Health related QoL

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It is valuable to obtain information on both kinds of QOL because economic and social status affect HRQOL and both are necessary to understand health-related outcomes. However, more emphasis has been placed on the study of HRQOL for several reasons. First, effective disease management particularly for chronic diseases, in large part consists of finding treatments that minimize the QOL impact of disease. Second, HRQOL measurement is further advanced than measurement of non-health-related QOL. Finally, while housing, air quality, and other components of the environment are clearly important features of QOL, they are important mainly because of their effect on health and

health-related QOL(Albert). On the other hand, the two are sometimes hard to separate; for example, successful treatment by a physician may improve one’s capacity to make friends.

Health-related QOL emerged from research on health status. Early measures, such as the Sickness Impact Profile (SIP) (Bergner, et al.), sought to identify common domains affected by disease that would allow clinicians to gauge the impact of a clinical condition. The SIP identified twelve health-related QOL domains, which include ambulation, mobility, body care and movement, communication, alertness behavior, emotional behavior, social interaction, sleep and rest, eating, work, home management, and recreation. A key element of the SIP, and of almost all QOL measures since, has been that patients themselves rate their level of

impairment. This subjective element is the essential feature of health-related QOL, for who can better report on the QOL impact of a medical condition than the patient (Gill and Feinstein)? Indeed, health-related QOL is sometimes called ‘‘patient-reported outcomes’’ to stress this subjective focus.

If patients themselves have to rate their level of impairment how would it be possible to evaluate QOL in patients with cognitive disorders, such as Alzheimer’s disease? Answers awaited.

References:

Albert, S. M. ‘‘Assessing Health-Related Quality of Life Chronic Care Populations. In Measurement in Elderly Chronic Care Populations. Edited by J.A. Teresi, M. P. Lawton, D. Holmes, and M. Ory. New York: Springer Publishing Company, 1997. Pages 210–227.

Bergner, M.; Bobbit, R. A.; Pollard, W. E.; , D. P.; and Gilson, B. S. ‘‘The Sickness Impact Profile: Validation of a Health Status Measure.’’ Medical Care 14 (1976): 57–67.

Gill, T., and Feinstein, A. R. ‘‘A Critical Appraisal of the Quality of Quality of Life Measurements.’’ Journal of the American Medical Association 272 (1994): 619–626.