Page 114 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

88 Chapter 4. Quality of Life and Well- Being

Theories of QoL and Wellbeing

QoL is a hypothetical construct that acts as ‘an organising
concept that exists to guide its users’ (Wallander 2001 ). In
other words it has no physical foundation, but is rather
inferred from first-hand experience and theoretical knowl-
edge. Given this definition, it is not surprising that it has
been referred to as a ‘vague, ethereal construct’ (Shukla
et al. 2008 ). It is also a concept that is applied widely from
economics, through social policy to health. This wide appli-
cation, coupled with its hypothetical foundations, also
explains why there is such difficulty in agreeing a definition;
definitions vary in part depending on the aspect of our daily
lives to which QoL is being applied, and the perspective of
the user. In fact it has been suggested that having multiple
definitions is helpful from a theoretical perspective
(Wallander 2001 ), as it allows users to actualise the defini-
tion which best suits their needs. Thus an economist, social
policy maker and a clinician can work with the definitions
that is most apt for their purposes. Well-being is also a very
abstract concept, and like quality of life definitions are
known to be both ‘ambiguous’ and nebulous’ (Galloway
et al. 2006 ). However, this is not helpful from an applied
perspective, and so the aim of this section is to provide a
useful working definition that can be employed in clinical
practice.
QoL is a complex phenomenon that concerns an individu-
al’s satisfaction with all aspects of life from the physical to the
social and psychological. It is affected by many factors includ-
ing income, social and physical environment, interpersonal
relationships and health. The World Health Organisation
(WHO) defined QoL as:
‘an individual’s 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’(p1, WHO 1997 )
Usually in health care settings the focus is on assessing the
impact of changes in health status on a patient’s QoL; this
type of assessment is very specific and should be referred to