Case 7 - Quality of Life Flashcards

(40 cards)

1
Q

what is the WHO definition of Quality of Life

A

it is a broad ranging concept affected in a complex way by a person’s physical health, psychological state, level of independence, social relationships and their relationship to salient features in their environment.

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2
Q

what is health related quality of life

A

the impact of disease or illness on key aspects of physical, social and psychological functioning

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3
Q

how do people measure their own quality of life

A

a person’s general evaluation of their life and how it aligns to their values, goals and expectations

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4
Q

what are quality adjusted life years

A

measure of the state of health of a person or group in which the benefits in terms of length of life, are adjusted to reflect the QoL

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5
Q

what is one quality of life year equal to

A

one year of life in perfect health

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6
Q

what considerations are also included in this

A

ADLs
freedom from pain
mental ill health and well-being

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7
Q

what is a cost effective QALY

A

less than £20,000 per QALY is considered to be clearly cost effective

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8
Q

when must other sorts of benefits or considerations be evident

A

when it is £20,000-£30,000 per QALY

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9
Q

what happens if it is more than £30,000 per QALY

A

a strong case needs to be made for the technology to be recommended (NICE)

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10
Q

what factors are included when assessing QoL

A

health status
patent reported outcomes
patient reported outcome measures (PROMS)

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11
Q

what are the objective measures of health status

A

mortality rate
morbidity rate
measures of functioning

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12
Q

what is mortality rates

A

how many people die in one year compared to the year before

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13
Q

what are subjective measures of health status

A

QoL

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14
Q

what are patient reported outcomes

A

any clinical symptoms reported directly by the patient

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15
Q

how to measure the cost of clinical treatment

A

symptom assessment vs assessment toxicity

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16
Q

what are patient reported outcome measures (PROMS)

A

standardised, validated questionnaires that are completed by patients to ascertain:
- perceptions of their health status
- perceived level of impairment
- disability
- health related quality of life

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17
Q

what are the benefits of PROMS

A
  • promotes active patient involvement
  • provides patient centred focus in consultations
  • facilitates tailored and holistic care which can improve QoL
  • enable standardised monitoring of patient outcomes
18
Q

what to do on an individual level

A

inform patient choice
facilitate communication between healthcare teams to provide tailored care
identify those most in need

19
Q

what to do on a population level

A

audit and quality assurance
effectiveness data for treatments
for policy (e.g NICE)

20
Q

what are generic quality of life measurements

A

short form-36
Nottingham health profile
sickness impact profile
WHOQoL-100

21
Q

what are the six sections of the Nottingham health profile

A

physical mobility
pain
sleep
social isolation
emotional reaction
energy
(rate from worst health to best health)

22
Q

what are the uni dimensional measurements

A

general health questionnaire
hospital anxiety and depression scale (HADS)
beck depression inventory (BDI)
McGill pain questionnaire
self esteem scale

23
Q

what are the multidimensional measurements

A

assess health in a broad sense
‘how do you rate your state of health on a scale from 1-10”

24
Q

what is the individualised approach

A

schedule for evaluating individual quality of life

25
what is the standardised measurement
Barthel index - how independent the person is
26
what can quality of life measures do
screen for hidden problems facilitate communication improve shared decision making monitor change more accurately
27
what is reliability
measures consistently over time and between people
28
what is validity
measures what it set out to measure
29
what is sensitivity
ability to detect changes in quality of life
30
what is responsiveness
ability to distinguish clinically important changes as a result of an intervention
31
what is the adapted HRQoL model
LOOK UP DIAGRAM
32
according to the model, what are the characteristics of the individual
demographic developmental psychological biological factors
33
what are the characteristics of the environment
either social or physicals
34
what does biological function focus on
function of cells, organs and systems assessed through lab tests, physical assessment, medial diagnosis
35
what are the symptoms
physical emotional cognitive
36
what is the functional status
physical psychological social role function
37
what is good health a subjective measure of
biological function symptoms functional status
38
what is overall quality of life
subjective wellbeing satisfaction with life as a whole
39
what do the arrows in the diagram represent
the dominant causal associations
40
when judging our quality of life, what do we do?
use a frame of reference to help understand the question decide 'standards of comparison' decide on a 'sampling strategy' - which part of my life should I asess