Essay On Quality Of Life
The way we think about health and health care is changing. The two factors driving this change are the recognition of the importance of the social consequences of disease and the acknowledgement that medical interventions aim to increase the length and quality of survival. For these reasons, the quality, effectiveness, and efficiency of health care are often evaluated by their impact on a patient's “quality of life.” There is no consensus on the definition of quality of life as it is affected by health (health related quality of life). Definitions range from those with a holistic emphasis on the social, emotional, and physical well≠ being of patients after treatment 1 to those that describe the impact of a person's health on his or her ability to lead a fulfilling life. 2 This article assumes it to be those aspects of an individual's subjective experience that relate both directly and indirectly to health, disease, disability, and impairment. The central concern of this paper is the tendency to regard the quality of life as a constant. We contend that perceptions of health and its meaning vary between individuals and within an individual over time. People assess their health related quality of life by comparing their expectations with their experience. We propose a model of the relation between expectations and experience and use it to illustrate problems in measuring quality of life. The implications of these concepts for the use of quality of life as an indicator of the need for treatment and as an outcome of care are discussed.
Measures of the quality of life summarise the judgments people make to describe their experiences of health and illness. This is what distinguishes them from measures of disability that ask about an ability to complete specific tasks, such as climbing stairs or dressing oneself. Quality of life is a broader concept and is concerned with whether disease or impairment limits a person's ability to fulfil a normal role (for example, whether the inability to climb stairs limits a person at work). However, the measures do not consider how people arrive at these judgments. Understanding the mechanisms through which health, illness, and healthcare interventions influence the quality of life (that is, understanding the determinants of quality of life) may highlight ways in which it can be maximised. A primary aim of treatment, particularly in chronic disease, is to enhance the quality of life by reducing the impact of the disease. Yet patients with severe disease do not necessarily report having a poor quality of life. 3 Therefore the relation between symptoms and quality of life is neither simple nor direct. Considering quality of life as the discrepancy between our expectations and our experience provides a way of explaining how we evaluate it. 4 Our everyday lives are complex. When we are asked about them we need ways to simplify our thoughts to provide answers. We do this by using sets of stable assumptions (expectations) to inform our observations. A haematologist uses reference values in the same way. Patients with back pain, for example, may expect that consulting a doctor will solve their problem.