17 - Quality of Life Flashcards
What is TPQ?
Technical Perceived Quality: Visual, Feel, Sound, Smell Quality
What are the 5 factors to making healthcare decisions together?
- Patient experience (skills, knowledge, values)
- Other people and information (media, patients, family, social context)
- Health, illness and treatment (consultation, understanding, agreed choice)
- Health professional (experience, skills, knowledge)
- Other people and information (guidelines, team, infrastructure)
What is quality of life?
A person’s judgement of their overall experience of life influenced by all aspects life
What is a person’s ‘goodness of life’ judgement?
- Multi-dimensional
- Dynamic
- Subjective
What is multi-dimensional judgement?
Different aspects of his/her life
What is dynamic judgement?
Changes over time (transient/permanent)
What is subjective judgement?
His/her judgment within his/her culture
What are the 6 domains of a multi-dimensional quality of life?
- Physical health (e.g. pain, energy, sleep)
- Psychological factors (e.g. emotions, self-esteem, memory; feelings; body image)
- Level of independence (e.g. daily activities, work, self-care; treatment; work capacity)
- Social relationships (e.g. personal relationships, support)
- Relation to the environment (e.g. safety, home, money)
- Personal beliefs (e.g. religion)
What is health related QoL?
The functional effect of a medical condition and/or its therapy, as assessed by the patient
A person’s view on the impact of their illness and/or treatment on their life
What is PROMS?
Patient Reported Outcome Measures
Patient ratings of the effects of a disease, condition and/or treatment on their quality of life.
How can health outcomes to improve patient care be measured?
- Inform patient and professional: increase understanding illness experience for patient and professional.
- Monitor Treatment: measure treatment effects on subjective (PROM) outcomes.
- Treatment Planning: record multidimensional impact of treatment on patient experience/discuss alternatives.
How can impact illness and treatment be measured?
- Informal – ask patients to rate the impact of the illness and treatment on their life.
- Use Patient Reported Outcome Measures of Health- Related Quality of Life.
What are the 2 types of Patient Reported Outcome Measures (PROM) of Health- Related Quality of Life?
- Generic (e.g. EQ-5D – EuroQol group 5 dimensions scale)
* Disease-Specific (e.g. KDQoL – kidney disease QoL, EORTC QLQ-C30)
What is generic PROM EQ-5D with visual analogue?
5 dimensions scale with health rating scale
Use of Health Outcomes: Population Level
- Identify which treatments work or more/less effective (clinical trials and routine practice)
- Identify national and international variation • Promote equality
- Monitor performance against national targets, over time
- Identify which Trusts/Regions are more effective
- Promote quality improvement at local level (efficiency)
Describe response shift
- Disease and treatment –> Catalyst: change in health status
- Mechanism –> behavioural, social and cognitive processes
- Response shift
- Perceived health related QoL
Give example of catalyst
Progression of disability / flare
Give example of mechanisms to cope with progression of disability
Coping, social comparison, goal reordering, adherence, reframing expectations
Give example of response shift
Change in internal standards, values, conceptualisation
What would examples of antecedents be?
Impairment, adherence predictors, social/physical environment, associated symptoms
From a rehabilitation perspective, what are 5 distinct phases of life?
- Pre injury
- Immediate post injury
- Intermediate post injury • Long-term post injury
- Ageing
What is a response shift?
Changes over time (dynamic)
What do patient reported outcome measures assess?
Health related QoL
What is essential in judging quality of care?
Patient experience
