W5 Quality of life Flashcards
What are the World Health Organisation Quality of Health (WHOQOL) 4 categories?
PEPS
Psychological
Environment
Physical
Social
What are some examples of physical health?(7)
- Activities of daily living
*No dependence on medicinal substances and medical aids - Energy and fatigue
- Mobility
- Pain and discomfort
- Sleep and rest
- Work Capacity
What are some examples of psychological health? (6)
- Bodily image and appearance
- Negative feelings
- Positive feelings
- Self-esteem
- Spirituality / Religion / Personal beliefs
- Thinking, learning, memory and concentration
Name the different types of social relationships (3)
- Personal relationships
- Social support
- Sexual activity
What are some examples of environment? (8)
- Financial resources
- Freedom, physical safety and security
- Health and social care: accessibility and quality
- Home environment
- Opportunities for acquiring new information and skills
- Participation in and opportunities for recreation / leisure activities
- Physical environment (pollution / noise / traffic / climate)
- Transport
What can affect Health-related Quality of Life?
- Clinical decisions often affect patients’ health-related quality of life (HRQoL).
- Evidence on patients’ HRQoL can be obtained using patient-reported outcome (PRO) measures.
What is Dijkers’s model of quality of life?
(3 main categories)
Societal Standards and Priorities:
* Standards
* Values
Achievements:
* Statuses
* Performance
* Possessions
* Relationships
* Accomplishments
* Characteristics
* Health
Individual Expectations and Priorities :
* Goals
* Aspirations
* Values
* Standards
* Desires
* Needs
* Wants
What are the pros and cons of Generic Measures of HrQOL?
E.g. EQ-5D, Short Form 36 (SF-36) ,Nottingham Health Profile, The Sickness Impact Profile (SIP)
- Wide variety of populations
+ Usually a single instrument
+ Established reliability and validity
+ Allow comparison between conditions or interventions - Do not focus on area of interest
- May not be responsive
What are the pros and cons of Disease Specific Measures of HrQOL ?
E.g. The Asthma Quality of Life Questionnaire, Arthritis Impact Measurement Scale, Inflammatory Bowel Disease Questionnaire
- Focus on problems associated with specific diseases, patient groups or areas of function
+ Clinically sensible
+ May be more responsive than generic instruments - Do not allow comparison between conditions
- Limited in terms of populations and conditions
What is the EQ-5D?
Who is it recommended by?
What are the 5 dimensions of health?
- Most widely used generic PRO questionnaire internationally
- It is the instrument recommended by NICE
- Asks patients to indicate whether they have no, some, or extreme problems on each of five dimensions of health:
- Mobility
- Self-care
- Usual activities
- Pain/discomfort
- Anxiety/depression
What are some personal considerations of medications:
- Personal situation
- How to take the medicine
- Preferences for treatment and expectations
- Coping with side effects
- Benefits
- Age
- Sexual activity
Professional considerations of a patient taking a medication (6)
- Life expectancy
- Frailty
- Time to benefit
- Net benefit
- Magnitude of benefit
- Risk vs. benefit
How to agree treatment targets with patient and/or carer:
Examples include:
* Primary prevention
* Symptom control for acute problems
* Outcome expected
* Stopping criteria
* Required tests
Consider alternative approaches:
* Lifestyle change(s)
* Self care (OTC medicines)
* Non-pharmacological options