Concept of Quality of Life
Quality of life as a concept has become an integral part of contemporary health care and nursing theories. This idea emerged in the social sciences but found use in health care. The integration of this concept into health care and nursing took decades of theorizing and research. Based on the different perspectives of quality of life, its definition emerged as the “intangible, subjective perception of one’s lived experiences” (Plummer & Molzahn, 2009, p. 139).
Another definition of quality of life is “a person’s perception of his/her overall life quality” (Dallimore & Mickel, 2006, p. 63). These definitions imply a number of things. One is the subjectivity of the concept because it depends on a person’s perception. Other people’s perception could be an influencing factor but an individual’s perspective towards the quality of his/her life experiences is what matters. The other is the holistic scope of life, which encompasses the entirety of lived experiences including physical and psychological health.
Concepts Related to Quality of Life
During the efforts to develop and establish the meaning of quality of life, a number of related concepts emerged. On one hand, some of these related concepts helped in distinguishing the parameters of quality of life as a concept. On the other hand, the other related concepts made complex the concept of quality of life.
Quantity of life is one concept that helped in clarifying quality of life. Quantity of life refers to the length of a person’s life directly linked to age (Kane, 2003). This differs from quality of life, which refers to the meaning and value of the entirety of experiences during one’s lifetime (Plummer & Molzahn, 2009). There is a clear distinction and one cannot be substitute quantity of life for quality of life. Nevertheless, age when taken together with the other determinants of quality comprise the components or elements of quality of life.
Well-being is another concept closely related to quality of life. This concept found use as a synonym for quality of life (Plummer & Molzahn, 2009). As a separate concept, well-being refers to a contented state because of the soundness of body and mind as well as experiencing prosperity (Bahrami, Parker & Blackman, 2008). This also refers to the ultimate experience of what is good for an individual. This is similar to quality of life because of the reference to life experiences. However, this differs from quality of life because well-being refer to good life experiences while quality of life pertains to the all life experiences with high quality of life achieved when there are more good than bad experiences.
Life satisfaction is another concept linked to quality of life. This concept is also another synonym used for quality of life (Plummer & Molzahn, 2009). Life satisfaction means the state of contentment or fulfillment because of the achievement of goal or having the capability to cope with everyday challenges (Bahrami et al., 2008). Like quality of life, life satisfaction is also a fluid concept that could be positive or negative depending on the weight of good and bad experiences. Unlike quality of life, life satisfaction aligns with goal achievement while quality of life covers an overall life experiences whether these form part of targeted goals or not. Nevertheless, life satisfaction influences quality of life.
Health is another concept closely related to quality of life. Health is also another concept used as synonym for quality of life (Plummer & Molzahn, 2009). Health refers to the state of physical and mental wellness or freedom from any disease or infirmity (Kane, 2003). The link of health to quality of life lies in the fact that physical and mental soundness and disease free condition are determinants of quality of life. Quality of life is a broader term encompassing health.
Analysis of the Concept of Quality of Life
The concept of quality of life serves a significant purpose in various fields including nursing. This concept finds significance in research, professional practice, and policymaking. Having a clear definition of quality of life is important because this influences the direction and goal of research, strategic focus of best practice, and prioritization in decision and policy development.
The definition of the concept of quality of life emerging from theories is clear and sufficient. The definition covers the key elements of the concept, particularly subjective perception and overall life experiences. Moreover, the definition is also broad enough to encompass individual circumstances. These support the applicability of quality of life in different contexts, such as in health care.
Research is one area where the concept of quality of life serves a purpose by providing a direction for research on issues such as in health care (Dallimore & Mickel, 2006). Various studies use quality of life as the framework for theoretical or empirical investigations on various fields of study and issues. The concept also offers use in professional practice by providing the goal or target of service delivery as well as the measures of evaluating goal achievement (Plummer & Molzahn, 2009). The concept also serves as guide in understanding people and addressing interpersonal needs (Dallimore & Mickel, 2006). The concept is also important to policymaking by pointing to areas requiring resources and the prioritization of allocation.
While the concept has multiple uses, it also gives rise to issues, especially in its use. One issue is the lack of consistency in its practical definition in different fields and by various parties (Kane, 2003; Plummer & Molzahn, 2009). This limits the effectiveness of interface outcomes of different fields. Another issue is the debate over the validity of objective measures of quality of life (Plummer & Molzahn, 2009). While the definition propounds subjective perception, research and practice use objective measures. This requires reconciliation to support the effective application of the concept and usher useful outcomes.
Social Context of Quality of Life
By encompassing the entirety of life experiences, the concept of quality of life operates within a social context. On one hand, social issues such as poverty, unemployment, poor health conditions, low levels of education, and high crime rates are conditions reflecting on individual perceptions of life experiences. Experience of these issues influences how people perceive the quality of their life. On the other hand, quality of life issues such as negative or poor perception of quality of one’s life trace back to the experiences of social conditions.
Physical and mental soundness, having sufficient resources, good working conditions, work-life balance, leisure and other determinants of quality of life depend on the social conditions within which a person lives. As such, understanding and resolving social issues and quality of life issues would always involve this interrelationship. (Kane, 2003; Dallimore & Mickel, 2006) As an example, the social issue of poverty results to negative life experiences such as hunger, malnourishment and disease while the quality of life issue of poor health condition is rooted to poverty conditions. Understanding and resolving one issue involves consideration of the other.
Interdisciplinary &/or Temporal Comparisons of Quality of Life
Quality of life applies in different disciplines such as social science, health science and business. In social science, quality of life refers to the conditions focused on by its sub-disciplines such as the achievement of needs and equilibrium conditions in economics, mental state in psychology, or gender and cultural experiences in sociology. In health science including nursing, quality of life pertains to physical and mental health that influences overall life experiences. (Plummer & Molzahn, 2009) In business, quality of life refers to working conditions, human relations and work-life balance (Dallimore & Mickel, 2006). While quality of life operates in various disciplines differently, the concept links these disciplines under overall life experiences.
Quality of life also operates in gradations. As a flexible concept, quality of life works in a range from low or poor quality of life, in one end of the spectrum, to high or excellent in the other end of the spectrum depending on perceptions of life experiences. One way of depicting temporal variation in quality of life is through Maslow’s hierarchy of needs with perceived achievement or experience of basic needs comprising the lowest rung of quality of life while the perceived achievement of self-fulfillment and actualization constitute the highest gradation of quality of life (Chang & Hsiao, 2005). A person’s perspective can move up or down the hierarchy depending on life experiences. A different way of showing gradation is through the extent of achievement of the three dimensions of quality of life in health care, which are quality health care, quality work environment, and health promotion (Arah et al., 2006). While these do not fall within a hierarchy, the achievement of all these dimensions reflects a high quality of life for practitioners and patients alike.
Hypotheses and Implications for Further Development
Quality of life as a concept is undergoing continuous development. A number of hypotheses support the need for the further development of this concept. One hypothesis is the complexity of the concept because of its multi-dimensional scope. Its application in different fields only focuses on certain determinants of quality of life without considering the entire life experience of a person. Thorough understanding, guided application and training could ensure the holistic approach to quality of life. This implies the importance of inter-disciplinary cooperation in addressing this issue. The first hypothesis relates to the other hypothesis on the difficulty in measuring quality of life. By being dependent on subjective perception, employing objective measures is possible but requires care in ensuring that measures are accurate and comprehensive enough to cover diverse life experiences while susceptible to valid generalizations.
References
- Arah, O. A., Westert, G. P., Hurst, J., & Klazinga, N. S. (2006). A conceptual framework for the OECD Health Care Quality Indicators Project. International Journal for Quality in Health Care, 18(S1), 5-13.
- Bahrami, M., Parker, S., & Blackman, I. (2008). Patients’ quality of life: A comparison of patient and nurse perceptions. Contemporary Nurse, 29(1), 67-79.
- Chang, Y. W., ; Hsiao, S. (2005). Quality of life: Scaling with Maslow’s need hierarchy. Gerontology, 51(3), 170-173.
- Dallimore, E., & Mickel, A. (2006). Quality of life: Obstacles, advice, and employer assistance. Human Relations, 59(1), 61-103.
- Kane, R. A. (2003). Definition, measurement, and correlates of quality of life in nursing homes: Toward a reasonable practice, research, and policy agenda. The Gerontologist, 43(S2), 28-36.
- Plummer, M., & Molzahn, A. E. (2009). Quality of life in contemporary nursing theory: A concept analysis. Nursing Science Quarterly, 22(2), 134-140.
