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Quality of Life

Introduction

The pursuit of quality of life (QL) is so central to human existence that the question of what is QL and what variables influence QL has been the focus of intellectual debate and scientific investigation from the time of the early philosophers. Current research on QL encompasses many disciplines and issues, including psychology, sociology, medicine, nursing, pharmaceutics, economics, education, architecture, geography, business marketing, the arts, income, employment, and community and environmental concerns.

In 1976, Campbell, Converse, and Rogers published a book that would become a classic, The Quality of American Life. Campbell et al. described QL as a vague and ethereal entity, something that many people talk about, but which nobody has a clear idea of what it is. The work by Campbell et al. inspired researchers to search for an accurate definition of QL and to develop QL measurement instruments. A mere glance at the numerous publications recently dedicated to the study of QL would give the reader a fair idea of how highly influential this subject has become at both the basic and applied levels of scientific inquiry. In 1975, the term ‘quality of life’ was adopted as a ‘key word’ by the Medical Subject Headings of the US National Library of Medicine to classify research in their computerized search system, MEDLINE. Since then, numerous books and other publications have been exclusively devoted to the study and measurement of QL. Among the many books that have outlined appropriate steps in developing and testing new QL measures, the following stand out: Quality of Life Assessment. Key Issues in the 1990s, edited by Stuart R. Walker and Rachel M. Roser in 1993, The International Assessment of Health-Related Quality of Life. Theory, Translation, Measurement and Analysis, edited by Sally A. Shumaker and Richard A. Berzon in 1995, Cross Cultural Health Outcome Assessment: A User Guide, edited by A. Hutchinson, N. Bentzen, and C. König-Zahn in 1997, and the Compendium of Quality of Life Instruments, 5 vols., compiled by Sam Salek and published in 1998. There are now two QL-specialized journals and one electronic catalogue dedicated to investigation of QL issues. Quality of Life Research and the Journal of Happiness Studies first appeared in 1992 and 2000, respectively. The On-Line Guide to Quality of Life Assessment is a computerized system of programs and databases in the area of health and quality of life assessment that provides guidance on the choice of assessment techniques for specific clinical trials and research projects. This system complements the many large international electronic databases that are so helpful in facilitating the search of QL publications (MEDLINE, CINAHL, EMBASE, PSYCLIT, PSYCINFO, CLINPSYCH, SOCIOFILE).

The Concept of Quality of Life

It is important to re-emphasize that QL does not refer to a clearly defined entity with a universally accepted measurement procedure. It is a complex, multifaceted concept which continues to defy consensual definition (Fernández-Ballesteros, 1998). The term QL represents a broad range of domains or dimensions of human existence, ranging from the procurement of basic needs (e.g. food and shelter) and material necessities and goods in general (e.g. means of transportation) to the achievement of a sense of personal fulfilment and happiness. Although there is no consensus on the definition of QL, experts agree that QL is a universal human concept that encompasses both behavioural functioning and subjective psychological well-being. Interestingly, although people from different cultures may differ with regard to the specific basic conditions they have available to them to strive for a good QL, they do not necessarily differ in their reports of how happy and satisfied they are. That is, a person's subjective perception of QL is not a linear reflection of his/her life conditions. This finding does not imply that societal improvements of life conditions are irrelevant to the betterment of QL but draws attention to the fact that human perception may be the most important common denominator in QL research.

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