Establishing a theoretical basis for quality of life measurement
Spence, NJ 2010, Establishing a theoretical basis for quality of life measurement , PhD thesis, Salford : University of Salford.
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A literature review established a definition of Quality of Life (QoL) using thematic analysis of the papers retrieved. The QoL definition included subjective and objective elements and multiple domains and acknowledged the gap between present and ideal QoL. A literature search and reflective account were combined to establish theories relevant to QoL, which were reviewed. A composite theory of QoL was proposed, which included the International Classification of Functioning, Disability and Health (ICF), needs, health, coping and a theory of eliciting responses. Whether existing QoL instruments reflect the QoL definition or the composite theory was unclear. Therefore, a systematic review was undertaken in 2007 of existing QoL instruments to identify whether any of the sixty-nine texts met the clinical needs of the Multidisciplinary team (MDT) in stroke rehabilitation. Findings indicated that instruments were either psychometrically sound or individual. The review identified a limited theoretical background to QoL instruments, necessitating a theoretical review. The systematic review was repeated to ensure currency, identifying four new instruments. Instruments were screened against inclusion and exclusion criteria for a theoretical review. A theoretical review critical appraisal tool was developed using inductive methodology and was pilot tested. This developed a unique theoretical critical appraisal tool that has the potential to be transferable to other instruments. Seven instruments met the inclusion criteria and were subjected to a detailed theoretical review. Recommendations were made to inform future instrument development. Theoretical recommendations were combined with user requirements using thematic analysis. Stroke patients', their carers' and health care professionals' requirements of QoL instruments were established and triangulated with the QoL definition, composite theory and QoL instruments. This stage validated the definition and theory of QoL. The research concluded with recommendations for future instrument development, informed by user opinion, establishing a framework for future QoL developments. Conclusion The redefined QoL producing a new evidence based QoL definition reflecting changes in QoL thinking. The PhD produced a new theory of QoL based upon clinical experience and evidence incorporating needs, coping and social theories with the International Classification of Functioning (ICF). The QoL theory is unique and adds to QoL knowledge. The definition and theory of QoL were tested with stroke and subsequently revised incorporating omissions from preceding theories. The PhD identified a framework for future QoL instrument development. The PhD developed a new critical appraisal tool to evaluate instruments theoretical underpinnings. The critical appraisal tool was piloted and revised with QoL.
|Item Type:||Thesis (PhD)|
|Schools:||Colleges and Schools > College of Health & Social Care|
Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
|Depositing User:||Institutional Repository|
|Date Deposited:||03 Oct 2012 14:34|
|Last Modified:||03 Jan 2015 23:28|
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