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Europa Medicophysica 2003 December;39(4):191-8

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Quality of life assessment in rehabilitation medicine

Franchignoni F. 1, Salaffi F. 2

1 Unit of Occupational Rehabilitation and Ergonomics “Salvatore Maugeri” Foundation Clinica del Lavoro e della Riabilitazione, IRCCS Istituto Scientifico di Veruno (NO), Italy 2 Department of Rheumatology University of Ancona, Ancona, Italy


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Health-relat­ed qual­ity of ­life (­HRQOL) ­refers to ­the ­individual’s psy­cho­log­i­cal ­well-­being in ­and gen­er­al sat­is­fac­tion ­with phys­i­cal, psy­cho­log­i­cal ­and ­social ­domains of ­life ­and ­how ­this is affect­ed by dis­eas­es, acci­dents ­and treat­ment ­from ­the ­patient’s ­point of ­view. The ­major dimen­sions of ­HRQOL instru­ments ­include: impair­ments (symp­toms, sub­jec­tive com­plaints ­etc.); func­tion­al ­states (phys­i­cal, psy­cho­log­i­cal ­and ­social); gen­er­al ­health per­cep­tions (sat­is­fac­tion ­with ­health, per­ceived ­well-­being ­etc.). The rela­tion­ships ­between dif­fer­ent con­cepts ­and indi­ca­tors ­are influ­enced by a num­ber of indi­vid­u­al ­and envi­ron­men­tal fac­tors. The ­main per­spec­tives ­for meas­ur­ing ­HRQOL ­rely ­upon descrip­tions of spe­cif­ic beha­vi­ours, sub­jec­tive ­states, ­and rel­a­tiv­is­tic assess­ments, ­always fil­tered by ­the ­individual’s per­cep­tions ­and expec­ta­tions. ­HRQOL instru­ments ­can be clas­si­fied accord­ing to ­range of pop­u­la­tion ­and con­cepts ­embraced (gener­ic vs spe­cif­ic meas­ures), ­types of ­scores pro­duced (indi­ces, pro­files, ­etc.), ­source of ­report, ­mode of col­lec­tion, ­and weight­ing ­system. Differences ­among ­HRQOL instru­ments main­ly con­cern ­the empha­sis on dif­fer­ent indi­ca­tors, ­the ­extent to ­which dif­fer­ent ­domains ­are cov­ered/weight­ed, ­and ­the for­mat. Caution is rec­om­mend­ed in inter­pret­ing ­HRQOL ­scores, ­due to ­the sub­jec­tive ­nature of ­the con­struct, ­its indi­rect assess­ment, ­the mul­ti­ple sourc­es of meas­ure­ment ­error, ­and ­many oth­er fac­tors. In ­order to fos­ter ­the appli­ca­tion of ­HRQOL meas­ures in clin­i­cal prac­tice ­and deci­sion-mak­ing, ­and pol­i­cy devel­op­ment, ­future ­research ­should ­address ­both method­o­log­i­cal ­and ­applied ­issues (e.g. ­item-­response-the­o­ry ­use, respon­sive­ness ­and bet­ter cal­i­bra­tion of ­the instru­ments, com­par­abil­ity ­across dif­fer­ent pop­u­la­tions).

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