Quality of Life: A Deconstruction for Clinicians

Abstract

Quality of life has been an issue in medical research for more than twenty years 1 , and many authorities now regard it as a key measurement in clinical trials 2,3. Yet the concept remains controversial. In the clinical world, scepticism is exemplified by a comment by Wulff in the JRSM: 'Scientists may use rating scales and visual analogue scales to measure pain, and they may even invent scoring systems quantifying types of handicaps; but when they talk about measuring quality of life they have gone too far' 4. This statement reflects a two-world model of medicine and of human experience in which objective facts are clearly distinguished from subjective values 4,5. It can be seen as a reaction to the World Health Organization's concept of health and of quality of life that invites us to mix facts and values non-systematically:

A population‐based study of the impact of specific symptoms on quality of life in women with breast cancer 1 year after diagnosis

“…A cutoff value of 50 has been suggested by Koller and Lorenz to indicate clinically significant impairments. 13 We calculated Pearson partial correlation coefficients to assess the association between symptom and function scores (including overall QOL) after adjustment for age and to discover which symptoms or health complaints may be responsible for impaired QOL in women with breast cancer. Multiple regression analysis with stepwise forward selection (P ¼ .15) was applied to identify subsets of symptoms that were independently predictive for various function domains and overall QOL.…”

Quality of Life after Radical Cystectomy and Diversion

“…Bu tariften yola çıkarsak yaşam kalitesini kişinin sadece fiziksel sağlığı değil, fizyolojisi, psikolojik durumu, toplumsal ilişkileri ve çevresel faktörler, toplumsal ve dinsel dogmaları da etkileyebilmektedir. Tüm bu etkenler yüzünden klinik olarak uygun kullanımlı ve doğru ölçen modüllerin geliştirilmesine çalışılmaktadır (11). Bu modeller oluşturulurken en büyük sorun sağlık ve sağlık dışı etmenlerin hangilerinin dahil edilip hangilerinin dışlanacağıdır.…”

The quality of life of opiate addicts in Novi Sad // Kvalitet života zavisnika od opijata u Novom Sadu

“…4 Kvalitet života predstavlja individualnu percepciju osobe svog ličnog položaja u životu, što se tiče konteksta kulture, kao i sistema vrednosti u kojima ista i živi, ali i prema svojim ciljevima, standardima, očekivanjima i interesovanjima. 5,6 Kvalitet života zavisnika psihoaktivnim supstancama je smanjen zbog velikog broja problema koji se javljaju u svakodnevnom funkcionisanju. 7 Tačno je da se naša zemlja suočava sa sve većim brojem omladine, koja zbog problema sa zavisnošću, traži pomoć.…”