Quality of life

Quality of life (healthcare)

Quality of Life (QoL) is a phrase used to refer to an individual’s total wellbeing. This includes all emotional, social, and physical aspects of the individual’s life. However, when the phrase is used in reference to medicine and healthcare as Health Related Quality of Life, it refers to how the individual’s wellbeing may be impacted over time by a disease, a disability, or a disorder.

Ascertaining Health Related Quality of Life

Initial HRQoL measures referred to simple assessments of physical abilities by an external rater (e.g.: patient is able to get up, eat and drink, take care of personal hygiene without any help by others), or even to a single measurement (e.g. the angle to which a limb could be flexed).

The current concept of HRQoL acknowledges that subjects put their actual situation in relation to their personal expectation. The latter can vary over time, and react to external influences such as length and severity of illness, family support, etc. As with any situation involving multiple perspectives, patients' and physicians' rating of the same objective situation have been found to differ significantly. Consequently, HRQoL is now usually assessed using patient questionnaires. These are often multidimensional and cover physical, social, emotional, cognitive, work- or role-related, and possibly spiritual aspects as well as a wide variety of disease related symptoms, therapy induced side effects, and even the financial impact of medical conditions.

Similar to other psychometric assessment tools, HRQoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. As such, hundreds of validated HRQoL questionnaires have been developed to suit the needs of various illnesses. The questionnaires can be generalized into two categories:
  1.  Generic instruments (e.g. SF-36, Short-Form with 36 questions)
  2.  Disease or Disorder specific instruments (e.g. the LC -13 Lung Cancer module from the EORTC   Quality of Life questionnaire library, or the Hospital Anxiety and Depression Scale (HADS) ).