Page 461 - Encyclopedia of Nursing Research

428 n QuAlITy OF lIFE

health (Anderson & Burckhardt, 1999; and data for tracking various aspects of pop-
Bergner, 1989; Frank-Stromberg & Olsen, ulation health (www.cdc.gov/hrqol/index.
Q 2004). However, these (and other) global htm).
QOl concepts may be too broad and inclu- QOl phenomena amenable to nursing
sive to be meaningfully operationalized in studies have enjoyed a long history of pub-
research (Bard, 1984). lished research. using the key terms quality
Thus, interest in the systematic assess- of life and limiting the search to research pub-
ment of specific dimensions of QOl, such lication type and nursing journals, a recent
as health-related quality of life (HRQOl) cumulative Index to Nursing and Allied
has emerged in research and clinical prac- Health literature search yielded 5,147 arti-
tice (Bergner, 1989). One formal definition of cles published between 1977 and August
HRQOl is, “the extent to which one’s usual 2010, with 2,675 or 52% published since 2005.
or expected physical, emotional, and social Similarly, an identical cumulative Index to
well-being are affected by a medical con- Nursing and Allied Health literature search
dition or its treatment” (cella, 1995). This for health-related quality of life yielded 518
definition encompasses both the subjectiv- articles published between 1993 and August
ity and multidimensionality of the concept 2010, with over half (n = 282) published since
of HRQOl, two important aspects of QOl 2006. These data-based research publications
(Aaronson, 1988). The following paragraphs demonstrate the prolific nature of HRQOl
describe QOl in a health-related context for research in nursing.
use in nursing research and practice; thus, QOl research is vital to individual- and
the term QOL is used interchangeably with population-level clinical and policy deci-
HRQOL (varricchio & Ferrans, 2010). sion making and implementation and com-
Nursing and other health care research- parative effectiveness research (Gatsonis,
ers are most often interested in determining 2010; Guyatt, Feeny, & Patrick, 1993; Kaplan
how disease or injury or the treatment of dis- and Bush, 1981; lauer & collins, 2010). The
ease or injury affects QOl. Similarly, health American Recovery and Reinvestment Act
promotion researchers may use specific QOl of 2009 brought comparative effectiveness
constructs to ascertain the effectiveness of research to the forefront in an era of health
measures taken to enhance or improve men- care reform by appropriating $1.1 billion
tal, physical, social, or spiritual health. Health solely to comparative effectiveness research,
care policy makers and third-party payers $400 million to the National Institutes of
may use HRQOl information in public pol- Health, and the remainder to the Agency for
icy and reimbursement decision making. Healthcare Research and Quality (lauer &
The importance of QOl research is collins, 2010). Within this new and evolv-
evident through federal funding of health ing research context, it will be important for
research. For example, strategic areas of QOl phenomena to remain cogent determi-
research emphasis of the National Institute nants of clinical decision making. One of the
of Nursing Research (NINR) include many major challenges for nurse scientists in this
opportunities for research that will improve new research infrastructure will be to deliver
QOl by enhancing individuals’ role in man- meaningful, multifaceted, yet granular QOl
aging disease, relieving symptoms of dis- information for evidence-based clinical deci-
ease and disability, and improving outcomes sion making.
(NINR, 2006). Included in the NINR empha- In a recent concept analysis, Plummer
sis on QOl are self-management, symptom and Molzahn (2009) used critical appraisal
management, and caregiving. The centers for of the literature to enhance conceptual clar-
Disease control and Prevention also have a ity of QOl from a nursing perspective with
division for HRQOl that provides measures five nursing theorists (Peplau, Rogers, King,