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In an asthma center, the nurse took two quality-of-life measurements using the 1

ID: 2441456 • Letter: I

Question

In an asthma center, the nurse took two quality-of-life measurements using the 15-D questionnaire. The scores (on a scale of 1–5) for the first and the second are presented in the table below. The first measurement was taken when the patient entered the clinic, and the second was taken one week later, after the patient received asthma medicine. What is the effectiveness, in quality-adjusted life years, of the asthma medicine?

Use the following importance weights:

Dimension

Importance weight

Breathing

0.075

Mental functioning

0.044

Speech

0.065

Vision

0.075

Mobility

0.046

Usual Activities

0.057

Vitality

0.074

Hearing

0.104

Eating

0.040

Eliminating

0.033

Sleeping

0.090

Distress

0.079

Discomfort/symptoms

0.072

Sexual Activity

0.084

Depression

0.062

Dimension

Importance weight

Breathing

0.075

Mental functioning

0.044

Speech

0.065

Vision

0.075

Mobility

0.046

Usual Activities

0.057

Vitality

0.074

Hearing

0.104

Eating

0.040

Eliminating

0.033

Sleeping

0.090

Distress

0.079

Discomfort/symptoms

0.072

Sexual Activity

0.084

Depression

0.062

Health Dimension Breathing Mental functionin Speech Vision Mobility Usual activities Vitality Hearing Eating Eliminating Score at First Visit Score at Second Visit 3 2 3 2 2 2 2 4 3 3 3 2 Distress Discomfort Sexual Activity Depression 2 3 5 2 4 2

Explanation / Answer

A model of quality of life is proposed that integrates objective and subjective indicators, a broad range of life domains, and individual values. It takes account of concerns that externally derived norms should not be applied without reference to individual differences. It also allows for objective comparisons to be made between the situations of particular groups and what is normative. Considerable agreement exists that quality of life is multidimensional. Coverage may be categorised within five dimensions: physical wellbeing, material wellbeing, social wellbeing, emotional wellbeing, and development and activity. A research agenda is discussed as are the particular problems caused by difficulties in understanding and communicating.

Quality of life (QOL) is the general well-being of individuals and societies. QOL has a wide range of contexts, including the fields of international development, healthcare, politics and employment. It is important not to mix up the concept of QOL with a more recent growing area of health related QOL (HRQOL[1]). When we look at HRQOL we in effect look at QOL and its relationship with health.

Quality of life should not be confused with the concept of standard of living, which is based primarily on income.

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