Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches

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Abstract

Over the past decades, the concept of quality of life has been of paramount importance for evaluating the quality and outcome of health care. Despite its importance, there is still no consensus on the definition or proper measurement of quality of life. Several concept analyses of quality of life have been published. However, they appear to have had a rather limited impact on how empirical studies are conducted. Therefore, we present an overview and critique of different conceptualisations of quality of life, with the ultimate goal of making quality of life a less ambiguous concept. We also describe six conceptual problems. These problems were used as criteria to evaluate the appropriateness of different conceptualisations. This evaluation suggests that defining quality of life in terms of life satisfaction is most appropriate, because this definition successfully deals with all the conceptual problems discussed. The result of our concept evaluation was not surprising for it corroborated the results of several concept analyses and the findings of a structural equation modelling study. Based on the findings revealed by our review, we propose that the scientific community should revitalise the conceptual discussion on quality of life. Furthermore, our findings can assist researchers in developing more rigourous quality-of-life research.

Section snippets

What is already known about the topic?

  • The concept of quality of life has been increasingly used in biomedical and nursing research during the past decades

  • There is no consensus on the definition and measurement of quality of life

What this paper adds

  • Six conceptual problems are described and discussed

  • The different conceptualisations are evaluated in the context of the six conceptual problems

  • Quality of life is most appropriately defined in terms of life satisfaction

Conceptualisations of quality of life in biomedical and nursing literature

A wide spectrum of quality of life definitions exists in the literature. In the early 1990s, Ferrans developed a useful taxonomy of quality of life conceptualisations (Ferrans, 1990, Ferrans, 1992, Ferrans, 1996), grouping them into six broad categories: (1) normal life, (2) social utility, (3) happiness/affect, (4) satisfaction with life, (5) achievement of personal goals, and (6) natural capacities. In addition to these six conceptual approaches, we also recognised utility and satisfaction

Critique of the different conceptual approaches to quality of life

The diversity of approaches to defining quality of life compelled us to make a critical appraisal of the value of the various quality of life conceptualisations by analysing the limitations of each approach. Many articles and book chapters about the concept of quality of life have been published. However, to date, these publications have primarily focused on measurement issues and psychometric properties, leaving conceptual issues unaddressed. Some articles anecdotally report conceptual

Evaluation of different conceptualisations

To assess the appropriateness of conceptualisations or definitions of quality of life, researchers should evaluate these definitions on the basis of the conceptual problems described here. Table 1 illustrates whether the respective conceptualisations address the identified problems.

Discussion

Despite the increased interest in quality of life, there is still no consensus on the definition of this concept. Moreover, it seems that the conceptual discussions has tempered. To enhance the conceptual understanding of quality of life, we used an alternative approach. In contrast with the methods of concept analysis, we identified problems of the various conceptualisations of quality of life and evaluated the appropriateness of these conceptualisations, which have been used previously in

Conclusion

In order to stimulate the scientific community to discuss concept underlying quality of life and to assist researchers in developing more rigourous quality-of-life research, we have evaluated the appropriateness of different conceptualisations of quality of life. This evaluation suggests that defining quality of life in terms of satisfaction with life is most appropriate. Based on this finding, researchers and theorists can initiate conceptual debates with the aim of making quality of life a

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