Quality Of Life Concept Research Articles

Qualidade de vida em foco

This article aims to discuss aspects concerning Health-related to quality of life concepts. This paper presents some piece of information regarding the quality of life instruments.

Assessing Individual Support Needs to Enhance Personal Outcomes

Education and human service organizations providing services to people with intellectual and closely related developmental disabilities are increasingly being impacted by the supports paradigm, the quality of life concept, and the evaluation of personal outcomes. In this article the authors discuss the relationship among these three areas, including examples that illustrate how assessed support needs data can be aligned with quality-of-life–related core domains so as to establish individualized support systems that enhance personal outcomes. The article concludes with a discussion of the implications for educators and habilitation professionals of integrating the supports paradigm, the quality of life concept, and the evaluation of personal outcomes.

Quality of life: a reappraisal

PurposeWith this reappraisal, the purpose of this paper is to present a reflexion on and discussion of the concept of quality of life (QL) with the intention of delimiting its meaning and application within the scope of the research project entitled “Costs and benefits of urban dispersion on a local scale”.Design/methodology/approachThe concept of QL contains a significant degree of complexity and multidimensional variables, in addition to the dynamic nature inherent in all social phenomena. The application of this concept at a local level and within the context of the Portuguese socio‐territorial reality requires rethinking the concept through the different authors and approaches, in order to delineate the research process, and guarantee its operationalisation, selecting the social indicators than can serve this purpose, with the intent of gaining a clearer understanding of QL as perceived and evaluated by the people and groups living in various dispersed urban areas.FindingsFrom the readings of literature in the field, one can understand the importance of choosing the relevant domains when analysing and measuring QL. As with the choice of indicators, in order to be able to measure the QL, simultaneously, at a local level, the choice of indicators and the delimitation of units of analysis are also fundamental in order to be able to obtain the comparison and real measure of quality of life and not the contingencies of specific contextual characteristics.Originality/valueThe study aims to open a new research perspective in the field of social sciences, more specifically in the areas related to QL and urban dispersion.

Quality of Life in Old Age: Problematic Issues

Quality of Life (QoL) is a concept widely used in gerontology, as well as in other fields such as anthropology, health sciences, psychology, sociology and political sciences. Historically, although Aristotle is considered as an antecedent, the term QoL emerged in about the sixties in scientific literature. In the field of ageing, it is considered as an outcome of projects, programmes, services or policies and is used for describing populations, contexts and individuals. QoL is considered by most experts as a multidimensional concept involving multiple domains (health, psychological, social and environmental), containing objective and subjective components. Nevertheless, in recent years, QoL has been reduced to the subjective appraisal, to health or to subjective psychological attributes such as well-being, happiness or life satisfaction. Moreover, conceptual confusions can be found between QoL and other concepts related to positive ageing. In this conceptually-driven paper, after reviewing a set of expert and lay conceptualizations of QoL and identifying the diversity of its components, three critical issues will be discussed: its reduction to health or to the subjective appraisal of a set of domains, the confusion of QoL with other subjective or positive concepts and, finally, its methodological reductionism to self-reports as an exclusive procedure for QoL data collection. From these criticisms some conceptual and methodological suggestions are proposed.

Subjective quality of life in patients with chronic schizophrenia: relationships between psychosocial and clinical characteristics

Background Using the theoretical framework of quality of life (QOL), many studies have demonstrated that the beliefs individuals hold about their QOL are important in predicting health outcomes. This study tested the Taiwanese version of the World Health Organization Quality of Life-Brief (WHOQOL-BREF) assessment in schizophrenia patients. The WHOQOL-BREF is a cross-cultural and widely used measure for assessing health-related QOL. This brief version of the questionnaire derived from the concepts included in the 100-item WHOQOL questionnaire was adapted for use in Taiwan. Methods In the current cross-sectional study, 104 patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for schizophrenia or schizoaffective disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria were recruited and independently interviewed using the Taiwanese version of the WHOQOL-BREF. Patients were also examined using various other scales assessing insight, symptom severity, general psychopathology, and antipsychotic-induced side effects. In addition, we analyzed demographic data, clinical variables, and several self-rating scales as correlates of the Taiwanese version of the WHOQOL-BREF. Results As predicted, age, onset of illness, insight measures, symptom severity, general psychopathology, and antipsychotic-induced side effects were all significantly related to the QOL scores. Multiple regression analyses revealed that depressive symptoms, antipsychotic-induced parkinsonism side effects, hopelessness, and age at illness onset were the 4 strongest predictors of subjective QOL in schizophrenia patients. These variables accounted for 39.2% of the total variance of this QOL model. Conclusions The results suggest that the WHOQOL-BREF is a promising model for mental assessing health problems in schizophrenia patients. Furthermore, the present findings highlight the importance of understanding the complex nature of the concept of QOL. Our study also supports the belief that different domains of QOL are likely to have different predictors.

Response shift in the assessment of quality of life among people attending cardiac rehabilitation

To examine whether any response shift in quality of life (QoL) assessment over the course of a cardiac rehabilitation (CR) programme could be explained by changes in individuals' internal standards (recalibration), values (reprioritization), and/or conceptualization of QoL and the extent to which any response shift could be explained by health locus of control, optimism, and coping strategy. Longitudinal survey design. The schedule for evaluation of individual QoL-direct weighting (SEIQoL-DW) was administered at the beginning and end of a CR programme. At the end of the programme, the SEIQoL-DW then-test was also administered to measure response shift. A total of 57 participants completed these measures and other measures to assess health locus of control, optimism, and coping. Response shift effects were observed in this population mainly due to recalibration. When response shift was incorporated into the analysis of QoL a larger treatment effect was observed. Active coping as a mechanism in the response shift model was found to have a significant positive correlation with response shift. This study showed that response shift occurs during CR. The occurrence of response shift in QoL ratings over time for this population could have implications for the estimation of the effectiveness of the intervention.

Quality of life in rare genetic conditions: A systematic review of the literature

Quality of life (QoL) refers to an individual's sense of overall well-being encompassing physical, psychological, emotional, social, and spiritual dimensions. Although genetics healthcare providers strive to promote patient well-being, and the term QoL is often invoked to refer to this outcome, there is lack of clarity as to what actually constitutes QoL from the patient's perspective. This systematic literature review aims to summarize and integrate research findings to help elucidate how healthcare providers can more effectively enhance the QoL of patients affected with rare genetic conditions. Eligible studies were those that measured QoL as a primary outcome variable using a validated, multi-dimensional scale. Detailed criteria were used to rate quality of design, methodology, and analytic rigor. Fifty-eight studies were selected for inclusion in the review, and a narrative synthesis of the data was performed. A central theme emerging from the literature is that, although genetic conditions have the potential to have significant negative consequences for individuals' lives, having a genetic condition does not necessarily entail poor QoL. Evidence demonstrates that factors beyond the physical manifestations of the disease, such as psychological well-being, coping, and illness perceptions, influence QoL and may serve as potent targets for intervention. The field of research on QoL in rare genetic conditions will be advanced by uniting around a clear conceptualization of QoL and using more rigorous methodology with comprehensive measures of global QoL.

Quality of Life Among Norwegian Older Adults: Focus Group Results

Fundamental to the nursing profession is understanding what issues are important to quality of life (QoL) for older adults. The aim of this study was to explore issues of importance to older adults and to compare findings with Lawton's theoretical QoL conceptualization. Five focus groups were conducted with healthy and hospitalized adults and health professionals. Many valued aspects of human existence were found to affect QoL, and results lend empirical support to many of the themes appearing under Lawton's four sectors. Results indicate the need for multidimensional assessments of QoL among older adults related to health, psychological, personal competency, social, environmental, and spiritual indicators. Issues related to time use, happiness, cognitive functioning, self-concept, coping with change, social functioning, self-determination, altruistic activity, living conditions, security, and technological aids should also be considered in future assessments of QoL. Research is needed to explore the relevancy of these issues in future assessments of QoL among older adults.

An opportunity to refine our understanding of “response shift” and to educate researchers on designing quality research studies: response to Ubel, Peeters, and Smith

There is no advantage at this time to abandon the term "response shift" as suggested by Ubel et al. (Qual Life Res, 2010). The term is well known in the research field and has impacted the way we think about measuring quality of life (QOL) longitudinally. However, Ubel et al. (Qual Life Res, 2010) have provided the incentive to start an open dialogue on the subject with opportunities to refine the language of response shift and educate researchers. In this article, we identify opportunities in designing research studies to minimize or account for response shifts by considering the (1) selection of QOL concepts to measure, (2) questionnaires used to assess the QOL concepts, (3) design of the research study, (4) target population, and (5) analyses and reporting of results. Careful consideration of each of these issues will help us identify new methodologies and improved study designs that will move the QOL research field forward.

Quality of life among opiate-dependent individuals: A review of the literature

Quality of life (QoL) has become an important outcome indicator in health care evaluation. A clear distinction has to be made between QoL – focussing on individuals’ subjective satisfaction with life as a whole and different life domains – and health-related QoL (HRQoL), which refers to the absence of pathology. As opiate dependence is the primary drug of most persons entering treatment and as the attention for QoL in addiction research is growing, this review of the literature intends to summarise and differentiate the available information on QoL in opiate-dependent individuals. A comprehensive literature review was conducted, including database searches in Web of Science, Pubmed and Cochrane Database of Systematic Reviews. Articles were eligible for review if they assessed QoL or HRQoL of opiate-dependent individuals, used a QoL or HRQoL instrument and reported at least one specific outcome on QoL or HRQoL. In total, 38 articles have been selected. The review showed that various instruments ( n = 15) were used to measure QoL, mostly HRQoL instruments. Opiate-dependent individuals report low (HR)QoL compared with the general population and people with various medical illnesses. Generally, participation in substitution treatment had a positive effect on individuals’ (HR)QoL, but long-term effects remain unclear. Psychological problems, older age and excessive alcohol use seem to be related with lower (HR)QoL scores. The assessment of QoL in research on opiate dependence is still in its infancy. Still, the chronic nature of drug use problems creates the necessity to look at outcomes beyond the direct consequences of drug dependence and based on clients’ needs. HRQoL, with its unilateral focus on the functional status of clients, does not give information on clients’ own experiences about the goodness of life, and is as a consequence unsuitable for measuring QoL. Future research starting from a subjective, multidimensional approach of the concept of QoL is required.

Quality of life and mental health in Chinese culture

Quality of life (QOL) has become a standard outcome measure in psychiatry. The QOL concept is culture-dependent, which means that the results of Western studies may not be applicable to Chinese patients. The aim of this study is to summarize the recent literature on QOL and mental health in Chinese culture. QOL has increasingly been used as an outcome measure of pharmacotherapeutic or psychosocial interventions in Chinese societies. Recent studies have suggested that socio-cultural factors exert an influence on the QOL of Chinese psychiatric patients. Patients with major psychiatric disorders have a poorer QOL than the general population. Socio-demographic characteristics have no, or only weak, associations with QOL in schizophrenia, whereas novel antipsychotics and antidepressants improve QOL relative to traditional psychotropic medications in the short term. The inclusion of QOL measures in routine clinical practice and research in Chinese societies should be encouraged, and culture-sensitive QOL measures should be developed. Chinese psychiatry should also implement appropriate strategies and effective measures in line with the findings on the relationship between QOL and socio-demographic and clinical factors.

Qualidade de vida e epilepsia: perspectivas futuras e ações práticas para a pessoa com epilepsia

INTRODUÇÃO: O evento de Qualidade de Vida (QV) promovido pela ABE teve por objetivo reunir profissionais da área e traçar um breve panorama dos estudos da literatura e da situação dos estudos em nosso país. METODOLOGIA: Temas como instrumentos utilizados mundialmente na avaliação da QV das pessoas com epilepsia (PCE), validações realizadas no Brasil, fatores que afetam a QV nas epilepsias e aspectos da família foram amplamente discutidos. RESULTADOS: Frequência e gravidade das crises, depressão, ansiedade, efeitos adversos das medicações, tratamento cirúrgico, bem como fatores psicossociais (estigma, isolamento social, ausência de suporte) exercem influência marcante sobre a QV. CONCLUSÃO: Ações práticas futuras requerem a realização de estudos brasileiros multicêntricos.

Quality of life: what does it mean for general practice?

There is no doubt that maintenance or improvement of health-related or disease-related quality of life (QoL) is the ultimate goal of general practice. When keeping this in mind it focuses practice not only on the physical aspects of disease, but also on how patients perceive their illnesses. Defining general practice as ‘comprehensive personal care’1 implies that therapies should be balanced between evidence and patient preferences, which are influenced by their present and anticipated future QoL. This is especially relevant in treating chronic and palliative patients, when shared decisions should be made about surgery, medication and pain relief, withholding of treatment, and even some forms of euthanasia. In the last few decades many studies have examined the concept of QoL and methods to gain a clear view of this aspect of history-taking. Symptoms only partially reflect the perceived burden of the disease. Ferrans2 showed that in patients with cancer, QoL instruments provide additional information about side effects and the impact on other aspects of life that cannot be captured by measures targeted at key symptoms. There is a considerable discrepancy between patients' assessment of their own health and their doctor's judgement.3,4,5,6 So it is vital for GPs to ask questions about the commonly distinguished QoL domains of physical, mental, social, and psychological consequences of disease. Instruments to overcome bias in the perceptions of healthcare providers might be helpful in determining QoL. The content, …

World Health Organization quality of life instrument-brief and Short Form-36 in patients with coronary artery disease: Do they measure similar quality of life concepts?

This study aimed to assess the validity and reliability of World Health Organization Quality of Life Instrument (WHOQOL)-brief and SF-36 in patients with coronary artery disease (CAD). Considering that depression is known to be associated with bad outcomes in CAD and it is highly associated with poor Quality of Life (QOL), we tested the correlation between WHOQOL and SF-36 and an instrument to screen depressive symptoms. It is a cross-sectional survey conducted in 103 patients with documented CAD. QOL was measured through WHOQOL-brief and SF-36 and depressive symptoms were assessed by the Beck Depression Inventory (BDI). To evaluate convergent validity, the correlations between both QOL assessment instruments were examined; discriminant validity was assessed through BDI and QOL instruments correlations. Coefficient Cronbach's α was used to test reliability. Percentages of floor and ceiling effects were higher in SF-36 scores than the WHOQOL-brief ones. Although WHOQOL-brief showed a maximum of 1% of floor effect and 9% of ceiling effect, SF-36 presented 40 and 32%, respectively. Internal consistency reliability ranged from 0.65 to 0.85 for the WHOQOL-brief and 0.57 to 0.89 for the SF-36. Correlations between subscales of WHOQOL-brief and BDI ranged from −0.74 to −0.61 and correlations between subscales of SF-36 and BDI ranged from −0.68 to −0.26. SF-36 and WHOQOL-brief seem to be valid and consistent QOL measures in patients with CAD. Researchers should define the aims of their studies before choosing which instrument to use, because they appear to measure different constructs of QOL.

Salud y calidad de vida en urología: Aspectos en urología general y oncológica

Frequently, the term "quality of life" has been used to justify personal and professional decisions in all fields of medicine. Nowadays, quality of life studies are based on development and validation of sensitive measures of patient outcomes, incorporating functional status and perceived health status. Thus, quality of life has become an outcome as important as survival and effectiveness. A systematic review using Pubmed and Medline was performed, searching for papers concerning health related quality of life and urology. The most relevant articles where questionnaires and interviews were described and validated were listed. Based on psychometric properties, a search between 1970 and 2007 identified a total of 25 recommendable articles with generic inventories and specific modules that have been developed, validated and used in clinical practice or research. Historical aspects, quality of life concepts, validation of questionnaires and structured interviews, and most used instruments in generic health-related quality of life, general urology and urological oncology have been discussed. A brief review of historic background of health related quality of life and urology was performed.

Mammography screening from the perspective of quality of life: a review of the literature

The purpose of this literature review was to explore how women attending a national mammography screening programme reacted to the screening process on quality of life (QoL). The research question was what implications regarding true-negative results and false-positive results from mammography screening were found among women? Quality of life including life domains as psychological, physical and social was the theoretical reference in the study. Guided by the concept of QoL on mammography screening a database search of Medline, Cinahl and Cochrane was carried out. Search terms such as QoL, anxiety and mammography have been used. A review of studies between 1995 and 2007 showed that the implications regarding a negative result were less than those regarding false-positive one. It was found that women with negative results after mammography screening experience minor negative psychological consequences, and some women have even measured less anxiety following mammography than before because of the reassurance given by a clear negative result. False-positive result and recalls were a problem for many women. The process following recalls do affect women emotionally, decrease their wellbeing and QoL for weeks and even months. Future research should be directed at measuring the short-term outcomes in representative populations for whom screening and prevention are indicated. This knowledge would be useful for the organisation of the mammography programmes and for communication with the general population, the women coming for screening and those who do not attend.

Patients’ understanding of the concepts of health and quality of life

Objective The aim of this study was to identify how persons’ with rheumatoid arthritis (RA) understand the concepts of health and quality of life (QoL). Methods A phenomenograpic approach was used to gauge variations in understanding of health and QoL. Semistructured interviews were conducted with 22 persons having RA. The interviews were audiotaped, transcribed verbatim, and analyzed, resulting in a descriptive system consisting of categories and subcategories. Results Health was primarily associated with being healthy/being free from disease, being able to function normally, experiencing well-being, and having a healthy lifestyle. Two above-mentioned domains, “being healthy” and “being able to function normally” overlapped with respondents’ understanding of QoL. Additional perceived domains included attitudes towards life and, social and physical environments. Conclusion The results show that patients’ understanding of the two concepts of health and QoL partially overlap and partially differ. Practice implications Patients’ understanding of the concepts is individual and diverse, which needs to be taken into account in patient–physician consultations to ensure good communication. Furthermore, the interpretation of results based on patient-reported outcomes instruments measuring health status and/or QoL needs to be further studied over time to identify possible changes in these conceptions.

Quality of life measurement: one size fits all. Rehabilitation medicine makes no exception

Quality of life (QoL) is among the most popular outcome variables in health care, particularly in the field of rehabilitation medicine. Quality may be defined as the ratio between value and cost. However, when applied to people rather than objects, quality remains a controversial concept. For some researchers QoL is an objective status of the person that can be inferred by such indexes as health, education, and social status. For others QoL is a subjective status. Most researchers agree, despite some ethical concerns, that QoL can be measured. This implies assuming that the variable exists. Even under such an assumption one should acknowledge that not all human variables can be measured (e.g., ethnicity and gender). Furthermore, the QoL concept is usually explored by questionnaires summing objective life conditions, satisfaction with life, satisfaction with care, and even functional improvement after minor surgery. Confusion may arise between QoL and other unsuspected variables, unless tools are developed and analysed using modern psychometric approaches such as Rasch analysis, which is rarely the case. As a result, a potential risk is that adhoc arbitrary measures of QoL are used to support decisions regarding the assignment and/or rationing of resources within the welfare system, thus blurring individual responsibility.

Not all roads lead to Rome—a review of quality of life measurement in adults with diabetes

Quality of life (QoL) is recognized widely as an important health outcome in diabetes, where the burden of self-management places great demands on the individual. However, the concept of QoL remains ambiguous and poorly defined. The aim of our review is to clarify the measurement of QoL in terms of conceptualization, terminology and psychometric properties, to review the instruments that have been used most frequently to assess QoL in diabetes research and make recommendations for how to select measures appropriately. A systematic literature search was conducted to identify the ten measures most frequently used to assess QoL in diabetes research (including clinical trials) from 1995 to March 2008. Six thousand and eight-five abstracts were identified and screened for instrument names. Of the ten instruments most frequently used to assess 'QoL', only three actually do so [i.e. the generic World Health Organization Quality of Life (WHOQOL) and the diabetes-specific Diabetes Quality of Life (DQOL) and Audit of Diabetes-Dependent Quality of Life (ADDQoL)]. Seven instruments more accurately measure health status [Short-Form 36 (SF-36), EuroQoL 5-Dimension (EQ-5D)], treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)] and psychological well-being [Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Well-Being Questionnaire (W-BQ), Problem Areas in Diabetes (PAID)]. No single measure can suit every purpose or application but, when measures are selected inappropriately and data misinterpreted, any conclusions drawn are fundamentally flawed. If we value QoL as a therapeutic goal, we must ensure that the instruments we use are both valid and reliable. QoL assessment has the proven potential to identify ways in which treatments can be tailored to reduce the burden of diabetes. With careful consideration, appropriate measures can be selected and truly robust assessments undertaken successfully.

The reliability and validity of the short version of the WHO Quality of Life Instrument in an Arab general population

BACKGROUND AND OBJECTIVES:There is rising interest in quality of life (QOL) research in Arabian countries. The aim of this study was to assess in a nationwide sample of Kuwaiti subjects the reliability and validity of the World Health Organization Quality of Life (WHOQOL-BREF), a shorter version of the widely used QOL assessment instrument that comprises 26 items in the domains of physical health, psychological health, social relationships, and the environment.METHODS:A one-in-three systematic random proportionate sample of consenting Kuwaiti nationals attending large cooperative stores and municipal government offices in the six governorates completed the Arabic translation of the questionnaire. The indices assessed included test-retest reliability, internal consistency, item internal consistency (IIC), item discriminant validity (IDV), known-groups and construct validity.RESULTS:There were 3303 participants (44.8% males, 55.2% females, mean age 35.4 years, range 16 to 87 years). The intra-class correlation for the test-retest statistic and the internal consistency values for the full questionnaire and the domains had a Cronbach's alpha≥0.7. Of the 24 items that constitute the domains, 21 met the IIC requirement of correlation ≥0.4 with the corresponding domain, while 16 met the IDV criterion of having a higher correlation with their corresponding domain than other domains. Domain scores discriminated significantly between well and sick groups. In the factor analysis, four strong factors emerged with the same construct as in the WHO report.CONCLUSION:The Arabic translation of the WHOQOL-BREF has impressive reliability and validity indices. The poor IDV findings are due to the multidimensional nature of the questionnaire. The highly significant validity indices should reassure researchers that the questionnaire represents the same constructs across cultures. Negatively worded items possibly need refinement.