Investigation of Lay
and Professional Meanings of Quality of Life
If you do not have Acrobat
Reader please click on the link below to download software to
read 'pdf' files
Quality of Life (QoL) assessment is regarded as
appropriate in the evaluation of treatment outcomes, the organisation
of health care services and in the monitoring and audit of services.
Using psychometrically valid, standardised questionnaires, researchers
assume that they are incorporating patients' and users' perspectives
in evaluations. Although there has been an enormous growth in
(QoL) research, there appears to be no consistent view about how
it should be defined or measured. Many researchers, however, agree
that it must incorporate non-clinical aspects of health such as
patients' social activities, relationships and expectations.
Aims and Objectives
The aim of this study is to examine the multiple
meanings of the concept of (QoL) for older stroke patients and
the ways in which this concept influences the delivery of health
care for them. The study will use stroke as a case study since
it has symbolic and pidemiological associations with ageing, and
is a leading cause of disability among older people.
The objectives of the study are to examine:
The perceptions of health professionals
about the constituents and meanings of (QoL) for older stroke
patients, both as a quantifiable outcome and as a tacit
The means by which professionals' views
of (QoL) influence decision making, practice and policy
making with regards to stroke patients.
||The views of stroke survivors about
the constituents and meanings of (QoL), comparing them to
Open-ended interviews with professionals will be
conducted with a purposive sample of clinical staff working with
older patients in three hospital settings. Clinical staff includes
junior and senior doctors, physiotherapists, psychologists and
occupational therapists. A two-stage interview process will explore
older people's perceptions of (QoL) after stroke. Initial interviews
with 50 stroke patients will be conducted prior to discharge from
hospital. A second round of interviews will take place with the
patients, six months after discharge to obtain data on longer-term
Ethnographic work will be conducted on wards and
in multidisciplinary team meetings to observe the ways in which
ideas about (QoL) affect decision making processes in acute settings.
A national postal survey of professionals delivering care for
older people and stroke care will also be conducted to explore
their views and current use of standardised instruments to evaluate
care services and guide clinical decision making. The national
survey will allow us to situate local findings in the hospitals
within the national context.
Policy Implications The study will clarify what
(QoL) is for health care professionals and how their definitions
compare to the ideas of older people and themselves. It will examine
how (QoL) assessment and tacit values influence health care delivery,
individual care and policy development. It will also identify
strategies to promote the inclusion of lay priorities in definitions
and assessments of (QoL).