Although the patients answered the multiple-choice questions readily, half of them were unable to use the LASA scales correctly. The highest nonresponse rate was on the LASA items related to sexual function. The Quality of Life Index (QLI), developed by Spitzer et al. (1981), has been tested in a variety of settings. It is used to assess the physical, psychological, and social functioning of patients. Alternative forms for completion by the patient, the physician or other health professional, relative, or significant other were developed to determine whether comparable ratings could be obtained from several sources.
Subjective versus outsider perspectives
All scores showed that patients reported higher quality of life with continuous rather than intermittent therapy. This review found that a diverse number of different measures are used to evaluate QOL. Most of the studies included a condition-specific measure, which is not surprising given that various disease populations were the target groups in most of the included studies.
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There is a need for improvements in this field, and researchers should pay closer attention to methodological and conceptual issues when planning QOL studies. Based on our evaluation of methodological and conceptual clarity, we conclude that most QOL studies in health and medicine have conceptual and methodological limitations. In general, theories and theoretical frameworks improve the understanding of QOL. The use of theoretical perspectives in empirical research deepens understanding and can help to establish new knowledge about QOL 22. Theory is a presupposition for the ability to compare results from different studies and is important in the development and testing of QOL measures. Basing research on theory also improves the conceptual clarity and therefore the validity of the measures.
Review Form for Quality of Life Index
- They used internal consistency analysis to detect discrepancies in responses and reported that 50 percent of the discrepancies were the result of correctable errors.
- Although the patients answered the multiple-choice questions readily, half of them were unable to use the LASA scales correctly.
- Shek 9 argued that this can be explained by the socioeconomic and political circumstances, in addition to cultural differences, such as different sets of values and philosophical foundations.
- The basic issue is the use of quality-of-life measures to assess short-term against long-term responses to therapy.
- There are several possible explanations for the focus on adults, primarily that the prevalence of disease and long-term conditions is much lower in children than in adults.
Some assessments attempt to move from states of health to judgments of the worth or value of life with a given state of health. Health economists have used this approach to compare technologies in terms of costs per QALY gained. Not everyone agrees with such an approach, because it tends to diminish the value of a good, but troubled, life. Quality of life represents an aspect of health that is different from that generally measured using traditional methods of assessment, such as X-rays, blood tests, and clinical judgment. The latter have tended to dominate within health care and medicine in part because they are seen to be relatively objective.
Quality-of-life research has included the study of levels of economic, political, social, and psychological well-being resulting from varying governmental and economic systems, as well as policies and public programs related to health. Schuessler and Fisher (1985) wrote that quality-of-life research began in the 1960s with the Report of the President’s Commission on National Goals in the United States. Most specialists agree that the term ”quality” has the same meaning as “grade” or “rank,” which can range from high to low or best to worst. The term “quality of life” serves as a catchword for different notions of the good life. It is used in fact to denote a set of qualities of life, which can be ordered on the basis of the following two distinctions. One distinction is between opportunities for a good life and the outcomes of life.
A disabled person may report a high quality of life, whereas a healthy person who recently lost a job may report a low quality of life. Within the arena of health care, quality of life is viewed as multidimensional, encompassing emotional, physical, material, and social well-being. The research designs of the included studies included descriptive, longitudinal, and experimental designs. QOL is increasingly used as an endpoint in clinical trials, often as part of an evaluation of different treatment or intervention outcomes. It is noteworthy that many of the interventions described in the included studies are not intended to increase QOL and therefore, QOL appears as an important, but secondary, outcome. Including QOL as a secondary outcome emphasizes the importance of such issues when assessing the benefits of different treatment options; that is, researchers are interested in both the medical outcomes as well as the effects of treatment on patients’ lives.
The WHOQOL is a quality of life assessment developed by the WHOQOL Group with fifteen international field centres, simultaneously, in an attempt to develop a quality of life assessment that would be applicable cross-culturally. The women responded to items about how they had felt during the past two weeks on a seven-point scale. Countries can be ranked on their economic systems and on the types and amounts spent by governments on social programs relative to expenditures on industry and the military. At the level of the individual, the elements can be objective (for example, job, income, shelter, and food) or subjective (happiness, sense of well-being, self-realization and the perceptions of the worth and value of life, and the like).
Quality of Life and Technology Assessment: Monograph of the Council on Health Care Technology.
Independent ratings by two quality of life definition students of 30 patients with mixed diagnoses correlated highly (0.86). Using 100 patients in a second study, the correlations were higher (0.96) (Grieco and Long 1984). The utility value assigned to a health state generally ranges from 0, the value ascribed to death, to 1, the value ascribed to the reference state of a healthy life. By multiplying a utility value for a health state by the number of years of duration of the expected health state, the resulting product is the Quality Adjusted Life Years (QALY). Health economists posit that health care programs should be evaluated by comparing the relative costs of the programs with the QALYs produced.
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