Page 115 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Theories of QoL and Wellbeing 89

Health Status

HRQoL Quality of Life
Functional status

Figure 4.1 The relationship between QoL, HRQoL, functional sta-
tus and health status (Based on Morrison et al. ( 2003 ))

as health related QoL or HRQoL. In practice however the
terms QoL and HRQoL are often used interchangeably,
although it can sometimes be useful to make the distinction
between HRQoL and QoL.
HRQoL is itself a complex, multidimensional construct,
which focuses on an individual’s experience of the impact
that their health status has on their QoL. HRQoL should not
therefore be confused with either health status or functional
status. Although these terms are also sometimes used inter-
changeably, this is conceptually inaccurate. Whilst it can be
difficult to distinguishing these three concepts, it is not impos-
sible. The difficulty lies in their shared characteristics. Health
status refers to the evaluation (either objective or subjective)
of a person’s state of health including any illness, treatment
and level of functioning; functional status is therefore a part
of health status and indicates an individual’s capacity to carry
out everyday tasks (Morrison et al. 2003 ). This relationship is
shown diagrammatically in Fig. 4.1 .
Figure 4.1 also demonstrates, health status and functioning
will impact to some extent on an individual’s QoL. HRQoL
therefore concerns the interface between an individual’s health
status, functioning and QoL and is therefore a distinct and spe-
cific component of QoL. Of course, since HRQoL is one aspect
of our overall QoL, it is inevitable that changes in HRQoL will
influence overall QoL. Thus whilst in a clinical setting the
measurement may focus specifically on HRQoL, when consid-
ering the impact of having a chronic wound on the individual
the distinction between HRQoL and QoL is less clear.