Quality of Life (QoL) Assessment

Bimba Wickramarachchi

University of Ruhuna

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Introduction�WHO definition: “An individual’s perception of their position in life…in the context of culture, values, goals, and expectations”�Importance in gerontology: beyond disease-free survival, focus on well-being and dignity�Domains: physical, psychological, social, environmental, spiritual

Why Assess QoL in Older Adults?�- Identifies unmet needs and care priorities�- Helps guide patient-centered care�- Evaluates outcomes of interventions (rehabilitation, nursing care, chronic disease management)�- Useful for policy-making and health service planning

�Dimensions of QoL�- Physical health: pain, mobility, ADLs�- Psychological health: mood, cognition, autonomy, resilience�- Social relationships: family, community, intimacy�- Environmental factors: safety, financial security, access to services�- Spiritual well-being: meaning, hope, life satisfaction

�Common Tools for QoL Assessment��- WHOQOL-OLD (older adult-specific module)�- SF-36 / SF-12 Health Survey�- EQ-5D (mobility, self-care, usual activities, pain/discomfort, anxiety/depression)�- Nottingham Health Profile (NHP)�- Quality of Life in Alzheimer’s Disease (QoL-AD)�- Self-report vs. proxy assessments

�WHOQOL-OLD Instrument�- 24 items, 6 facets: Sensory abilities�- Autonomy�- Past, present, and future activities�- Social participation�- Death and dying�- Intimacy�- Validated across cultures, widely used in research and practice

• Nursing Role in QoL Assessment�Holistic assessment → physical, psychological, spiritual care�Advocacy for older adults’ preferences�Incorporating QoL assessment into CGA (Comprehensive Geriatric Assessment)�Linking findings to care planning and evaluation

Case Scenario�Mrs. D, 79 years Widow, lives with daughter, history of hypertension & osteoarthritis. Complains of joint pain, limited mobility, loneliness�Assessment: WHOQOL-OLD�- Low scores in autonomy & social participation�- High anxiety about future health�Interpretation: Physical limitations + psychosocial isolation = reduced QoL�Nursing implications: pain management, mobility support, community engagement, counseling

��Overview of SF-36 & SF-12 Health Survey��Purpose: Generic tool to measure health-related Quality of Life (HRQoL)�SF-36:36 items�Covers 8 domains�Widely validated, comprehensive��SF-12:Short version (12 items)�Produces similar results with less burden�Applicability: General population, chronic diseases, older adults��

Domains & Scoring�8 Domains in SF-36 (also represented in SF-12): Physical functioning�Role limitations (physical health)�Role limitations (emotional problems)�Energy/Fatigue (vitality)�Emotional well-being (mental health)�Social functioning�Pain�General health perceptions�Scoring: Each domain scored 0–100 (higher = better health status)�Physical Component Summary (PCS) & Mental Component Summary (MCS) scores�Advantages: Widely used, sensitive to change, good for comparisons�Limitations: May miss age-specific or culturally specific aspects of QoL

References�The WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28(3), 551–558.��Lawton, M. P. (1991). A multidimensional view of quality of life in frail elders. In J. E. Birren, J. E. Lubben, J. C. Rowe, & D. E. Deutchman (Eds.), The concept and measurement of quality of life in the frail elderly (pp. 3–27). Academic Press.

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