Quality: Its Definition and Measurement as Applied to the Medically Ill

Quality of life (QoL) is frequently discussed among health care professionals and often invoked as a goal for improvement, but somehow rarely defined, even as it is measured. It is understood that some medical patients have a better QoL than others, but should it be assessed against an ideal state of well-being, or is it too personal and subjective to gauge? Can a better understanding of the concept help health care systems deliver services more effectively? Is QoL worth measuring at all?

Probing sophisticated concepts in psychology, philosophy, neurocognition, and linguistics, Quality of Life breaks down the cognitive components that comprise the judgment of quality, including description, evaluation, and valuations, and applies them to issues specific to individuals with chronic medical illness. In this context, QoL assessment becomes essential to ethical practice, a critical step toward improving the relationship between providers and clients. The author considers linear, non-linear, and complexity-based models in analyzing key methodology and content issues in health-related QoL assessment, including:

" Objective versus subjective indicators.
" Signs and symptoms, e.g., pain and fatigue.
" Categories and domains.
" Health status and quality of care.
" Functional status.
" Neurocognitive capacity/degeneration.
" Well-being and emotional regulation.

Quality of Life is certain to stimulate debate in the research and scientific communities. This forward-looking volume takes great strides toward promoting a common language in the discussion of QoL issues, and a greater appreciation of the ongoing moral issues involved in health care.