Quality of Life

James A. Lenker, MS, OTR/L, ATP OT 541 University at Buffalo

Origins

  Achieving complete physical, mental, and social well-being (World Health Organization, 1947) Lyndon Johnson, Great Society speech – 1964  Implied domain: Standard of living

QOL – One definition

 “Quality of life is the multidimensional evaluation, by both intrapersonal and social normative criteria, of the person-environment system of the individual.” (M. Powell Lawton, 1991)  Collection of dimensions    Observed and self-report Objective and subjective Attribute of the P-E system

Powell’s Model

Objective

Quality of Life

Subjective Behavioral Competence leisure and discretionary activities Environmental Quality structure and process of care Perceived QOL time, friends, family Psychological Well Being satisfaction, affect

Critique of

Health-Related

Quality of Life (Lawton, 1997)

   There is more to QOL than health Other life aspects increase QOL Measures are prone to biased responses if people are asked to attribute QOL to their health

So, What Do We Do?

“In summary, the user who wishes to measure QOL must first and foremost make his or her own choice about what is included in QOL. My four-sector model provides some guidance for such a choice.” (Lawton, 1997)

Canadian Centre of Health Promotion

     QOL is, “the degree to which the person enjoys the important possibilities of his or her life" (Renwick & Brown, 1996). Humanistic-existential model Humans have needs   Physical, psychological, and spiritual Affiliation and self-actualization 3 Elements of their Model  Being, belonging, and becoming. Renwick, R., & Brown, I. (1996). Quality of Life in Health Promotion and Rehabilitation: Conceptual Approaches, Issues, and Applications. Thousand Oaks, CA: Sage Publications.

Principles of Renwick & Brown

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QOL is multidimensional QOL is bio-psycho-social QOL appraisal must be holistic QOL components are common to all people and the human condition, i.e. not different for people with disability Disability doesn’t imply increased or decreased QOL QOL meaning is individual

Renwick and Brown (con’t.)

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Being

is comprised of physical, psychological and spiritual dimensions; 

Spiritual Belonging

is comprised of social, community, and ecological dimensions 

Community Becoming

is constituted by personal growth, leisure, and practical. 

Growth

Renwick & Brown’s Conceptualization Quality of Life Personal Values

Physical

• Personal safety • Health • Fitness • Mobility

Material

• Finance • Housing • Transport • Security & tenure

Social

• Relationships family, friends • Community

Development & Activity

• Competence independence, choice & control • Productivity job, education home life, leisure

Emotional Well Being

• Mental health • Self-esteem • Faith • Sexuality • Fulfillment