Page 116 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

90 Chapter 4. Quality of Life and Well- Being

According to Draper and Thompson ( 2001 ), HRQoL is
one of the most widely used terms in the health care profes-
sion, being applied across professions (nursing, allied health,
health economists, public health) and activities (e.g. research,
medical ethics, health services management). Despite this,
there is no consensus on definition, even at this level of speci-
ficity. Different ways of conceptualizing HRQoL can
therefore be found throughout the literature (Rapley 2003 ;
Lach et al. 2006 ). As with QoL, definitions appear to depend
upon the perspective and purpose of the clinician or
researcher; for example, a surgeon is most likely to focus on
HRQoL as a tool to assess health outcomes following life sav-
ing treatment, whereas an epidemiologist will want to assess
the determinants of HRQoL.
Wellbeing is also sometimes used as a synonym for QoL,
and again this is neither correct nor desirable. Well-being has
been defined as:

‘a holistic, subjective state which is present when a range of feel-
ings, among them energy, confidence, openness, enjoyment, hap-
piness, calm and caring are combined and balanced’ (Pawlyn and
Carnaby 2009 )
Although QoL and well-being inevitably overlap – both
are subjective assessments and both refer to psychological
states – and the terms are often used interchangeably, it is
important to distinguish between the two. In essence, QoL
refers to a person’s cognitive assessment of their overall stan-
dard of living, or their ‘personal assessment of life satisfac-
tion’ (Price and Harding 2004 ). As can be seen from the
WHO definition, QoL asks about an individual’s perception
of what their life is like. In contrast, the term ‘well-being’
refers to the presence of positive emotions and contentment,
with the absence of long-lasting and persistent negative emo-
tions (e.g. Zikmund 2003 ; CDC 2011 ). Well-being therefore
refers to an individual’s emotional response to what their life
is like. In essence, QoL (and therefore HRQoL) concerns the
cognitive appraisal of an individual’s situation, whereas well-
being refers to their emotional appraisal. This is a very clear