Conceptualisation and Measurement of Quality of Life Based on Schalock and Verdugo’s Model: A Cross-Disciplinary Review of the Literature

Abstract

Researchers in the medical and social sciences have shown a rapidly growing interest in the concept of Quality of Life (QoL) in the past few decades. Reasons include its potential as an outcome measure of service delivery, and the opportunity of using a shared language both within and between different disciplines. Despite the widespread use of QoL in research, practice and policy development, there is little agreement on the defining aspects, as well as on the operationalization of the concept. In an attempt to broaden the knowledge on QoL and to give an overview of interdisciplinary consensus-and discussion aspects, a review of peer-reviewed QoLreviews, indexed in Web of Science, and published from 2000-2013 (n=75) was carried out. Theoretical and measurement principles, derived from the QoL-framework of Schalock & Verdugo (2002) were systematically explored. Results indicate a growing interdisciplinary consensus on QoL as (1) a multidimensional construct, (2) composed of both objective and subjective dimensions, (3) with an emphasis on the subjective evaluation of one's life circumstances, (4) which is dynamic in nature and (5) which can be influenced and enhanced by a variety of factors, implying a positive view on social services. Contrary, debate is still going on (1) the ideal method to assess QoL, (2) the use of proxies in QoL-measurement and (3) the preference for a general or on the contrary disease-or target group specific QoL-instrument. (6) when operationalized by means of the question "How satisfied are you with your life as a whole", its composition dominantly reflects a stable and positive mood state, also referred to as 'Homeostatically Protected Mood', rather than a cognitive evaluation of people's lives. The homeostatic system seeks to defend this state of SWB (Cummins 2009; Davern et al. 2007). Felce and Perry's QoL model (1995; 1997) has been used with persons with intellectual and multiple significant disabilities (Petry et al. 2005; 2007). Felce and Perry define and conceptualize QoL as "an overall general wellbeing that comprises objective descriptors and subjective evaluations of physical, material, social, and emotional wellbeing, together with the extent of personal development and purposeful activity, all weighted by a personal set of values" (Felce & Perry 1995, p. 62). Three essential components can be discerned: objective life conditions on different life domains, subjective feelings of wellbeing on these domains, and personal values and aspirations regarding these domains. These components are in a constant dynamic interaction with each other, as changes in one of the components may induce changes in the other components. At the same time these three elements are able of evolving independently as a result of external influences, such as age and maturation, or social, economic and political variables (Felce & Perry 1995). As the components can be influenced by external factors, any measurement of QoL should include the assessment of all three aspects (Felce & Perry 1995). The World ...

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