Quality of life, popularly abbreviated as QOL is defined as the degree to which a person enjoys the important possibilities of life individually or as a society. The health aspect of QOT is known as the healthcare quality of life (HRQOL) (Hosseini et al., 2013). Generally, QOT means different things to different people due to philosophies, religious beliefs, background, or environment (Petiprin, 2016). This paper seeks to understand the different concepts of QOT, its various prerequisites and its relevance to different aspects of life.
Understanding of quality of life from different schools of thought
Many scholars, philosophers, and theorists including Jeremy Bentham, Immanuel Kant, John Stuart Mill, Karl Marx, Friedrich Nietzsche, and John Dewey have voiced various varying opinions about QOT. Divergent opinions have always come up on the concept of quality of life but the three general orientations of the concept have been arrived at (Petiprin, 2016). These are the hedonic theories, the rational preference theories, and the human flourishing theories.
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Hedonic Theories
This theory considers quality of life from a personal perspective. It respects the different thought patterns of different people and defines quality of life from the perspective of the person living that life as opposed to having a universal approach. The soundness of this theory has been questioned by its distractors on several grounds; pain, suffering or misery being definite issues. Whatever opinion the sufferer has of them, they are still painful and any positive opinion about them is just a form of escapism (Petiprin, 2016).
Rational preference theories
This is more objective since it looks and defines quality of life from its capacity to meet actual rational desires and preferences of the individual or society. The person need not be happy or satisfied as long as from rational parameters, he is or should be. Under this theory however, a person will only be actually happy if his opinion of a good quality of life is congruent with the rationally accepted opinion (Petiprin, 2016).
Theories of human flourishing
This theory looks at quality of life from a developmental perspective with the instinctive raw man being the least developed while fully educated and polished man through social interaction among other avenues of learning being the most developed. The quality of life is then measured from the perspective of the most developed man, the closer you are to having the things that this developed man desires and the further you are from what he abhors, the better quality of life you have (Petiprin, 2016). A good quality of life is not only limited to being able to meet basic and secondary needs but also the ability to develop a capacity to interact with humanity.
Criteria for the Concept of Quality of life
As there are many schools of thought with regard to this concept, several yardsticks have also been developed as the criterion for this concept. Among the generally accepted include;
Material living conditions criterion
This refers to the assessment of the quality of life premised on the three pronged parameter of income, expenditure and material conditions. A person with a fixed income in Tokyo or New York cannot be considered on the same parameter as someone earning the same income in a rural farming neighborhood where basic and secondary needs are much cheaper thus the use of income and expenditure. Material conditions are also important since you may have all the money but lack basic amenities since they are not available for sale or are too expensive (Pukelienė & Starkauskienė, 2009).
Productive or main activity
This parameter, mostly used in European societies, looks at what activity is available to the person in their environment. This mostly refers to the economic activity in the general area of the society. It looks at the working hours, social life allowances of the nature of work, safety, and ethics of employment (Pukelienė & Starkauskienė, 2009).
Health
This parameter looks at the heath and healthcare issues by assessing the life expectancy, infant mortality, and average number of years of enjoyment of perfect or near perfect health, availability of healthcare services and self-evaluation of one’s health from the individual’s opinion of good health (Pukelienė & Starkauskienė, 2009).
Education
Contemporary economies are knowledge based and one of the best parameters for knowledge is education. Education can be measured by academic achievement or by level of competency and the capacity to find work, retain the job, and perform it well (Pukelienė & Starkauskienė, 2009).
Leisure and social interactions
Social interactions are a powerful force in forging the quality of one’s life, how much leisure time is available, and how it is spent, either in having fun, playing games or even volunteering for social work can be a good parameter for assessing the quality of life.
Economic and physical safety
Being able to plan ahead and generally predict what may and may not happen also affects the quality of life for an individual or society. Even when life seems prosperous but all of it can go to waste in an instant through high propensity for natural or man-made calamities makes for a poor quality life even if the interim seems affluent (Pukelienė & Starkauskienė, 2009).
Natural and living environment
This mainly regards pollution; it is impossible to ignore the impact the environment has on the quality of one’s life. Exposure to air, water and noise pollution can negatively impact the health or well-being of a person or society despite the perfection of all the other aspects (Pukelienė & Starkauskienė, 2009).
Overall experience of life
This involves a three pronged approach with the following parameters: life satisfaction (logical appreciation), affect (a person’s feelings, both positive and negative, typically measured with reference to a particular point in time) and eudaemonics (a sense of having meaning and purpose in one’s life, or good psychological functioning.) It is the totality or a cross section of these parameters that is employed as the basic criteria in the quality of life concept (Pukelienė & Starkauskienė, 2009).
Uses of the Quality of Life Concept
The world has always been interested in pursuance of a middle range with the better of endeavoring to pull up those who live the poorest quality of life to a comfortable middle range. What life is fundamentally different from what it seems to be; the quality of life concept is fundamental to the process of accurately ascertaining the standard of living of individuals and societies in order to be able to assist them. International organizations like the UN and its affiliates, governmental organizational like USAID and many non-governmental organizations utilize this concept to come up with the nature and level of assistance to provide as well as to analyze and assess the effect of the assistance being given (Petiprin, 2016).
Challenges in Use the Concept of QOT
The controversy surrounding the concept of Quality of life may however quite a challenge be its use. Whereas the criterion is well settled, the users of the concept has to figure out which one of the many schools of thought to follow or which conglomeration and in which dimensions (Petiprin, 2016). There is also the difficulty with the donor and recipient disagreeing on particulars in interpretation with the recipient favoring an aspect that is in opposition with that of the donor and vice versa, there is therefore a need to narrow down the various opinions with regard to the concept for ease of usability.
Attributes of the Concept of Quality Life
The concept of quality of life involves two general sets of attributes; the individual and the collective attribute.
Individual Attribute
The individual attribute of quality of life involves the objective and the subjective elements. The objective elements revolve around the pursuit of and availability of basic and secondary needs and the availability of the requisite material resources to fulfill the individual’s social requirements and expectations as a member of the larger society. The subjective elements regard freedom, autonomy, and responsibility to make decisions and carry out activities that the individual finds necessary and expedient (Petiprin, 2016).
Collective Attribute
This Attribute of QOT has a global outlook especially with regards to environmental sustainability and what the world is doing to keep the earth a better place. It also looks at issues like justice, fairness, equity, social justice and egalitarianism (Petiprin, 2016).
Antecedents and Consequences
The QOT concept keeps coming back to the initial issue of the disagreement regarding its nature and its variant definition. From its criteria, uses to its attributes, the QOT concept, albeit, solid, necessary, valid and useful, it is continually bogged down by the different schools of thought. If a solid definition with concrete parameters were to be established the concept would thrive in use as it does in theory with consequences of making the world a better place and the accomplishment of a middle range in quality if a good life (Petiprin, 2016).
Theoretical perspectives of the concept
The current circumstances facing the nursing profession create a definite paradox between the fundamentals of the profession as a care-giver and the commercial aspect as a business with the consequent commercial prerequisite of pleasing the client (Petiprin, 2016). The traditional nurse whose only allegiance was to the nightingale oath and universal well good, the contemporary nurse has to consider the requirement, needs and unfortunately even wants of the patient, which more often than not may lead to a quagmire (Hosseini et al., 2013).
It therefore follows that any and all nursing theories that involves actual contact between the nurse and the client have to be tempered with the concept of QOT involves inter alia a careful criterion of how to consider analyses and decide between the requirements, needs and wants of a patient and make the right decision (Petiprin, 2016).
Application in Nursing
QOT is an important concept for nurses in oncology related to settings as the physical, psychological, and social welfare of the patients being affected by the ailment and its management. The critical understanding and use of effective, dependable, and clinically appropriate measures of quality of life will facilitate planning of appropriate care and the evaluation of specific interventions. (Hosseini et al, 2013; Petiprin, 2016).
A good example is the now common and controversial use of the euthanasia on a patient who desires to die or is in a vegetative state, yet the family is holding on to hope under hopeless situations and the hospital is accumulating immense bills or perhaps the facilities being put to waste could be used on a patient. These entire scenarios will require a proper understanding and utilization of the concept of QOT.
Conclusion
Despite the obvious controversies, it is universally agreed upon that the concept of QOT is the important and relevant to healthcare and social good. In many cases, this concept creates the capacity to differentiate between the seemingly case and the actual case, a differentiation that is fundamental in nursing care. A lot however need to be undertaken to universalize this concept and bring together all schools of thought and all interrelations together so as to have one interpretation and a singular systems of parameters since a concept that operates on a perchance is too lose for a profession as fundamental and care-giving.
References
Hosseini, B., Nedjat, S., Zendehdel, K., Majdzadeh, R., & Montazeri, A. (2013). Response Shift in Measuring Health-related Quality of Life: Concepts, Definitions, and Challenges. Basic & Clinical Cancer Research, 5(4), 2-9.
Mizohata, S., & Jadoul, R. (2013). Towards International and Interdisciplinary Research Collaboration for the Measurements of Quality of Life. Social Indicators Research , 111(3), 683-708.
Petiprin, A. (2016). Nursing theories and nursing models - nursing theory. Retrieved June 1, 2016, from http://www.nursing-theory.org/theories-and-models/
Pukelienė, V., & Starkauskienė, V. (2009). Quality of Life concepts, measurement and challenges. Applied Economics: Systematic Research, 3(2), 51-65.
