Wednesday, May 16, 2012

Quality of Life Index Research Paper

Overview of Ferran's and Power's Quality of Life Index

Reliability and Validity
Over the past decades, the concept of quality of life has begun to play a significant role in many academic fields. This tool has been used to evaluate the “quality and outcome of health care” (Moons, Budts, De Geest, 2006, p. 892). However, despite this popularity one perfect measurement method has not been discovered (Moons, Budts, De Geest, 2006, p.891). This paper will deal with Quality of Life Index tool.

The content validity of Quality of Life Index method is supported because its items are both taken from the academic literature and the first person reports on quality of life. These two sides contribute greatly to the method’s validity. The construct validity is supported by strong correlation between the results obtained by this method and by other methods used in the field, as well as by factor analysis. The face validity of this tool, meaning, whether the instrument is measuring the appropriate construct, is strong (chapter 14, p. 377). The above can be concluded by any individual completing the instrument, who sees that the asked questions do require answers that help come to valid result.

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Quantitative researches view three aspects of reliability: stability, internal consistency, and equivalence (chapter 14, p. 374). The discussed tool showed strong stability when measuring the same way each time, under the same conditions with the same subjects, showing strong reliability. Internal consistency is showed in measurement of the same trait by the tool that also is strong in case of QLI. Finally, equivalence of this tool that concerns “the degree, to which, two or more independent observers or codes agrees about the scoring on an instrument” (chapter 14, p. 375) is reliable, considering the results received so far.

Questionnaire Result and Analysis
Completing QLI Questionnaire was a rather interesting experience. Over the last couple of years many questionnaires of this kind have been published. What is peculiar about the given questionnaire is that even though similar questions are asked over and over again, they are formed in a slightly different way. This makes the recipient take time to come up with the most suitable answer and evaluate the question and its meaning.

The results of the questionnaire showed that I have a high level of life satisfaction. Such result is natural because this tool is usually used to measure quality of life of patients with serious illnesses. As I am a healthy and young individual, naturally the outcome in all three areas targeted in the index (symptom control, physical well-being, psychological well-being) came out to have high satisfaction scores.

The questionnaire showed that the most important things for me are the well-being of my family, my relationships with friends/spouses, and my ability to control my life financially and physically. I believe the above result to be valid because in fact these are the main factors that are of importance to me in life.

I believe the tool to be very useful in measuring the life satisfaction, though I consider that the tool helps obtain valid results mostly for those people who are suffering from a disease. In my opinion, unhealthy people tend to take such questionnaires more seriously because they might help them increase life satisfaction and get the appropriate treatment. On the contrary, a healthy person would be less eager to obtain the reliable result, thus would put less effort into providing honest and thorough answers.

Article critique
The article that I intend to review is called Quality of Life, Chronic Pain, and Issues for Healthcare Professional in Rural Communities was written by Anita C. All, Juliet H. Fried, and Debra C. Wallace. The article can be found in Online Journal of Rural Nursing and Health Care.

The authors state that over the last years much attention had been paid to the concept of chronic pain. This phenomenon can be looked at from the psychological as well as physical sides. Sometimes, the reasons as well as treatment options cannot be fully comprehended. However, it is vital and relevant to know if there are differences in the perception of levels of quality of life by individuals who had received an intervention for chronic pain and who had not. The fact that such differences do exist can be seen as one of the main theses of the article.

All, Fried and Wallace (2000) agree with many other professionals that chronic pain affects the life of an individual suffering from it in many ways. It is very hard to define whether pain treatment has been successful or not. This is due to the fact that this effectiveness and success can be defined and evaluated differently by the professionals providing treatment and by those receiving it. As a consequence, no measure of efficiency is valid (All, Fried, Wallace, 2000, p.20). However, what can be measured is the perception of individuals who had received treatment for chronic pain and those who not comparing their quality of life test results.

To support their arguments the authors carried out a pilot study that was intended to measure the perception of life of people suffering from chronic pain. For the sake of the study it has been assumed that people, suffering from chronic pain, are not heterogeneous and perceive their lives and treatment differently in urban and rural areas.

The study's sample consisted of two groups of individuals residing in the Southeastern area of the United States: one group of individuals had received treatment for chronic pain, and second group had not received treatment. The individuals in both groups were diagnosed with various cases of chronic pain. Quality of Life Index was used as a measurement tool for the give research, the data was analyzed using an independent t-Test.

The results of the research showed that some pain coping strategies do not always have direct short-term impact on perceived improvement in chronic pain, thus further measurement need to follow up the treatment and life quality perception correlation (All, Fried, Wallace, 2000, p. 26).

I believe that the hypotheses the authors used for their research and pilot study in particular is not logical, consequently it did not lead to building of a logical argument. Initially, I believe that it comes without saying that people who show higher life quality test scores tend to be healthy, happy, and generally more satisfied with their life. On the other hand, people who report a lower life quality tend to be unhealthy, unhappy, and unsatisfied with their life. Thus, both those that are and are not getting treatment and are presupposed to have lower QOL index because they are not healthy (Putzke, Richards, Dowler, 2000, p. 388). In my opinion, it would have been more vital to compare the quality of life perception of people not suffering from chronic pain and those that are, and are getting treatment for it.

In my opinion, the article is also not built in a clear and concise way. The authors tend to jump back and forth between their hypothesis and assumed research outcomes. Also, reading this article, one gets a feeling that the authors rely too much on the previous research in the field that strikes the reader negatively. However, given the philosophical and methodological difficulties that are associated with the measurement of a quality of life, the article should be assigned some academic relevance.

Taken into consideration all of the above, I can still say that the discussed article does open floor for further research in form of qualitative methodology and mixed methods. On top of that it provides some tips for nurses in rural communities as to the connection between chronic pain treatment and overall life satisfaction. I feel that the article by All, Fried and Wallace cannot be used as basis for any conclusion (the authors themselves point the latter out), however, it can have practical importance when combined with further research. In that case, the article might be helpful in determining how rehabilitation professionals can act on the findings of their QOL assessments.
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