Week 6: Quality Of Life

Question 1

What is meant by quality of life?

Answer 1

The ability of a person to live with good physical, mental and social wellbeing, to complete the hopes, wishes and daily activities that are important to them
To fulfill their life goals.

Question 2

What are the different domains considered within the WHO Quality of Life?

Answer 2

1. Physical health
2. Pyschological health
3. Level of independence
4. Social relationships
5. Environment
6. Personal values and beliefs

Question 3

What is included within the physical health domain of quality of life?

Answer 3

Energy and fatigue
Pain and discmofort
Sleep and rest

Question 4

What is included within the psychological domain of quality of life?

Answer 4

Body image and appearance
Negative or positive feelings
Self-esteem
thinking, learning, memory and concentration

Question 5

What is included in the level of dependence domain of quality of life?

Answer 5

Mobility
Activities of daily living
Dependence on medicines and medical aids
Work capacity

Question 6

What is included in the social relationships domain of quality of life?

Answer 6

Personal relationships
Social support
Sexual activity

Question 7

What is meant by the environment domain of quality of life?

Answer 7

Freedeom, physical safety and security
health and social care - access and quality
Home environment
Opportunities for acquiring new skills and information
Participation in and opportunities for recreation
Levels of pollution
Transport access.

Question 8

What is included in the personal values and beliefs section of quality of life?

Answer 8

Religion
Spirituality
Personal beliefs
** bitter quality of life the closer you live to these values

Question 9

What are the four different approaches to defining/measuring quality of life?

Answer 9

1. Sum of objective measures - factors given a numerical value and compared against population average, e.g income.
2. Subsjective satasfication to these values - how a person feels about their life situation in comparison to others.
3. Combination of objective and subjective measures above
4. objective assessment of life conditions and subjective satisfaction, weight accorindly to the important an individual places on each domain

Question 10

How does measuring quality of life relate to health?

Answer 10

Health Related quality of life - considers physical, social, mental and emotional functioning society
Consider population health - morbidity, mortality and life expectancy
Evolved over time to include QOL measures alongside deficit measurement of health.
Includes: somatic sensations such as physical sensations and pain, concentration and mood, social and sexual functioning and occupational status
Is often related to well-being - includes satisfaction and positive emotions

Question 11

What are the common domains assessed by health professionals when thinking about quality of life?

Answer 11

Mobility
Freinds and relationships
Overall health
Symptoms
Ability to complete everyday tasks
Anxiety and stress

Question 12

What is measuring Quality of Life used for in health care services?

Answer 12

Connects different health disciplines - particularly medical, mental and social services
Determines the felt burden of non-communicable disease
Monitor progress or changes in the population health
Identifies groups of people with low perceived health or wellbeing that can then have targeted intervention
Allows comparison of treatment
Used to investigate reasons for poor adherence to treatment
Used in policy making

Question 13

What objective measurements are used to comppare treatment outcomes?

Answer 13

Mortality
Morbidity

Question 14

What are the disadvantages of using objective variables to compare treatment outcomes?

Answer 14

Limited understanding of peoples own views and quality of life
No appreciation for people interpretation of what illness or symptoms means to/effect them
For example some medical diseases are so common that they are not viewed as an illness - so may increase morbidity but will not decrease QOL.

Question 15

What are the three main applications of quality of life measurements in health care?

Answer 15

To compare treatments
To investigate reasons for poor adherence to treatment
In policy making - e.g allocate resources in the bet way to improve quality of life

Question 16

What method can be used to assess quality of life?

Answer 16

Q-LES-Q-SF form
Quality of Life Enjoymeny and satisfaction questionnaire - short form

Asks 16 questions on social, economic and biological factors that are answered on a rating score of 1-5 to repesrent very poor to very good.
Example questions include - mood, family relationships and physical health

result is given as a percentage of the maximum score - higher percentage indicates a greater quality of life.

Question 17

How can the bio-psychosocial model be applied to quality of life?

Answer 17

Biological - functional ability, disability, pain, fatigue and nausea
Psychological - feelings/mood, self-esteem
Social - relationship roles

Question 18

What is AQoL-8D is quality of life assessment?

Answer 18

Considers 35 items over 8 domains
Domains are split between physical (3 domains) and psych social (5 domains)

Question 19

What are the physical domains assessed in AQoL-8D?

Answer 19

Independent living - household taks, mobility and self care
Senses - visoin, hearing, communication
Pain - frequency, iseverity and interference with everday life

Question 20

What are the five domains considered within the psycho social element of AQoL-8D?

Answer 20

Mental health - sleep, self harm, depression etc
Happiness - contentment, enthusiasm
Self worth - confidence, feelin like a burden
Coping - energy level, control, coping
Relationships - intimacy, family role, community role

Question 21

What factors of quality of life also contribute to mental health?

Answer 21

Well being and ill being
relationships and ill-being
Activity
Self perception
Autonomy
Hope and hopelessness
Physical health

Question 22

What does quality of life indicators show about mental health?

Answer 22

Generic QoL indicators do not have enough information to judge quality of life
Depression has the greatest impact on quality of life
Measures of QoL should consider what adds and what takes away from quality of life
Large overlap between quality of lap and ‘personal recovery’ from illness

Question 23

What is self worth theory?

Answer 23

The idea that an individuals main priority in life is to find self-acceptance, often this is through achievement
Self worth is determined by our self evaluated ability, effort and performance - particularly in activities we deem valuable

Question 24

What questions might we ask to help determine a patient self worth?

Answer 24

In what situations do you compare yourself to others
In what areas are you most critical of yourself
In which situations do you feel like you need to pretend to be someone else in order to fit in?
When does your feeling of self worth increase?
What do you fear the most that people might say about you?
When do you feel most insecure?

Question 25

What are the five different types of coping stratergies?

Answer 25

Problem focused coping Emotion focused coping Social support Religious coping meaning making

Question 26

What is problem focused copinf?

Answer 26

Adopting behaviours and thought processes to fix the problem such as information seeking, breaking the problem down into more manageable tasks. Making a plan of action to follow up on later (delay can still be problem focused)

Question 27

What is emotion focused coping?

Answer 27

Aim to manage emotional response to the problem. Express emotions to someone, in journiling, or suppressing emotions in alcohol or food

Question 28

What is social support as a mechanism of coping?

Answer 28

seeking emotional and concrete adis from others. the outcome of this often depends on the reaction of the confidont

Question 29

What is meant by religious coping?

Answer 29

Combines social support, with problem focused and emotion-focused coping> Seeks to conserve or transform meaning of stressor. Seeking comfort, support or meaning from a divine being.

Question 30

What is meant by meaning making as a coping mechanism?

Answer 30

Cognitive reappraisal - changing how you think about a problem to give it a more positive meaning - for example changing a stressor from a threat to an opportunity.

Question 31

What is problem avoidance and distraction techniques as a coping stratergy?

Answer 31

Acting like nothing happened Avoiding the problem in order to avoid stress Often distract yourself with something else - this is considered maladaptive.

Question 32

What is the difference between mutlidimensional and unidimensional Quality of Life Data?

Answer 32

Multidimensional - subscale scores and different scales/question focuses that combine to give a total score e.g Short form 36 health survey Unidimensional - single overall score and focus only on one element of QoL - e.g Beck Depression Inventory

Question 33

What is the difference between a specific and generic Quality of Life data?

Answer 33

Specific - specific to one health condition or group of people Generic - can be used to measure quality of life in many different scenarios/people e.g General health questionnaire.

Question 34

What is the difference between an individualised and standardised quality of life data?

Answer 34

Standardised - makes up majority of QoL data, same terms and questions are used for every patient Individualised - adapts criteria and questions to each patient, to recognise what is important to them in order to understand their quality of life.

Question 35

What is the difference between personal and subjective?

Answer 35

Personal - recognising humans as separate from other things, something that belongs to an individual or is unique to them, belief or knowledge a person has that is not based on facts. Subjective - an individual understanding or opinion, varies based on previous experience and the context of the situation, interpretation of things

Question 36

Why is subjectivity and personality important to quality of life?

Answer 36

Difference people consider different aspects more important to their quality of life For example - financial stability over fun experiences and vice versa.

Question 37

What is it challenging to measure/understand quality of life?

Answer 37

The term quality of life means different things for different people, professions and groups. Highly subjective - people evaluate positive and negative aspecits of life very differently - different people in the same situation may have very different ideas around their quality of life Large overlap between QoL and life satisfaction - makes QoL research more difficult to complete

Question 38

What are patient perspectives linked to QoL? Why is this important?

Answer 38

Patients interpretation of a particular physical variable or conditions is different between different people - makes if difficult to compare quality of life Difficult to measure what somethings means to someone Suggests somatic and physical variables should be included in QoL measurements in order to create a degree of objective measurement alongside subjective variables.