Quality of Life (QoL) v/s Well-Being (WB) -

Differences and similarities Stella I. Tsartsara

April 2015

Definition of QoL – 1

WHO defines Quality of Life as “individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns”. It is a broad ranging concept affected in a complex way by the person's physical health, psychological state, level of independence, social relationships, personal beliefs and their relationship to salient features of their environment (Oort, 2005)

Definition of QoL – 2

• QoL can have subdivisions such as the Health Related QoL (HRQoL) that is “a functional effect of a medical condition and/or its consequent therapy upon a patient.

• HRQOL is thus subjective and multidimensional, encompassing physical and occupational function, psychological state, social interaction and somatic sensation”

From the ISOQoL http://www.isoqol.org/about-isoqol/what-is-health-related-quality-of-life-research

Definition of Well Being

1. Well-being has been defined from three perspectives: absence of negative conditions, prevalence of positive attributes and pursuit of life satisfaction. The 6 domains of well-being are:

• Life Evaluation

• Emotional Health -

• Physical Health

• Healthy Behaviour

• Work Environment

• Basic Access.

2. Wellbeing is distinguished in evaluative WB (life satisfaction), hedonic WB (emotions) and eudemonic WB (meaning of life).

3. Measured by multi-country longitudinal studies (Gallup World Poll) since 2008. http://www.gallup.com/poll/146822/gallup-healthways-index-

questions.aspx

Measuring PURPOSE SOCIAL FINANCIAL PHYSICAL COMMUNITY

Measurement of the QoL by WHOQoL-100 and WHOQoL - BREF

• WHOQOL – 1OO is an extensive set of 100+ indicators developed by the WHO QoL Group since 1995.

• WHOQOL-BREF, is an abbreviated version of 27 of the WHOQOL-100 quality of life assessment indicators produces scores for 4 domains related to QoL: physical health, psychological, social relationships and environment.

Measurement of the QoL by WHOQoL-100 and WHOQoL - BREF

• Domain scores produced by the WHOQOL-BREF correlate highly (0.89 or above) with WHOQOL-100 domain score and demonstrated good discriminant validity, content validity, internal consistency and test-retest reliability.

• BREF is used in studies that require a brief assessment of quality of life e.g. in large epidemiological studies, clinical trial and treatment efficacy where QoL is needed.

• An example on QoL measurement after Rehab treatment in several diseases http://www.rehabmeasures.org/Lists/RehabMeasures/PrintView.aspx?ID=937

Another theory and measuring : Active Ageing Index

• WHO Study on global AGEing and adult health (SAGE) http://www.who.int/healthinfo/sage/en/

Differences and similarities between QoL and WB Indexes

• They are both Patient Reported Outcome (PRO) tools. AAI is not; data collection through statistical institutes.

• They are both cross sectional instruments applied in many different types of cohorts (patients, refugees, elderly people etc).

• WB is expressed so far only in longitudinal studies while QoL mostly QoL-BREF is used in short term studies that need to measure QoL in treatment

• They both matter in economic and health policy terms as WB & QoL in elderly people’s lives have positive effects in a longer, healthier and more active life.

Conclusions

• QoL is the most “ancient” method (1995) by WHO

• WB is a US driven survey and policy tool (2008)

• Active Ageing by WHO and Index the most recently developed (2012) run mostly by EU

• They all aim at the same goal: “Measuring well-being gives leaders a unique perspective on where their populations are and where they can be — information that is vital to inform well-being improvement strategies. Improving well-being has been shown to lower healthcare costs and increase worker productivity, in turn enhancing organizational and community competitiveness.” (by WBI Gallup -Healthways).

WBI being an expression of Behavioural Economics is most appropriate tool for healthcare cost reduction policy purposes.

References

• Angner, E. (2008). The philosophical foundations of subjective measures of well-being. Capabilities and Happiness, 286-298.

• Diener, E. (2009). Subjective well-being. The Science of Well-Being, 11-58.

• Felce, D., & Perry, J. (1995). Quality of life: Its definition and measurement* 1. Research in developmental disabilities, 16(1), 51-74.

• Gallup – Healthways Index Methodology, 2009. Gallup Inc.

• Gallup & Healthways WBI 2013 “State of Global Well-Being 2013”

• Gough, I., & McGregor, J. (2007). Wellbeing in developing countries: from theory to research: Cambridge Univ Pr.

• International Society of QoL http://www.isoqol.org/about-isoqol/what-is-health-related-quality-of-life-research

• Lindströ, B., & Henriksson, B. (1996). The essence of existence On the quality of life of children in the Nordic countries. International Journal of Social Welfare, 5(2), 117-118.

• Oort, F. (2005). Using structural equation modeling to detect response shifts and true change. Quality of Life Research, 14(3), 587-598.

• Smith, B., Tang, K., & Nutbeam, D. (2006). WHO health promotion glossary: new terms. Health Promotion International, 21(4), 340.

• WHO – QoL Group: http://www.who.int/mental_health/publications/whoqol/en/

• WB in Gallup World Poll http://www.well-beingindex.com/