QOL-AD (both the patients' and the caregivers' responses) revealed three factors that were named 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The 'psychological wellbeing' factor was significantly correlated with the Mood factor of the NPI. The 'human relationships' factor was significantly correlated with the Psychosis factor of the NPI. The 'physical and social environment' factor was significantly correlated with the HADL. Both the patients' and the caregivers' responses to the Japanese version of the QOL-AD were composed of three factors: 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The present results support the multi-domain concept of QOL proposed by Lawton.

Quality of Life Is to Experience Adult Social Status

AbstractQuality of life (QoL) has become an important outcome in evaluations of services and support for people with intellectual disabilities (ID). Many people with ID request more say and want to be involved in the development of services and support provision. The original Uppsala QoL (UQoL) model consists of a general essence and hierarchically ordered themes and describes QoL from the perspective of people with ID through individual interviews. The aim of the present study is to examine the UQoL regarding its inherent component parts and to explore the interrelationship between them. The study contributes to the understanding of the concept of QoL from the perspective of people with ID. Focus group interviews were conducted with people with mild and moderate ID. The results indicate that QoL is to experience well‐being. The key component of QoL is to experience adult social status. which is determined by whether the individual experiences having control of their life, experiences a sense of personal safety and feels social belonging. In concordance with the original model, the UQoL2 is mainly made up of components equivalent to those frequently reported in the QoL literature. Nevertheless, some differences require attention. The primary component, adult social status, has not previously been highlighted in the QoL literature. The point of departure in the UQoL model is the users´ perspective rather than the user perspective as perceived by professionals or researchers. The UQoL is not primarily linked to the quality of service provision, but to peoples' daily life. A revised version of the original UQoL is suggested. Unlike the original model, other than the fact which that adult social status is superior, the components are not hierarchically organized, rather the interrelation between them is emphasized.

The Effects of Community Quality of Life on Local Policy Decisions

Extensive scholarly debate still exists on the determinants of local policy decisions. Although many studies have explained how political, economic, institutional, and demographic factors influence local policy decisions, they have rarely applied the concept of QoL in existing public administration and policy literature. To examine the impact of QoL on local policy decisions, this study tests the relationships between QoL and local budgetary decisions, based on Peterson’s (1981) scheme that divides policy into three areas: developmental, allocational, and redistributive. Using local government expenditures and citizen surveys data from 167 municipalities in the U.S., this study finds that community QoL is a critical factor in all of the three policy spending areas. It also confirms that the impact of QoL on local spending is moderated differently across the three areas by city income levels. The findings may help local government scholars and practitioners to better understand complex and dynamic citizen needs, which in turn may result in more responsive policy decisions.

The assessment of quality of life in clinical practice in patients with schizophrenia

The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and specific QoL scales in patients with schizophrenia. Affective symptoms were major obstacles for QoL improvement in patients with schizophrenia. Though positive symptoms, negative symptoms, and cognitive functioning may be seen as largely independent parameters from subjective QoL, especially in cross-sectional trials, long-term studies confirmed a critical impact of early QoL improvement on long-term symptomatic and functional remission, as well as of early symptomatic response on long-term QoL. Results of the present review suggest that QoL is a valid and useful outcome criterion in patients with schizophrenia. As such, it should be consistently applied in clinical trials. Understanding the relationship between symptoms and functioning with QoL is important because interventions that focus on symptoms of psychosis or functioning alone may fail to improve subjective QoL to the same level. However, the lack of consensus on QoL scales hampers research on its predictive validity. Future research needs to find a consensus on the concept and measures of QoL and to test whether QoL predicts better outcomes with respect to remission and recovery under consideration of different treatment approaches in patients with schizophrenia.

Measuring the quality of life of people with dementia in nursing homes in Germany - the study protocol for the Qol-Dem Project.

Background: QUALIDEM is a standardized dementia-specific quality of life (Qol) measurement, which was developed and validated in the Netherlands. A German version has been available since 2008. This study protocol describes the design and methodology for the quality of life of people with dementia (Qol-Dem) project.Objective: This project aims to evaluate the reliability and validity of the German version of the QUALIDEM. Method: Due to the lack of both a universal definition of Qol and of standards to verify the validity of Qol measurements, this study is divided into three phases. The aim of the first theoretical phase is the development of a dementia-specific Qol model as a result of a meta-synthesis of qualitative studies. The second empirical phase consists of the three following steps: (a) an investigation of the scalability and internal consistency of the measure, (b) an evaluation of the interrater and intrarater reliability, and (c) an extensive evaluation of the validity of the QUALIDEM. The resulting Qol model (phase 1) will be used for the selection of appropriate comparators for validity testing. In the third phase, the QUALIDEM will be adapted, if necessary, based on the knowledge generated in the first two phases.Conclusion: The findings of the Qol-Dem project should deliver an accurate assessment of the psychometric properties of the German version of the QUALIDEM. The results will contribute to the further development of the instrument. Furthermore, the results will contribute to the theoretical development of the concept of Qol among people with dementia.

The clinical use of quality-of-life scales in neurological disorders

ObjectiveQuality of life (QoL) is a growing issue in medicine, particularly in the evaluation of rehabilitative care. The concept of QoL is included in and expands the definition of health given by the WHO (World Health Organization) and comprises complete physical, mental, and social well-being. It expresses the degree of satisfaction in various areas as a result of the opportunities that arise during one's lifetime despite the restrictions and impediments that life itself puts forth. The last decade has exponentially increased the number of studies on QoL, although they are still limited.MethodsWe performed a literature review on the QoL scales used in patients with neurological disorders.ResultsRecent studies have shown the importance of QoL assessment because standard treatments do not assess the treatment impact felt by the patient. In fact, by understanding the impact of treatment on survival and QoL, one can make a clearer interpretation of the health of the patient.ConclusionThis review has adopted an innovative holistic methodological approach, which allowed a global evaluation of the comfort reported by the patients. The scales applied in this study allowed to choose the most suitable therapeutic strategies and programme individual therapeutic treatment.

Improving Patients' Quality of Life at the End of Life

Improving Patients' Quality of Life at the End of Life

Practitioner Review: Quality of life in child mental health – conceptual challenges and practical choices

The terms ‘quality of life’ (QoL) and ‘health related quality of life’ (HRQoL) are fraught with preconceptions, misconceptions and, frequently, confusion: How are these terms best defined? What are the best ways to measure them? These challenges, which are present even in the relatively well-studied fields of adult physical health, are magnified considerably when considered in the context of child and adolescent mental health. They are, however, concepts that are being increasingly discussed by child and adolescent mental health clinicians, researchers and service planners. The purpose of this review is to analyse and discuss the concept of QoL and HRQoL (for simplicity we will use the umbrella term QoL in this paper except when there is a need to draw more fine-grain distinctions) as they relate to child and adolescent mental health, and review the various reasons for measuring QoL in this population. The paper is divided into three main sections. First, we introduce the concept of QoL and draw out the issues raised with regard to the field of childhood mental health research and practice. Second, we discuss the range of challenges raised as we move from concept to measurement. Third, we review and contrast some of the many different measurement tools currently available.

Measuring quality of life

Caution needed when interpreting scores

Comparing quality of life using the World Health Organization Quality of Life measure (WHOQOL-100) in a clinical and non-clinical sample: Exploring the role of self-esteem, self-efficacy and social functioning

Background: Quality of life assessments provide a measure of client-assessed wellbeing and help clinicians recognize issues of importance to clients. Comparing quality of life in individuals with a mental illness and individuals without mental illness would allow us to profile and understand the needs of individuals with mental illness understand the impact of stigma and narrow the treatment gap.Aims: To compare quality of life in individuals with severe mental illness against a sample of the general population and to investigate the role of self-esteem, self-efficacy and social functioning.Method: The World Health Organization Quality of Life measure (WHOQOL-100) along with the Rosenberg Self-Esteem Scale (RSE) and the Generalized Self Efficacy Scale (GSES) were administered to 104 individuals, 52 of whom were mental health service users with the remaining 52 participants sampled from the general population.Results: Significant differences were found between clinical and non-clinical groups in four domains of the WHOQOL-100 and in a majority of the facets within domains. Two domains, Level of Independence and Social Relationships, were important differentiating aspects of QoL between the clinical and non-clinical sample as the highest significant differences were recorded there (t = 12.150, p < 0.001 and t = 7.252, p < 0.001 respectively). Lower self-esteem and self-efficacy scores were recorded for the clinical sample compared to the non-clinical sample.Conclusions: The negative repercussions of mental illness encompassed almost all aspects of QoL that individuals had ascertained to be important for satisfaction and wellbeing in everyday life. Findings also indicated that individuals with mental illness have similar needs to a “normal” population in terms of social support and social networks and that inter-personal issues were probably more pervasive than intra-psychic events with regard to QoL. We conclude that the concept of QoL offers clinicians an increased awareness and greater concern for life issues for people who are mentally ill, helping us to develop collaborative relationships and provide effective interventions for individuals with mental illness.Declaration of interest: None.

A review of quality of life instruments used in dementia

To provide an overview of QOL measures applicable for research in dementia, the scale content, method of data collection, and their psychometric properties. Literature research. Six dementia-specific QOL measures were identified, eight generic measures were used in a demented population, and three dementia-specific measures related to QOL are described as well. Measures vary considerably in scale content, and method of data collection. Reliability indexes were always available, support of instrument validity was often reported, but reports of responsiveness to change were found only for two dementia-specific QOL measures. When the interest is primarily on people with dementia, a dementia-specific instrument is to be preferred. Further clarification of the concept of QOL and particularly its relation to disease severity is required.

Quality of Life and Epilepsy Surgery

EpilepsiaVolume 44, Issue s6 p. 61-61 Free Access Quality of Life and Epilepsy Surgery First published: 18 August 2003 https://doi.org/10.1046/j.1528-1157.44.s6.25.xCitations: 1AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat An important implicit aim of the surgical treatment of epilepsy has always been to improve the individual's well-being. Outcome measures, however, until recently have been focused mainly on seizure relief. It is clearly important that evaluation of surgical outcome should include an assessment of the effects of seizure relief or reduced seizure frequency on the individual's psychosocial functioning and well-being, often termed health-related quality of life (HRQOL). PSYCHOSOCIAL FUNCTIONING AND QOL Before the advent of the concept of QOL, postoperative improvement in psychosocial functioning was shown to be associated with freedom from, or substantial reduction in, seizures as well as with the preoperative level of functioning. However, positive changes were seen predominantly in those who already had a relatively high level of psychosocial function preoperatively (1–4). Furthermore, most studies have found that employment rates change only to a limited degree although relief from seizures may lead to improved vocational functioning (1,3–7). In two recent series, however, employment rates increased significantly among patients who became seizure free (8,9). Higher QOL scores have been reported following surgery for epilepsy in people who have achieved total seizure relief than in those who continue to have auras (10,11). In addition, people in whom seizure frequency has been substantially reduced have higher QOL scores than those who still have frequent seizures (9,11). However, even though complete seizure relief is a desired outcome of epilepsy surgery, it is not always achieved. In some people, the aim of surgery is to reduce the severity or frequency of disabling seizures, and for these people, the present measurement of QOL may not be appropriate (12). RECOMMENDATIONS The future use and development of existing epilepsy-specific QOL measures must take account of the wide range of surgical procedures performed in patients with varying disabilities. Individual rehabilitation plans should be based on realistic expectations of the possibilities and limitations of epilepsy surgery, with emphasis on the importance of initiating rehabilitation planning and counselling preoperatively (6). REFERENCES 1 Taylor DC, Falconer MA. Clinical, socioeconomic and psychological changes after temporal lobectomy for epilepsy. Br J Psychol 1968; 114: 1247– 61. 2 Rausch R, Crandall PH. Psychological status related to surgical control of temporal lobe seizure. Epilepsia 1982; 23: 191– 202. 3 Dodrill CB, Batzel LW, Fraser R. Psychosocial changes after surgery for epilepsy. In: HO Lüders, ed. Epilepsy surgery. New York: Raven Press, 1991: 661– 7. 4 Vickrey BG, Hays RD, Hermann BP, et al. Outcomes with respect to quality of life. In: Engel J Jr, ed. Surgical treatment of the epilepsies. New York: Raven Press, 1993:623–35. 5 Guldvog B, Löyning Y, Hauglie-Hanssen E, et al. Surgical versus medical treatment for epilepsy, II: outcome related to social areas. Epilepsia 1991; 32: 477– 86. 6 Fraser RT, Gumnit RJ, Thorbecke R, et al. Psychosocial rehabilitation: a pre- and postoperative perspective. In: J Engel, ed. Surgical treatment of the epilepsies. New York: Raven Press, 1993: 669– 77. 7 Lendt M, Helmstaedter C, Elger CE. Pre- and postoperative socioeconomic development of 151 patients with focal epilepsies. Epilepsia 1997; 38: 1330– 7. 8 Sperling MR, O'Connor MJ, Saykin AJ, et al. Temporal lobectomy for refractory epilepsy. JAMA 1996; 276: 470– 5. 9 Kellett MW, Smith DF, Baker GA, et al. Quality of life after epilepsy surgery. J Neurol Neurosurg Psychiatry 1997; 63: 52– 8. 10 Vickrey BG, Hays RD, Graber J, et al. A health-related quality of life instrument for patients evaluated for epilepsy surgery. Med Care 1992; 30: 299– 319. 11 Malmgren K, Sullivan M, Ekstedt G, et al. Health related quality of life after epilepsy surgery: a Swedish multicentre study. Epilepsia 1997; 38: 830– 8. 12 Taylor DC. New measures of outcome needed for the surgical treatment of epilepsy. Epilepsia 1997; 38: 625– 30. Citing Literature Volume44, Issues6September 2003Pages 61-61 ReferencesRelatedInformation

The potential clinical value of quality-of-life information response to Martin.

years of clinical practice. No one would refute the importance of tumor response or disease-free survival as outcome indicators. However, some 54 years ago, David Karofsky developed the Kamofsky Performance Status scale2 because he believed that traditional indicators of disease activity, such as tumor response, did not adequately depict the impact of disease or treatment on patients' lives. Other clinical specialties soon followed with their own indicators of function and well-being.3-7 Today, hundreds of disease-specific measures of QOL exist.8 Martin discussed using simple or measures of benefit weighed against harm in treating individual patients. First, instinctive measures are not standardized and, as such, are highly variable between clinicians at any point in time and within a single clinician over time. Second, some scholars of the Hippocratic Oath conceptualize benefit as a personal and subjective evaluation (ie, patient centered) that goes beyond measures of pathophysiology.9 Conceptualized as such, the concept of benefit is not unlike the concept of health-related QOL: they comprise subjective and objective evaluations of aspects of physical and mental health status that are influenced by disease, treatment, and natural history. Fadan and Leplege'1 argue that QOL assessment

A substantive theory of quality of life of adults with chronic leukaemia

The person with chronic leukaemia is living with a chronic and life-threatening disease. The aims of this study were to gain a deeper understanding of what individuals with chronic leukaemia consider QOL to be and to give the concept of QOL a theoretical and empirical significance relevant to nursing care. Fifteen adults with different forms of diagnosed chronic leukaemia have been interviewed about their experience of QOL. Verbatim transcripts were analysed using constant comparative analysis. The emerging core category was life satisfaction. Under this construct there were four categories; self-esteem, interpersonal relationships, performance ability and social ability. Changed QOL was described in two ways. First, coping was the core category for living with chronic leukaemia. The strategies were action, denial and hope. Second, QOL was seen as individual perception, experience of a positive attitude to life and self-contemplation.

Measurement of the quality of life in cancer survivors.

A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n = 1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physical r = 0.88, Psychological r = 0.88, Social r = 0.81, and Spiritual, r = 0.90. The second measure of reliability was computation of internal consistency using Cronbach's alpha coefficient as a measure of agreement between items and subscales. Analysis revealed an overall r = 0.93. Subscale alphas average ranged from r = 0.71 for spiritual well being, r = 0.77 for physical, r = 0.81 for social, and r = 0.89 for psychological. Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r = 0.74), QOL-CS Psych to FACT Emotional (r = 0.65), QOL Social to FACT Social (r = 0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.