HRQOL Models Flashcards
Wilson & Cleary’s Model
- biomedical and social science
- linear relationship between constructs
- impacted by environmental and individual factors
- founded on biological and psychological aspects of health outcomes
Wilson & Cleary’s 5 Domains
- bio-physiological status
- symptoms
- functional status
- general health perception
- quality of life
Wilson & Cleary: Bio-physiological Status
- Commonly conceptualized, measured and applied in clinical practice
- Focuses on function of cells, organs and systems
Wilson & Cleary: Symptoms
- Focus shifts from cells/organs to organism as a whole
- Physical symptoms – a perceptions, feeling or belief about the state of the body
- Psychophysical – associated with mental health; symptoms not clearly physical or psychological
- Emotional
Wilson & Cleary: Functional Status
Asses the ability of the individual to perform defined tasks
Wilson & Cleary: General Health Perception
Integration of all health concepts
Wilson & Cleary: Quality of Life
Subjective assessment of well-being, happiness and satisfaction
Ferrans et al. Model & how it built upon Wilson & Cleary’s model?
- HRQOL= desired end product
- environment and individual effects are linear
- explained individual and environmental characteristics
- removed non-medical factors
- simplified the interrelation of domains
- dominant causal relationships
- retains reciprocal relationships
WHOICF Model
- unifying
- covers many demographics
- examines disease and how it affects HRQOL?
- ICF= similar to DSM
- Part 1= functioning/disability
- Part 2= context (individual and environmental)
What is unique about the WHOICF?
- stresses health and functioning
- every person can experience disability (universal human experience)
- shifts from cause of health conditions to their impact
WHOICF: Universality
- classification of functioning and disability should be applicable to all people irrespective of their health condition
WHOICF: Parity
- disability should not be differentiated by etiology (i.e. “mental” vs “physical”)
WHOICF: Neutrality
- domains should be worded in neutral language
WHOICF: Environmental
- SM of disability
- factors range from physical factors such as climate and terrain, to social attitudes, institutions, and laws
Applications of WHOICF at the Individual Level
- assessment of individuals
- individual treatment planning
- evaluation of treatment and other interventions
- communication amongst health care teams
- self-evaluation by consumers
Applications of WHOICF at Institutional Level
- educational and training purposes
- resource planning and development
- quality improvement
- management and outcome evaluation
- managed care models of health care delivery
Applications of WHOICF at Social Level
- eligibility criteria for state entitlements
- social policy development
- needs assessments
- environmental assessment for universal design
WHOICF: Contextual Factors
- external environmental factors (social attitudes, architectural characteristics, legal and social structures, as well as climate, terrain…)
- internal personal factors, which include gender, age, coping styles, social background, education, profession, past and current experience, overall behavior pattern, character and other factors that influence how disability is experienced by the individual
3 Levels of Human Functioning Classified by the ICF…
- functioning at the level of body or body part
- the whole person
- the whole person in a social context
Hierarchy Order of WHOICF
Chapter (sensory functions and pain)-> Second level (seeing functions)-> Third level (quality of vision)-> Forth level (colour vision)
Mishels Uncertainty of Illness Theory
- how people cope with a disease when given a diagnosis?
- antecedents of uncertainty
- appraisal of uncertainty
- coping with uncertainty
- useless as it cannot measure uncertainty
OHRQOL
Reflects people’s comfort when eating, sleeping and engaging in social interaction; their self-esteem; and their satisfaction with respect to their oral health
OHRQOL Core Concepts
- multidimensional: well being, emotional well being, expectations, satisfaction, sense of self
- Subjective
- balance: both positive and negative aspects
- unclear on how to achieve adequate oral health (doesn’t connect to HRQOL and QOL)
OHRQOL Dimensions
- oral health
- social/emotional
- environment
- treatment expectations
- function