Introduction
This analysis aims to reach a clear definition of the term “quality of life” by studying the way it has been applied in healthcare and other fields. This clarity will ensure effective communication about the quality of life between nurses and patients. Apart from that, clarifying what quality of life means will determine treatment choices regarding the quality of life improvement. Clarification of this term will be achieved by delving into the literature to find out various ways in which the term has been used. Further, the paper will cover critical attributes of quality of life and case examples to explain the features. Empirical referents will be pointed out as well as antecedents and consequences.
Uses of the Concept
Philosophical theories of quality of life advocate the things that make human life worth living, for example, their interaction with other people in society. According to particular research, Hedonic theories associate life’s quality with the states of consciousness, awareness, or individual experiences (“Philosophical and Ethical Dimensions, n.d”). As maintained by Hedonic theorists, pleasure, and happiness are essential elements of quality of life.
Religions have also used the term “quality of life” in different contexts. From a religious perspective, quality of life often refers to spiritual well-being, religiosity, personal beliefs, hopeful feelings, as well as inner peace (Counted et al., 2018). Quality of life is associated with the individual’s fulfillment, which is based on critical areas of life that trigger a feeling of well-being, both emotionally and physically.
In the field of psychology, the concept of quality of life refers to the understanding of an individual in the light of their cultural aspects and social environment. According to Moudjahid and Abdarrazak (2019), quality of life can refer to the individual’s inclination towards the attainment of their desires and interests consistent with their mental state. As a result, the quality of life is influenced by certain factors such as social relations and physical and psychological states.
Further, health programs have also defined the concept of quality of life. As stated by the Office of Disease Prevention and Health Promotion (2020) quality of life often refers to a concept comprising social, emotional, mental, and physical functioning domains. It can also be considered as a measure of morbidity and mortality, including general satisfaction, health perception, vitality, sleep, emotion, cognition, social activity, function, and physiology.
Modern scholars have used the concept of quality of life in various ways. In a particular study by Thapa et al. (2019), quality of life is a subjective concept in the sense that most of its domains cannot be calculated directly. The reason is that it is linked to the individuals’ perceived influence on their own lives. According to this empirical research, quality of life refers to the social, psychological, and physical dimensions of health determined by the individual’s perceptions, expectations, beliefs, and personal experiences. In addition, quality of life has been regarded by Söylemez et al. (2020) as a multidimensional, dynamic, individual, and subjective construct that comprises the assessment of adaptation and the results.
Similarly, Whelan et al. (2019) acknowledged that quality of life comprises dimensions like work-life balance, safety, life satisfaction, health, civic engagement, environment, education, community, income, jobs, and housing. Moreover, Leeuwen et al. (2019) classified aspects of quality of life into various domains. The domains include financial security, neighborhood, home, spirituality, emotional comfort, adaptation, attitude, relationships, health perception, activity, and autonomy.
Critical Attributes
First, it is important to understand the meaning of critical attributes. Based on the concept of analysis developed by Walker and Avant (1995), critical attributes refer to features of the idea that are regarded as repetitive. These vital attributes are dynamic, subjective, multidimensional, and satisfaction. When descriptive terms like individualized, interpretation, context, and perception are used, the personal character of quality of life can be seen. As such, it is unique to every person based upon their evaluation and assessment of the circumstance. In case the subjective review is impossible, it can be determined through objective evaluation. Satisfaction is regarded as multidimensional in that it comprises the social, spiritual, psychological, and physical realms of life.
Notably, the physical domain contains the definition attributes like physical health, cognitive function, exercise, functional status, comfort, rest, and sleep. Attributes such as satisfaction, independence, control, security, enjoyment, happiness, emotion, and fulfillment are found in the psychological domain. The spiritual realm of life entails attributes like sanctity, spirituality, religion, morale, inner peace, and meaning. The social realm often comprises attributes like environment, personal resources, social engagement, recreation, role performance, income, work productivity, and relationships. This domain is dynamic in the sense that it constantly changes depending upon the developmental state, disease state, and life circumstances, among other things.
Empirical Referents
The meaning of empirical referents can be understood by looking at the concept analysis approach. Walker and Avant (1995) referred to them as categories or classes demonstrating the manifestation of the actual concept. A practical quality of the idea is a unique evaluation of life fulfillment. It is the best-case scenario in which quality of life can be decided. It would be easy to determine the quality of life when the patients are involved in rating their wellbeing, happiness, and fulfillment (Counted et al., 2018). “WHOQOL” is a medium developed by the World Health Organization to determine the quality of life.
In research from World Health Organization (n.d.), WHOQOL involves twenty-eight questionnaires that touch on satisfaction, social, psychological, functional, and physical elements. Santos et al. (2019) concluded that the WHOQOL tool could assess the physical, social, psychological, and environmental domains. That means it can determine an individual’s mobility, rest, sleep, sexual activity, social support, self-esteem, financial resources, and physical security.
Various tools are established to decide, in an objective manner, the development of quality of life even when individual statements are absent. Despite the devices being not necessarily empirical referents, they are helpful, especially in the absence of a subjective examination of the concept. In case a subjective assessment is absent, the questions should be directed to family members or close friends who may know more about the individual.
The quality of life can also be decided through observation. Observation includes activities such as evaluating the individual’s social and physical behavior, their ability to formulate practical goals, how they exhibit emotions of discontent, and their capacity to maintain healthy relationships. The evidence of intense suffering, poor living conditions, or abuse indicates a lack of quality of life (Moudjahid & Abdarrazak, 2019). However, given that quality of life is a subjective examination of an individual’s own life (Thepa et al., 2019), they may not regard some of the elements to lower their quality of life. That is why someone can find meaning in their anguish that enhances the quality of their life. In short, a person’s subjective analysis is the most excellent way to determine their quality of life.
Model Case
A model case refers to an example of the concept usage demonstrating the concept’s defining characteristics. It comprises the entire attributes of the concept and should be a non-fictional example of the concept usage (Walker & Avant, 1995). The following narration attempts to demonstrate how the idea of the quality of life can be applied. Jane, a forty-five-year-old, has three children and a caring husband. After paying off her mortgage, she saved some money to support her children in school. Jane is also financially stable, having been promoted in her job. She is contented with her financial security, friends, family, and health. She considers her life to be good since she is supported and loved.
The above scenario exemplifies many of the essential attributes of quality of life. Jane considers her life’s condition subjectively and finds it satisfying based on various factors: physical health, financial stability, social satisfaction, and emotional happiness. Notably, these dimensional aspects are crucial to Jane’s life fulfillment. It is also important to note that these aspects are dynamic. Jane’s situations that have contributed to her happiness might have changed previously and are bound to change in the future.
Contrary Case
Although contrary cases do not contain all the concept’s defining attributes, they include most of them. Walker and Avant (1995) have regarded contrary cases as scenarios inclined to disagree with the concept. The following example represents a contrary case for the quality of life. Susan is a ninety-one-year-old woman diagnosed with chronic cancer. Susan has been in the hospital for more than two months. She is incontinent and unable to eat. Most of the time, she cries and begs for aid, voicing her wish to die. Her son, however, insists that she should not be administered pain medication as it makes her sleepy.
Susan is anesthetized and weaned off so many times after receiving a feeding tube. Susan’s son commands the nurses and doctors to do what it takes to keep his mother’s life. This case contradicts all the attributes of quality of life. There is no subjective evaluation of Susan’s life, and her satisfaction in many dimensions has not been assessed. Also, there is no objective evaluation of Susan’s life other than the fact that she needs to be alive.
Related Case
Cases associated with the concept but lack the defining characteristics are called related cases. Related cases lack critical attributes despite them being relatable to the concept (Walker & Avant, 1995). The following is a related case of quality of life. Claire is watching a live briefing regarding a gambler who has won a significant amount of money through the lottery. Claire thinks the man will be financially stable and happy. Although it may appear that he will lead a good life, many critical attributes are absent in this scenario. The case relies on a subjective evaluation of the man from someone who does not know what would make him happy. Since it does not look at other aspects of life, it cannot be regarded as multidimensional. It also uses one situation to make a generalized conclusion that the man will live a happy life.
Analysis of Antecedents
It is essential to distinguish between antecedents and consequences in concept analysis. Walker and Avant (1995) have regarded antecedents as the incidences that take place before the occurrence of the concept. Based on this definition, life is the most significant antecedent of quality life. In other words, an individual cannot talk about the quality of life without it. A recent study indicates that consciousness is another important antecedent of quality life. According to Christiansen et al. (2019), quality of life is determined by the capacity to make decisions, evaluate, appraise, or assess one’s own life. As a result, life and cognitive development are the two most significant antecedents of quality life.
Analysis of Consequences
Generally, consequences refer to the outcomes of a particular event. They denote “those events or incidents that occur as a result of the occurrence of the concept” (Walker & Avant, 1995, p. 45). To successfully analyze the consequences of the concept, its change in status has to be identified. It is significant to acknowledge that this adjustment can either be negative or positive. The difference usually decreases or increases the individual’s pride, self-esteem, a feeling of wellness, and happiness (Counted et al., 2018). According to new research, it can lead to enhanced psychological and physical health (Moudjahid & Abdarrazak, 2019).
The change can also trigger an altered life perspective and the ability to respond to various circumstances. It can result in the achievement of crucial life functions, self-care, and the ability to make individual choices. It can help the individual develop essential resilience during the old age period (Leeuwen et al., 2019). Moreover, this change can result in acceptance of life’s situations and enhanced ability to cope (“Philosophical and Ethical Dimensions, n.d”). Also, it leads to an improved appreciation of individual preferences and uniqueness. In short, the consequences significantly vary and can be either positive or negative.
Summary
The term “quality of life” is not well defined, even though it is usually used in healthcare practice. This paper on concept analysis focused on bringing more simplicity to the term for application in healthcare. In the literature review, it is revealed that the word “quality of life” has multiple definitions and can be used to signify different concepts. Nevertheless, the simplicity of the term was achieved by analyzing its application in literature, describing the critical attributes, and articulating a functional meaning about the essential healthcare qualities. Planning adequate care and assessing treatment procedures will be easier if accurate, credible, and effective clinical quality of life measures are followed.
The analysis of the subjective essence of quality of life is of profound importance, especially to advanced practice nurses. In case the personal evaluation of quality life is absent, the objective assessment can be attained by questioning the family or those close to the individual. However, there must be a realization of its multidimensional nature. In that regard, the quality of life can only be determined by the individual’s preferences.
For instance, when choosing treatment plans and goals, the patient must be involved to decide what would impact their quality of life. There is a need for healthcare practitioners to suspend their ways of thinking and instead consider the patient’s desires. Quality of life measures is tailored to take into account the patient’s perspectives regarding clinical decision-making. For the individualized quality of healthcare to be avoided, the quality of life decided by an individual should be respected. When the clinician’s assessment of the quality of life is contrary to the patient’s, the clinician should remember that the patient has the final word.
References
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