Page 117 - Psychology of Wounds and Wound Care in Clinical Practice ( PDFDrive )

Theories of QoL and Wellbeing 91

Time 1 Time 2 Time 3 Time 4
ideal self
Actual self

Figure 4.2 An illustration of gap theory

distinction, one that can help provide a useful working defini-
tion which can be applied in practice.
In summary, QoL is a broad concept, an umbrella term
which encompasses HRQoL, and is related to well-being. As
noted earlier, a number of factors impact upon our QoL
including health, income, social status and of course our well-
being. It is of course just as likely that our well-being is in turn
influenced by these same factors – health, income, social
status and QoL. It is therefore probably more accurate to
view QoL and well-being as interdependent factors that work
together in a dynamic relationship.
The relationship between well-being and QoL is undoubt-
edly a complex one. To begin to work this out, we first need
to understand how individuals reach an assessment of their
QoL. It is usually suggested that QoL is the gap between a
person’s expectations and their fulfilment. This is commonly
known as ‘gap theory’ and is illustrated in Fig. 4.2 . Thus it is
assumed that poorer QoL is the result of discrepancies
between an individual's actual (‘like me’) and ideal self (‘how
I would like to be’) (Eiser and Eiser 2000 ). As Fig. 4.2 dem-
onstrates this can fluctuate over time as functioning and
expectations change. Figure 4.2 illustrates how a person’s