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“Quality of life” umbrella often refers to self-reports of . Symptoms Functional status Perceptions Opportunities. associated with disease and treatment. Alternative Concepts or Different Concepts?. Health Status : death, disease, disability, discomfort, dissatisfaction (5 D’s)
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“Quality of life” umbrella often refers to self-reports of • Symptoms • Functional status • Perceptions • Opportunities associated with disease and treatment
Alternative Concepts or Different Concepts? • Health Status: death, disease, disability, discomfort, dissatisfaction (5 D’s) • Functional Status: performance of social roles and activities • Well-Being: wellness, feelings • Quality of life: safe environment, adequate housing, guaranteed income, respect, love, freedom, spirituality, meaning and purpose • Health-related quality of life: those aspects of quality of life attributed to health and the importance of health
Concepts Intertwined • Most aspects of life involved in life-threatening illness and some chronic illnesses • Patients and clinicians use language that mixes concepts, e.g. “getting up at night to urinate” • Symptoms (G. symptoma) may be mixed with signs (L. signum) as subjective phenoma that may or may not be seen, heard, or measured
Symptoms and QoL • Symptoms sometimes confounded with function and perceived quality of life in measurement • Symptoms can be viewed as related to but separated from function and perceptions • Symptoms important to patients and clinicians in diagnosis and evaluating treatment effectiveness
Toward Conceptual Clarity • Health status and quality of life are different and useful in distinguishing proximal and distal impacts of treatment • Symptoms, functional status and perceptions often called QoL, can be highly related, but are not equal • Best chance of sorting out relationships is to label carefully and evaluate separately