Quality of life (QoL) is a multidimensional construct that communicates an individual’s overall sense of well-being and life satisfaction. Health care practitioner and patient/family agreement on primary contributors to QoL are key to the provision of effective health care. This is particularly important in guiding treatment choices and measuring outcomes in individuals with chronic health conditions. The concept of QoL has changed over time. It encompasses social, cultural, and political factors that affect people’s decisions regarding QoL. Culture is a way of life that shapes the way people make meaning out of illness and suffering. Home care practitioners should strive to be aware of the cultural influences on a client’s health care decision making. The purposes of this article are to (a) describe the dimensions of QoL, (b) discuss cultural influences on QoL, (c) explain common measurement tools used to assess health-related QoL, and (d) provide suggestions to home health practitioners for implementing strategies to foster patient-centered care and outcome assessment that emphasizes QoL.
Amarantos, E. , Martinez, A., & Dwyer, J. (2001). Nutrition and quality of life in older adults. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 56(2), 54-64.
2.
Bergner, M. , Bobbitt, R. A., Carter, W. B., & Gilson, B. S. (1981). The Sickness Impact Profile: Development and final revision of a health status measure. Medical Care, 19(8), 787-805.
3.
Cella, D. F. (1995). Measuring quality of life in palliative care. Seminars in Oncology, 22(2), 73-81.
4.
Council of Economic Advisors . (1997). Changing America: Indicators of social and economic well-being by race and Hispanic origin. Washington, DC: Government Printing Office.
5.
Crawley, L. , Marshall, P., & Koeing, B. (2001). Respecting cultural differences at the end of life. Philadelphia: American College of Physicians— American Society of Internal Medicine.
6.
de Bruin, A. F. , de Witte, L. P., Stevens, F., & Diederiks, J. P. (1992). Sickness Impact Profile: The state of the art of a generic functional status measure. Social Science & Medicine, 35(8), 1003-1014.
7.
de Bruin, A. F. , Diederiks, J. P., de Witte, L. P., Stevens, F. C., & Philipsen, H. (1997). Assessing the responsiveness of a functional status measure: The Sickness Impact Profile versus the SIP68. Journal of Clinical Epidemiology, 50(5), 529-540.
8.
Elkin, M. , Perry, A., & Potter, P. (2000). Nursing interventions & clinical skills. St. Louis, MO: Mosby.
9.
Fadiman, A. (1997). The spirit catches you and you fall down: A Hmong child, her American doctors, and collision of two cultures. New York: Farrar Status & Giroux.
10.
Fang, J. , Madhavan, S., & Alderman, M. H. (1996). The association between birthplace and mortality from cardiovascular causes among Black and White residents of New York City. New England Journal of Medicine, 335(21), 1545-1551.
11.
Grant, M. , Padilla, G., & Farrell, B. (1994). Manual of quality of life with a single instrument. Duarte, CA: City of Hope National Medical Center.
12.
Hobson, P. , Bhowmick, B., & Meara, J. (1997). Use of the SF-36 questionnaire in cerebrovascular disease. Stroke, 28(2), 464-465.
13.
Johnson, J. R. , & Temple, R. (1985). Food and Drug Administration requirements for approval of new anticancer drugs. Cancer Treatment Report, 69(10), 1155-1159.
14.
Jurkovich, G. , Mock, C., Mackenzie, E., Burgess, A., Cushing, B., & deLateur, B. (1995). The Sickness Impact Profile as a tool to evaluate functional outcome in trauma patients. Journal of Trauma, 39(4), 625-631.
15.
Kagawa-Singer, M. , & Chung, R. (1994). A paradigm for culturally based care for minority populations. Journal of Community Psychology, 6, 192-208.
16.
Kahn, S. B. , Houts, P. S., & Harding, S. P. (1992). Quality of life and patients with cancer: A comparative study of patient versus physician perceptions and its implications for cancer education. Journal of Cancer Education, 7(3), 241-249.
17.
Katon, W. , & Kleinman, A. (1980). A biopsychosocial approach to surgical evaluation and outcome. Western Journal of Medicine, 133(1), 9-14.
18.
Kleinman, A. (1980). Patients and healers in the context of culture. San Francisco: University of California Press.
19.
Landgraf, J. M. , & Nelson, E. C. (1992). Summary of the WONCA/COOP International Health Assessment Field Trial: The Dartmouth COOP Primary Care Network. Australian Family Physician, 21(3), 255-257, 260-262, 266-269.
20.
Martin, D. P. , Gilson, B. S., Bergner, M., Bobbitt, R. A., & Conn, J. R. (1976). The sickness impact profile: Potential use of a health status instrument for physician training. Journal of Medical Education, 51(11), 942-944.
21.
McDowell, I. , & Newell, C. (1996). General health status and quality of life. Measuring Health: A Guide to Rating Scales and Questionnaires, 2, 380-492.
22.
McHorney, C. A. , Ware, J. E., Jr., Lu, J. F., & Sherbourne, C. D. (1994). The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Medical Care, 32(1), 40-66.
23.
Meenan, R. F. , Gertman, P. M., & Mason, J. H. (1980). Measuring health status in arthritis. The arthritis impact measurement scales. Arthritis and Rheumatism, 23(2), 146-152.
24.
Nelson, E. , Wasson, J., Keller, A., Clark, D., Dietrich, A., & Stewart, A. (1987). Assessment of function in routine clinical practice: Description of the COOP chart method and preliminary findings. Journal of Chronic Diseases, 40(1), 55S-69S.
25.
Streppel, K. R. , de Vries, J., & van Harten, W. H. (2001). Functional status and prosthesis use in amputees, measured with the Prosthetic Profile of the Amputee (PPA) and the short version of the Sickness Impact Profile (SIP68). International Journal of Rehabilitation Research, 24(3), 251-256.
26.
Thompson, D. R. , Meadows, K. A., & Lewin, R. J. (1998). Measuring quality of life in patients with coronary heart disease. European Heart Journal, 19(5), 693-695.
27.
Ward, W. L. , Hahn, E. A., Mo, F., Hernandez, L., Tulsky, D. S., & Cella, D. (1999). Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 8(3), 181-195.
28.
Ware, J. E., Jr. , & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473-483.
29.
Williams, S. J. (1996). Measuring health status? A review of the sickness impact and functional limitations profiles. Health Care Analysis, 4(4), 273-283.
30.
World Health Organization . (1993). WHO—Quality of life study protocol: The development of the World Health Organization quality of life assessment instrument (MNGPSF 193-9). Geneva, Switzerland: Author.
