Quality of Life (QOL) – How It’s Defined in Healthcare, How It’s Measured, and Why It’s Important to Monitor — BioMatrix Specialty Pharmacy

How is quality of life (QOL) defined and influenced?

In 1948, the Constitution of the World Health Organization defined health as “a state of complete physical, mental and social well-being.” This was a departure from the tendency to see health only in terms of the presence or absence of disease.1 Today, QOL in healthcare is still defined and broken down by three domains, or ‘perceptions of health’.2

Physical functioning: symptoms resulting either from the disease itself or from treatment and the ability to perform a range of daily activities

Psychological functioning: ranges from severe psychological distress to a positive sense of well-being and may also encompass cognitive functioning

Social functioning: quantitative and qualitative aspects of social relationships and interactions and societal integration

Within these three domains/perceptions of health, QOL is influenced and determined by many factors. Over the past few decades, medical outcomes researchers and medical sociologists have categorized QOL determinants as:3

1. Health-related

2. Sociological and economical

Each of these domains can be measured both objectively and subjectively.

Health-related Parameters

When defining and measuring QOL, health-related parameters need to be both provider and patient reported. While the objective health status of symptoms is recorded by a physician, this fails to describe the patient’s tolerance and discomfort for these symptoms. Two people with the same health status may have very different expectations regarding health and the ability to cope. These differing expectations can greatly affect a person’s perception of health and satisfaction with life.2

Patient reported parameters are important because patients have the best perspective on the impact of their treatment. They experience first-hand the physical and financial burdens of treatment that may also affect their adherence to treatment and other provider recommendations.3

Sociological and Economical Parameters

Overall QOL may be strongly influenced by factors that are unseemingly related to health, such as economic status, employment status, and family situation.3 Again, there is both an objective and subjective component. For example, financial burden may decrease a patient’s adherence rate, objectively making treatment less successful while a stressful family situation may subjectively and negatively alter a patient’s perception of their treatment outcome.