The quality of life is a concept used in sociology , economics , politics , medicine and some other areas, denoting an assessment of a certain set of conditions and characteristics of a person’s life, usually based on his own degree of satisfaction with these conditions and characteristics. It is broader than material security ( standard of living ), and also includes such objective and subjective factors as health status, life expectancy , environmental conditions , nutrition, domestic comfort, social environment , cultural and spiritual needs , psychological comfort etc. [1] [2] [3]
The quality of life may depend on the state of health , communication in society, psychological and social status, freedom of activity and choice, stress and excessive concern, leisure activities , educational level, access to cultural heritage, social, psychological and professional self-affirmation, psychotype and adequacy of communications and relationships [3] [1] [2] .
The transition to a postindustrial society is accompanied by an increasing attention to the intangible aspects of the quality of life, provided with such. At the same time, many cannot compete at the proper level for various reasons, which gives a shift in society towards a class society.
In 2009, a report of the international Commission on the main indicators of economic activity and social progress was released under the leadership of Nobel laureates J. Stiglitz and A. Sen , which substantiates the use of the quality of life indicator as the main criterion for the economic development of society instead of GDP [4] [5] .
According to sociologists of the Financial University under the Government of the Russian Federation , the high quality of human life implies [6] [7] :
- adequate life expectancy supported by good health care and safety (the absence of significant threats to life and health),
- an acceptable volume of consumption of goods and services, guaranteed access to material goods,
- satisfactory social relations, the absence of serious social conflicts and threats to the achieved level of well-being,
- family well-being
- cognition of the world and development - access to knowledge, education and cultural values that shape the personality and ideas about the world,
- taking into account the views of the individual in solving social problems, participation in creating a generally accepted picture of the world and the rules of human behavior,
- social affiliation, full participation in social and cultural life in all their forms,
- access to a variety of information, including information on the state of affairs in society,
- comfortable working conditions, giving room for creativity and self-realization, a relatively short working day, leaving a person enough free time for various activities.
Quality of life measurements
With a certain approximation, the UN Human Development Index can be used as an indicator of the quality of life. It is built in the following areas: income level in a country or region (determined through GNI per capita at PPP), life expectancy, access to knowledge (determined on the basis of the share of the population enrolled in education at various levels).
Different quality indices of life can serve as a measure of quality of life in various countries, among which the “Better Life Index” calculated by the Organization for Economic Cooperation and Development [8]
Subjective assessment of the quality of life can also be measured using opinion polls. To do this, use a wide range of sociological tools [9] [10] . The most significant, integral indicator characterizing the subjective assessment of the quality of life is a person’s satisfaction with his life [11] [12] .
Quality of life in medicine
Many sections of medicine use the concept of quality of life associated with health ( English health related quality of life, HRQL ), or simply quality of life. As applied to medicine, quality of life is an integral characteristic of a patient’s physical, psychological, social and emotional state, assessed based on his subjective perception [13] . There are two aspects to the concept of quality of life. Firstly, when evaluating it, various areas of the patient’s life are taken into account, both directly related to the state of health and those that depend on it only indirectly. When assessing the quality of life of a patient, the physical, psychological, social, economic, spiritual aspects of his life are taken into account. Secondly, the assessment is based primarily on the opinion of the patient himself, his subjective perception of the quality of life in one way or another [13] .
Improving the quality of life is either the main or additional goal of treatment. An additional goal is to improve the quality of life if the disease can lead to a reduction in life, and the main one if it cannot lead to a reduction in life, or, conversely, if the disease is incurable and will certainly lead to the death of the patient. In the latter case, improving the quality of life remains the only goal of treatment [13] .
Quality of life research is carried out in many branches of medicine, in particular in palliative medicine , cardiology , transplantology , oncology , surgery , psychiatry , endocrinology , gerontology , neurology and others. The main areas of such research include standardization of treatment methods, examination of new treatment methods and drugs , development of prognostic models of the course of diseases, economic feasibility of treatment methods [13] .
Assessment Methodology
The main tool for assessing the quality of life of patients is specially designed questionnaires. Questionnaires are general and specialized. Specialized questionnaires can relate to specific areas of medicine, specific diseases, or even specific stages of the disease and conditions. Questionnaire writing is a complex and multi-step process. It includes validity assessment, reliability assessment, determination of the sensitivity of the questionnaire, which are carried out by qualified specialists using specially designed tests. Often used standardized questionnaires. Among the most common are: EUROQOL, MOS SF-36 , Quality fo Well-Being Index, Sickness Impact Profile, Nottingham Health Profile, Quality of Life Index . In preparing the questionnaire for use in an excellent linguistic and cultural environment, multilevel adaptation is carried out [13] .
In addition to collecting data using questionnaires, the assessment of quality of life also includes examination of patients, statistical processing, analysis and interpretation of data [13] .
Palliative care, palliative medicine
Palliative medicine is a branch of medicine whose task is to improve the quality of life of hopeless patients, for example, in the case of inoperable forms of cancer. It is based on the relief of pain, other symptoms, the solution of the psychological and social problems of the patient. The purpose of palliative care is to maximize the quality of life of a hopeless patient and his family [14] [13] . A variation of palliative care is hospice care .
Pharmacoeconomics and quality of life
Pharmacoeconomics is a research area that studies the cost and effectiveness of certain drugs and treatment methods. In the framework of pharmacoeconomics, the cost of treatment, cost minimization, the ratio of the cost of treatment and the final economic benefit, the cost of treatment and its effectiveness, the cost of treatment and its usefulness are calculated. In the 1970s, it was proposed to use the QALY value - years of life adjusted for quality ( English. Quality-adjusted life years ) to calculate the ratio of cost and effectiveness of treatment. Subsequently, based on this concept, a calculation of the ratio of cost and utility was developed. These calculations are used when choosing the most optimal treatment methods [13] .
QALY years of life
The years of life, adjusted for quality, are a conditional integral value that takes into account the patient's life expectancy and its quality. For its calculation, it is necessary to multiply each year lived by the patient by a coefficient reflecting the quality of his life. The coefficient can take values from 1.0 (absolute health, maximum quality of life) to 0.0 (death). At the same time, one year lived with the best state of health adds to the value of 1 year, lived qualitatively , a year lived with a quality of life coefficient of 0.6 adds 0.6, etc. Thus, when calculating the effectiveness of treatment, for example, two years lives with a coefficient of 0.5 are equal to one year with a coefficient of 1.0 [13] . The QALY value is widely used in Western countries.
See also
- Standard of living
- Quality of Life Index
- Palliative care
- Gross national happiness
- International Happiness Index
- Life Satisfaction Index
- Mercer World Quality of Life Rating
- World Values Review
Sources
- ↑ 1 2 Quality of life. // Raizberg B.A., Lozovsky L. Sh., Starodubtseva Ye. B. Modern economic dictionary. - 2nd ed., Rev. M .: INFRA-M, 1999 .-- 479 p.
- ↑ 1 2 Kamenskaya G.V. Quality of life. // New philosophical encyclopedia : In 4 vols. / Ed. V. S. Styopina . - M.: Thought , 2001.
- ↑ 1 2 Quality of life. // Philosophical Encyclopedic Dictionary . / Ch. Edition: L. F. Ilyichev , P. N. Fedoseev , S. M. Kovalev , V. G. Panov . - M.: Soviet Encyclopedia , 1983.
- ↑ Joseph Stiglitz . Globalist: More Than GDP
- ↑ Report by the Commission on the Measurement of Economic Performance and Social Progress - Template Lab
- ↑ Zubets Alexey Nikolaevich. Sources and the history of economic growth / M .: Publishing house "Economics", 2014. 463 p. ISBN 978-5-282-03354-0
- ↑ See the article on the website of the Financial University: Zubets A.N., Tarba I.V. The quality of life in Russia / Journal "Finance" M., No. 12, 2013, p. 68-70 (inaccessible link) . Date of treatment May 1, 2019. Archived November 2, 2014.
- ↑ See the relevant section on the OECD website.
- ↑ See the “Well-Being” section of the Gallup research company website.
- ↑ See materials on the topic “Standard of living” on the website of the research company Gallup
- ↑ For data on European Union population satisfaction with their lives, see the website of the Eurobarometer, the EU Sociological Center
- ↑ For data on the satisfaction of the Russian population with their life, see the review on the website of the Financial University under the Government of the Russian Federation. Archived copy of September 4, 2014 on the Wayback Machine
- ↑ 1 2 3 4 5 6 7 8 9 D.M. Novik A.A., c. n Ionova T. I. Guide to the study of the quality of life in medicine. 2nd edition / Ed. Acad. RAMS Yu. L. Shevchenko. - M.: CJSC "OLMA Media Group", 2007. - 320 p.
- ↑ World Health Organization . Definition of palliative care . 2002 year
Links
- United Nations Development Program - Human Development Report 2009 // Humanitarian Technology News.
- “Quality of life” of the concept // Scientific Communism: Dictionary / Alexandrov V.V., Amvrosov A.A., Anufriev E.A. et al .; Ed. A. M. Rumyantsev . - 4th ed., Ext. - M .: Politizdat , 1983 .-- 352 p.
- 2009 Quality of Life Report from internationalliving.com
- Vitamin D levels are closely linked to quality of life.