Application of Ferrans et al.'s conceptual model of health‐related quality of life: A systematic review

Abstract

Ferrans, Zerwic, Wilbur, and Larson proposed the conceptual model of healthrelated quality of life (HRQOL) in 2005 to explicate the constructs associated with HRQOL and to describe the associations among those constructs. In this systematic review, the authors aimed to describe empirical studies that used Ferrans et al.'s model and to examine the evidence related to the hypothesized model concepts. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Relevant articles were identified using Crossref, CINAHL, and PubMed. To be included, studies had to employ the model as a theoretical framework and be published in English between 2005 and 2020. Type of theory use was coded using four designations: informed by theory, applied theory, testing theory, and building theory. Thirty-one studies were included. Most studies involved adult patients with chronic illnesses (n = 20) and were conducted in Western countries (n = 22). The most common type of theory use was testing theory (74.19%). Among the seven concepts in Ferrans et al.'s model, all 20 hypothesized associations were tested and 19 were supported by study results. The three associations most frequently supported were between symptoms and functional status (n = 13), environmental characteristics and quality of life (n = 10), and individual characteristics and functional status (n = 8). No studies found an association between environmental characteristics and biological function. Our review found that Ferrans et al.'s model has been used extensively to guide HRQOL research. An emerging body of research provides preliminary support for the associations hypothesized in the model. Additional research is needed to confirm the hypothesized associations among model concepts.

A process-based approach to health-related quality of life as a “way of living”

“…This framework continues to evolve with adaptations such as the 2005 model by Ferrans et al [ 24 ], that expanded the hypothesized life domains that account for HRQL. A recent systematic review of this version of the taxonomy reported that among 31 studies (pooled n = 62,281), 19 of 20 hypothesized associations between life domains and HRQL were supported [ 25 ]. Interestingly, this evidence was obtained from studies where a clinically applied theory or framework for health behavior or HRQL was referenced in only 16.5% of papers, while only 6% applied a theory to account for the constructs used in assessing HRQL.…”

Health Literacy and Health-Related Quality of Life in Beijing Adolescents: A Path Analysis

“…Future studies are recommended to recruit adolescents from a wider range of socio-demographic backgrounds. Third, this study did not consider students' disease characteristics, function status and global health perceptions, which are essential pathway factors of HRQoL ( Duangchan & Matthews, 2021 ). Fourth, the standardized correlation coefficients in the final trimmed path model were small (ranging from 0.03 to 0.45), suggesting weak to moderate relationships between variables.…”