Health related Quality of Life Flashcards
What is quality of life?
Whatever a person says it is (Twycross, 2003)
What is Health Related Quality of Life?
A subcomponent of Quality of Life and ‘reflects the goodness of the dimensions of life that can be affected by health and health interventions (Lox et al., 2010)
What is Fayers and Machin (2007)’s definition of Health Related Quality of Life?
A multidimensional construct that reflects a person’s subjective evaluation of their well-being and functioning across multiple life domains
What are the 6 dimensions of HRQOL?
Physical functioning (strength, fitness, balance, ability to perform ADLs) Emotional functioning (levels of depression and anxiety) Social functioning (social roles, relationship with others, perception of being a burden) Cognitive functioning (concentration and attention, memory, comprehension) Health status (physical status, symptom management) Spiritual well-being (meaning/purpose of life, hope)
What methods exist to measure HRQOL?
Objective: QALYs or component specific HRQOL (e.g. blood pressure, cholesterol levels, symptom relief)
Subjective: Interviews or Questionnaires assessing level of functioning (e.g. Short-Form 36) or satisfaction of functioning (e.g. Perceived Quality of Life scale)
Who developed the SF-36?
Ware and Sherbourne (1992)
Who developed the Perceived Quality of Life scale?
Patrick et al. (1988)
What evidence is there that subjective measures of HRQOL are unrelated to objective measures?
Lox et al. (1995) = 12 week exercise intervention in HIV patients led to improvements in physical and emotional well-being despite no changes in CD4+ cells.
Wijkstra et al. (1994) = Objective improvements in physical fitness in COPD patients was not reflected in their perceptions of health status or emotional well-being
HRQOL is not about an objective marker (e.g. tumour marker levels) rather it reflects an individuals perspective of their health and functioning
Give 3 reasons as to why exercise is a good tool to influence HRQOL
It’s often cost-effective
Doesn’t have side-effects of many pharmacological treatments
Holistic in that it can map onto and improve various domains of HRQOL
What were the findings from Gillian et al (2009) regarding exercise and HRQOL?
Gillian et al (2009) meta-analysis of 54 studies showed exercise significantly improved overall QOL in the clinical population with effect size of 0.27. In well population, physical and psychological domains of QOL significantly improved with exercise. Whilst some domains in the clinical population didn’t show statistically significant improvement, for the participants, actual change may have been very meaningful - this is a downfall of quantitative HRQOL assessment
What were the findings from Albrecht and Taylor (2012) regarding exercise and HRQOL?
Quantitative: 6 studies in the systematic review of effects of exercise on HRQOL in advanced stage cancer. Improved physical well-being (improved function, ability, reduced pain, fatigue, SOB and insomnia) and improved psychological well-being (reduced depression and anxiety)
What were the findings from Burke et al. (2017) regarding exercise and HRQOL?
Qualitative: 40 studies in the meta-synthesis on PA and all stages+types of cancer. Exercise positively impacted the following domains of HRQOL - physical (managing consequences of cancer and the treatment), psychological (evoking positive self-perception), social (feeling understood by others and helping and receiving help from others) and spiritual well-being (redefining life’s purpose and finding meaning)
