Lexique

Defining Quality of Life

Defining Quality of Life

Quality of life is a multi-factorial concept (Leplege, 1999). In its broadest sense, the World Health Organization (1994) defines it as “an individual’s perception of their position in life in the context of culture and value systems in which lives in relation to their goals, expectations, standards and concerns”. This definition encompasses both the somatic state, physical independence, psychological condition, psychological functioning, well-being, social interaction, occupational and economic resources.

Blog on Health will use a limited concept in health care, entitled Heath related quality of life. It corresponds to an “aggregate representations based on health status, physiological status, well-being and life satisfaction” (MacKeigan and Pathak, 1992).

It excludes the professionals and spiritual realms. It is similar to the concept of health defined in 1947 by the World Health Organization by giving it its perceptual value, contextual, intimate, subjective and unique. It reflects the views of the patient or the person who is facing a health problem. It addresses the physical, psychological and relational aspects (Curtis et al., 1997). It can therefore be used to account for the effect of a therapeutic strategy. It is closely correlated to the notions of well-being (well-being in English), happiness (happiness in English), or integrity (wholeness in English). In short, it is a mixture of general life satisfaction and personal well-being.

If we regret the lack of consensus definition and progress towards greater clarity, its practical usefulness suffers no discussion. It helps to account for the overall subjective state of a person based on selected therapeutic / preventive solutions. It evaluates both in the context of clinical practice and research. It has the advantage to account for the complexity of the development of chronic diseases and the inherent to any making up treatment strategy (Leplege 1999) uncertainty. Quality of life related to health will depend on the overall health of the age of the (of) disease (s), the number of symptoms, pain, loss of functional autonomy and self-regard.

Quality of life related to health is a “cluster of performances based on health status, physiological status, well-being and life satisfaction” (MacKeigan and Pathak, 1992)

The measure of quality of life related to health

The measure of quality of life related to health has become essential in research as clinical (Ninot, 2012). It is done through: a statement of factual information (income, social status, physical living conditions …), a behavior observation grid, a hetero-administered questionnaire (write-third) interview guide, or a self-administered questionnaire (self-administration). The self-administered questionnaire is the form most commonly used. Its execution is fast, its analysis too. There are specific to a disease for patients or generic for the general population (Bowling, 2001). They usually offer scores by dimension and a global rating of quality of life related to health. The number of items questionnaire varies between 5 and 150 In some cases, a score increase reflects an improvement in quality of life, and in others, a degradation. Their psychometric properties and cross-cultural validation are not always quality (Ninot, 2014). Some have a threshold score of clinical change (Minimally Clinical Individual Difference or Minimally Individual Difference). A variation above this threshold indicates a clear change in the level of quality of life of a patient. A major advantage is the ability to place several trends graphically patients according to a therapeutic or preventive solution. This graph makes it easier to explain the changes to a general doctor, a therapist, a team and family. Quality of life is a common denominator that gives an overview of what the patient feels.

Poor quality of life related to health

One person is the only live daily with his illness or medical condition. What she has to say about his behavior guide health. Quality of life is a summary translation. A poor quality of life potentially reflects a misunderstanding of the disease, poor behavioral disease management in situations of emergency or routine, presence of comorbidities, loneliness, low support environment, a lack of ownership disease. The possible consequences are worsening the disease, the increase in cases of failure, the adoption of risk behaviors for health, the emergence of new problems and degradation of communication with caregivers and loved ones.


The message for Patients

Quality of life related to health is the product of an interaction between a subject and an environment (Ware, 2003). It is a perception at time t that guide lines health and influences the way to see the care and work with caregivers. This measure reflects the experiences and adaptation of the patient to his illness. She had interest among caregivers to enable them to give equal importance to the management of systemic effects of different phenotypes of disease and the increase in prices of all life.

What it means for Health Professionals

The passage of a biomedical model to a biopsychosocial model in medicine of the third millennium involves a broader look (eg a patient rather than a failing organ or altered function person) and subjective (eg the emphasis on felt and lifestyle) of the patient (and Préfaut Ninot, 2009). This context has given rise to the concept of quality of life related to health. Health authorities recommend that health professionals should, whenever improving the quality of life and increased life for all therapeutic choices.

In practice, the measurement of quality of life related to health allows (1) detecting a person with a poor quality of life, (2) to contribute to decision-making and sharing, (3) to monitor the efficacy of therapeutic action and to report, (4) to interact with a patient to make a decision, (5) using a retrospective presentation of measures of quality of life as a psychotherapeutic tool (Ninot, 2014) .

What it means for Researchers

Quality of life related to health has become an essential marker to verify the effectiveness of a therapeutic (Ninot, 2014). It is therefore an important goal of any therapeutic, not just the increase in lifespan or normalization of biological parameters.

What it means for Policymakers

Various national and international plans invite today to consider the quality of life of patients with chronic disease (e.g., the plan for improving the quality of life for people with chronic diseases 2007-2011). The idea originator of these plans is to improve the lives of people with a non-curable disease. Put forward the concept of quality of life is encouraging health professionals to reduce symptoms and improve the daily lives of patients as much as look at all costs to increase lifespan. In other words, a more patient in his head, his body better and better with others is likely to better manage their disease. He may be able to limit the number of unscheduled care and therefore save money. And indeed, a number of studies found a reduction in spending on health when prevention strategies and accompanying therapy are implemented. So, think about ways to improve the quality of life is a way to save money in the long run.


References

Bergner M (1989). Quality of life, health status and clinical research. Medical Care, 27, S148-156.

Bowling A (2001). Measuring disease: A review of Disease Specific Quality of Life Measurement Scales. Buckingham: Open University Press.

Curtis JR, Martin DP, Martin TR (1997). Patient-assessed health outcomes in chronic lung disease: what are they, how do they help us, and where do we go from here? American Journal of Respiratory Critical Care Medicine, 156, 1032-1039.

Kaplan RM, Ries AL (2007). Quality of life: concept and definition. COPD Review, 4, 263-71.

Leplège A (1999). La mesure de la qualité de vie. Paris: PUF.

MacKeigan LD, Pathak DS (1992). Overview of health-related quality-of-life measures. American Journal of Hospital Pharmacy, 49, 2236-2245.

Ninot G (2014). La qualité de vie liée à la santé dans les maladies chroniques. In F.Bacro (Ed.), La qualité de vie : approches psychologiques. Rennes : Presses Universitaires de Rennes.

Ninot G (2012). Enjeux cliniques et scientifiques des questionnaires courts de qualité de vie spécifiques à une maladie respiratoire. Revue des Maladies Respiratoires, 29, 367-370.

Ninot G, Delignières D, Varray A (2010). Stability of physical self: examining the role of chronic obstructive pulmonary disease. European Review of Applied Psychology, 60, 35-40.

Ware JE (2003). Conceptualization and measurement of health-related quality of life: comments on an evolving field. Archives of Physical Medicine and Rehabilitation, 84, 43-51.

WHOQOL Group (1994). Development of the WHOQOL: Rationale and current status. International Journal of Mental Health, 23,‎ 24-56.


To reference this Blog en Sante © article.

Ninot G (2014). Definition of quality of life. Blog en Sante, L2.

© Copyright 2014 Grégory Ninot. All rights reserved.