Quality Of Life

Quality of life is one of the important indicators to measure overall population health or health status of the people living in any location. As the end expected outcome of any medical intervention, nursing intervention or any public health program is to improve the quality of life, health professionals at least once think about measuring Quality of life among their population of interest in their professional life.

What is quality of life?

Quality of life is a multidimensional concept and it involves subjective evaluations of various aspects of life. Human life has complicated structure physically and socially, as human can’t exist alone. They have body, which is further controlled by the mind, their mind is further affected their social, physical surrounding, system and significant others. Thus, quality of life is very difficult to measure. However, experts have developed definitions and tools to measure the quality of life of people.

WHO defines quality of life as “individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.”

Why do we use quality of life?

  1. Comparison of people in different geographical region: people in different geographical area can be compared with this indicator. It will be easy to understand the reasons for the differences in Quality of life in those geographical region. Why do Swiss have better quality of life than Chinese or other countries?
  2. Impact of any program or intervention or Policy: Quality of life indicator is the ultimate outcome of any interventions. The aim of smoking control and prevention program could be to reduce the number of people, who smoke, its effect could be seen as the change in quality of life in the targeted population. The improvement in relationship, self-esteem, improvement in physical health, improvement in environment, reduction in expenditure increases the quality of life of the people through the smoking prevention policies and programs. Depending on assessment of the quality of life, the policy, programs or interventions could be designed and modified so that they increase the quality of life of targeted population.
  3. Health needs: Need of the population could be evaluated with this indicator. Lower quality of life indicates lack of good health or failings in other parameters and ultimately the shortcomings in the existing programs, and inadequate interventions to improve the quality of life.
  4. Effect of chronic illness, short term or long term illness: We can also estimate impact of certain disease conditions on quality of life and to measure the ways to improve quality of life of the people living with such disease conditions.

Tools to measure the quality of life

  • CDC HRQOL-4: Centre for disease control and prevention (CDC) uses 4 items questionnaire CDC HRQOL-4.
  • CDC HRQOL-14 “Healthy days measure”: This is constructed by adding 10 more items in CDC HRQOL-4 tool.
  • WHOQOL-100: This tool is developed by world health organization and it is elaborate. This includes 100 questionnaires from different aspects of life, that can affect the quality of life of a person.
  • WHOQOL-BREF: It is abbreviated form of WHOQOL-100 and consists of 26 items only.

There are some tools such as SF 36, SF 12, which can be used to measure Health status of any population. They also used as quality of life indicators sometimes by some authors.

Difference between CDC Health related quality of life (HRQOL) and WHOQOL scale

The definition of health includes mental, physical, social and spiritual domains of life and HRQOL should measure all aspects of those domains. HRQOL tends to measure the quality of life that are directly related to health status of the people. HRQOL tool used by CDC contains items/ questions related to subjective perception of overall general health status, mental health, physical health and activity limitations. WHOQOL is more elaborate and includes health, psychology, level of independence, social relations, environment, spirituality/ religion/personal beliefs. WHOQOL-BREF is usually used in small scale studies. Authors need permission to use WHOQOL tools and required to abide by user agreement and researchers need approval if any modifications of the tool is required. WHOQOL have been adapted for certain diseases, for example, WHOQOL-HIV is constructed especially to assess quality of life of people with HIV.

- by Pramila Rai

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