EPIDEMIOLOGY & POPULATION HEALTH

NR514-NEED RESPONSES

 Cyron Dalida 

The CDC defines the health-related quality of life (HRQL) on the individual level as physical and mental health perceptions and how they correlate with health risk conditions, functional capacity, social support, and socioeconomic status (CDC,2018). Furthermore, HRQOL on the community level includes resources available, conditions, policies, and practices that govern the populations’ perceptions of health and functional status.  The CDC also lists multiple measures for health-related quality of life, such as the Healthy Days Core Module, Activity Limitations Module, and Healthy Days Symptoms, which are questions assessing a person’s perceptions and current physical and mental health (CDC, 2018)

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HRQOL is a multidimensional concept that includes many components such as an individual’s physical, and psychological health, perception of independence, social relationships, and environmental factors that are important to that individual (Lin et al., 2013).  Furthermore, Lin et al. (2018) state that criticisms of HRQOL measures stem from a lack of conceptual clarity and measurement feasibility.   HRQOL measures can be adequately measured if these measures are both specific such as measuring specific disease (heart disease, cancer), and complement more generic measures assessing someone’s overall physical, mental, and social health.

References:

CDC. (2018).  Health-related quality of life : Methods and measures. Centers for Disease Control and Prevention.   https://www.cdc.gov/hrqol/methods.htm

Lin, X., Lin, I., Fan, S. (2013).  Methodological issues in measuring health-related quality of life.  Tzu Chi medical journal 25(1), 8-12.   https://doi.org/10.1016/j.tcmj.2012.09.002

 

 

Sharla Kurtz  

Epidemiology and Public Health Week 08 Discussion

Following their implementation, quality of life (QOL) measures metamorphosed and became integral to health outcomes and the associated appraisals. It availed a meaningful avenue to assess the effects of healthcare when the cure was not possible, particularly for populations with chronic ailments (Zucoloto & Martinez, 2019). In the past, multiple instruments were created purporting to measure QOL, but they measured causal indicators instead. The ideal scale currently comprises a 16-item instrument that evaluates five conceptual domains of life, including personal development and fulfillment. Others entail physical well-being, recreation, community and civic practices, and social relationship with others. Later, another domain was added independence, after incorporating what perceptions individuals with chronic conditions harbored about quality of life following descriptive research (Zucoloto & Martinez, 2019). Thus, to gain more insights into QOL measures, the text argues that the approach cannot be applied to adequately measure health-related quality of life, drawing illustrations from physical wellbeing.

In a clinical setting, the underpinning justification for using QOL measures borders on the need to ensure that treatment interventions and evacuations are directed toward patients. Unfortunately, this is often not the case because caregivers and healthcare facilities focus on ailments. In this view, quality of life, including physical wellbeing, cannot be the only avenue to assess patient-centered outcomes. Alternatively, there is the need to incorporate other factors to evaluate the outcomes, such as psychological wellbeing, social interaction and support, and measures of disability (Bourdel et al., 2019). Instead of being an adjunct to assessing outcomes linked to ailments, QOL measures focus on being a substitute, which is not ideal. For instance, rheumatologists fail to treat rheumatoid arthritis using antirheumatic medications based on the quality-of-life scores. In this case, health-related quality of life is not adequately measured when the primary emphasis is solely on physical wellbeing.

Another proof that QOL measures are inadequate to measure health-related quality of life is that they are less effective and accurate. Since the approach is broad and multidimensional and comprises 16-items, it tends to be less responsive, unlike methods specific to patient outcomes (Zucoloto & Martinez, 2019). For instance, emphasizing the physical wellness of individuals majorly means that other aspects, such as conditions leading to anxiety and depression, are neglected. In this regard, one may suppose that the approach is a highly individual concept. The quality-of-life measure does not capture all characteristics of life that are critical to the survival of a patient. However, the only merit to the method is that systems in which individuals may postulate at least some of the features may probably come closest (Zucoloto & Martinez, 2019). Thereupon, the realization behind some of the shortcomings of QOL measures should be an eye-opener to expand the model to incorporate all aspects of quality of life.

From a personal perspective, the inadequacy to measure health-related quality of life based solely on physical wellness results in various ethical concerns. As a concept, the main idea behind the quality of life entails that health problems can be revealed, including those at the periphery of the usual remit of medical care. For example, focusing on a particular aspect breeds the expectation that clinicians may influence it; otherwise, what would be the objective behind assessing it? The downside to this attitude is that in situations where caregivers cannot control outcomes; the process measurement may seem to harm patients. Another ethical concern is that some pressure groups may oppose the clinical measurement of quality of life, citing ‘overmedicalization.” Thus, QOL measurements need to integrate all aspects into practice, including social support and relationships.

 
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