Health Related Quality of Life Essay

Health Related Quality of Life Essay

The purpose of this paper is to explore the concept of health related quality of life (HRQoL) by studying a client situation in my clinical practice. My client’s name and hospital location will be kept confidential. I will be describing my client situation, discussing my rationale for choosing the concept and interpreting what quality of life means to my client. I will also identify specific nursing interventions that may facilitate adaption to their experience, and how this learning experience will positively influence my future nursing practice. Description of the Client Situation

In week two of my clinical practice, I received a 56-year-old male client who had undergone a total left knee replacement surgery due to osteoarthritis – a “slowly progressive noninflammatory disorder of the diarthrodial (synovial) joints. Health Related Quality of Life Essay. ” (Roberts, 2010) The total knee replacement required inserting a prosthetic joint in replacement. Hockey may have been the cause of his secondary osteoarthritis because strenuous exercise that involves quick stops, pivoting and repetitive physical activities overuses the knees, causes cartilage deterioration and has been associated with higher risks of knee osteoarthritis (Roberts, 2010).

My client stated that he was bothered by osteoarthritis and it affected his daily life activities, social life and work. Rationale for the Choice of the Concept HRQoL is the overall satisfaction that people have with their health. My client had pain and frustration for not being able to move around before surgery. He stated this has caused great inconvenience for social engagements and family relationships and he held low self-esteem and was not very happy. I chose to study this patient to learn more about the impacts of his illness on his quality of life.


I hope it can offer some insights on the concept of HRQoL on osteoarthritic patients. According to an article from Solomon et al, “Measurement of HRQoL is based on an assessment of physical and mental health, including such factors as physical and emotional function, symptoms, and disease processes” (2010, p. 837). In my case, I used observation, interview and examination methods for assessment and evaluation. Health Related Quality of Life Essay. Understanding and Interpretation of the Client’s Illness Experience Gill and Feinstein stated within Ibrahim et al that the best method of determining a client’s perception regarding QOL is to directly ask them to rate it. 2002) I asked him a global quality of life question: “How would you rate your overall quality of life prior to your surgery? ” He rated it as fairly poor because he was not able to enjoy quality time with his family or take time to enjoy himself and play sports. I also asked him to evaluate the extent of his osteoarthritic disability affecting his daily life with a scale from 1 to 14, with 1 being not affected at all and 14 being severely disabling. He answered 9 out of 14 due to pain and inability to maximize his joint movements.

This is consistent with the literature because “osteoarthrosis of the knee results in pain, loss of function and a reduced quality of life. ” (Hawker et al, 1998, p. 164) However, Rat et al has found that there is a greater improvement after knee replacement procedure in clients with poor baseline pain or physical function. (2010) which gives great hope for recovery. When asked about his instrumental support, “Could you use more help than you receive? ” He said: “ I have adequate finances and my wife and [adult] daughters are very helpful. When asked “Do you have many close friends and relatives you see often? ” He said that he had many loving family members and supportive friends and is very grateful. Ethogen et al reported that greater social companionship was related to better “physical function, mental health, role emotional, social functioning and vitality” in his study of clients with knee osteoarthritis. (2004, p. 321) I asked my client whether he had any other health problems. He replied that he only had mild asthma, which is stable.

Having no major co-morbidities increases his quality of life because “co-morbidities… and the presence of a painful location other than the [left knee] location contributed to low QOL” (Rat et al. 2010, p. 58). When asked about his psychological wellbeing, he told me that he had depression from being away from his job because he could not stand for long periods of time at his ‘machinery and manufacturing’ job. This is consistent with literature as Solomon et al noted that “greater ADL (activities of daily living) disability and depressed mood were associated with poorer QoL” (2010, p. 841).

My client and I both concluded that although he has good social support and finances, his pain, limited mobility, losing his job and further compounded by depression has all affected his quality of life negatively before his surgery. Factors Related to the Identified Concept Attributes of improved quality of life following a knee replacement surgery are “improvements in joint mechanics (such as range of motion and stability)” (Hawker et al, 1998, p. 164), pain relief and improvement in performing activities of daily living. Personal satisfaction and good self-rated health are also antecedents to good quality of health (Solomon et al, 2010). Health Related Quality of Life Essay.

Also receiving discharge teaching such as having an exercise plan and how to minimize or effectively treat post-operative pain will reduce post-op complication anxiety, reduce length of stay and improve client satisfaction. (Wellisch et al, 2012). In addition, my client was very satisfied with the surgery outcome and said “I’m actually very surprised at how smoothly it went. ” He feels that he can now function without being bothered with pain. He listened attentively to his doctors’ and physiotherapist’s advice and says he will follow their instructions.

Analysis of the Client Situation There are a number of nursing interventions which facilitate patients’ adaptation to their knee replacement surgery; and increase their quality of life. These are physiotherapy, pharmacological pain management, and effective post-operative teachings. Assisting the client with his physiotherapy enables him to increase his range of motion to perform activities of daily living (Hewitt & Shakespeare, 2001) and providing effective pharmacological pain management will further increase his personal satisfaction (Wellisch et al, 2012).

Additional interventions include providing non-pharmacological pain management such as guided imagery and music therapy reduce adverse reactions to medications, improve emotional well-being, physical health and social functioning (Roth & Susan, 2004). Another intervention is to provide emotional support. He has a supportive family, but felt that he was always on the receiving end, but he can be supported to gained back confidence so that he can also be the source of contribution to others.

Also, teaching about maintaining family ties, developing social relationships, participating in the community and exercising to maximize personal growth and satisfaction will also increase his quality of life (Felce & Perry, 1995). Discussion Through analyzing my client’s clinical experience and reviewing some of the related literature, I have gained more knowledge required to skillfully assess a client’s quality of life. It will definitely help me to effectively observe my clients, ask related questions, understand and interpret the illness experience and identify factors that contribute to quality of life.

I will be able to look for any antecedents to poor quality or good quality of life that a client may have. I will have a deeper appreciation for the multidimensional factors that influence my client’s quality of life including “physical health, personal circumstances (wealth, living conditions, etc. ), social relationships, functional activities and pursuits, and wider societal and economic influences” (Felce & Perry, 1995, p. 54). I also want to provide holistic nursing interventions to increase quality of life that include physical, emotional, physiological and spiritual support.

Conclusion In summary, my client had low quality of life satisfaction prior to his knee replacement surgery due to pain and decreased mobility. This interfered with his quality family time, his enjoyment of social engagements, and loss of his work role which lead to depression from social isolation. After his surgery, his self-rated health and personal satisfaction was greatly improved. Nursing interventions include providing holistic care, post-operative teaching on pain management and exercises to increase range of motion.

From researching quality of life, I learned that the most effective way of assessing one’s quality of life is for them to self-rate it.Health Related Quality of Life Essay.  I also learned more about the attributes of good quality of life which include good physical health, sufficient instrumental support, strong family and friend relationships and many other multidimensional factors. I will take this information with me for my future nursing practices as quality of life is an effective indicator of personal satisfaction and self-esteem that can be measured in everyone.

Background and Significance Health-related quality of life (HRQOL) has been endorsed as a crucial indicator of health outcomes of individuals in different age groups, both in the USA and Thailand (Health & Service, 2010; Ministry of Public Health, 2016). Adolescence is a time of significant and potentially stressful development during which constructing self-identity, continuing to develop autonomy, and exploring intimacy occurs (Steinberg, 2014). Experiencing and dealing with cancer during adolescence has been shown to have a major impact on normal development (Castellano-Tejedor et al., 2015; Shosha, 2016; Treenai et al., 2015). Evidence shows that adolescents with cancer reported lower HRQOL than their younger and older counterparts (Smith et al., 2013; Stokke et al., 2015), and low HRQOL was associated with treatment non-adherence (Rosenzweig & Liang, 2016; Song et al., 2015). Studies in mixed-age groups of adolescents and other age groups with cancer showed that HRQOL could be predicted by age, gender, cancer type, treatment, time since diagnosis, spiritual well-being, and depression (Bai et al., 2015; Punthmatharith et al., 2014; Perez-Campdepadros et al., 2015). However, research that exclusively includes adolescents with cancer does not exist, thus hindering a clear understanding about HRQOL in the target population whose growth and development could be jeopardized if not appropriately nurtured. Additionally, a model demonstrating predictors of HRQOL using

Topic Name: Health-Related Quality of Life & Well-Being

Health-related quality of life (HRQOL) is a multi-dimensional idea which has domains regarding physical, emotional, mental, and personal performance. Its likeliest past immediate methods of causes, life expectancy, and population health of death, and also concentrates on the effect health condition has on quality of life. Retrieved from

I think about that prior to starting to break down the various topics of the project it’s essential to begin with the 2 fundamental concepts:Health Related Quality of Life Essay.

Quality of life

Quality of life (QOL) is an extensive multidimensional idea which often features very subjective evaluations of equally negative and positive factors of life.2 What causes it to be difficult to evaluate is the fact that, though the word “quality of life” has meaning for almost everyone and every academic discipline, groups and individuals are able to determine it differently. Although health is among the key domains of general quality of life, you will find other domains also – for instance, schools, housing, jobs, the neighborhood. Elements of culture, values, and humility are crucial domains of general quality of life which contribute to the intricacy of the measurement of its. Nevertheless, scientists have created helpful methods which have helped to conceptualize as well as determine these many domains and the way they connect with one another. Retrieved from

Health-related quality of life

The idea of health-related quality of life (HRQOL) as well as its determinants have developed since the 1980s to cover those elements of general quality of life which may be certainly proven to influence health possibly mental or physical. On the unique level, HRQOL incorporates mental and physical health perceptions (e.g., energy level, mood) and also their correlates – along with conditions and health risks, social support, functional status, and socioeconomic status.

On the neighborhood level, HRQOL incorporates community level online resources, policies, conditions, and methods which influence a population ‘s functional status and health perceptions.

According to a synthesis of the medical literature as well as guidance from the public health partners of its, CDC has defined HRQOL as “an individual’s or maybe group ‘s perceived mental and physical wellness after a while. Retrieved from



The very first overarching goal for the Healthy People 2010 decade was increasing years and quality of good living.  Health Related Quality of Life Essay.Methods of healthy life and life expectancy expectancy (HLE) were utilized to report on this particular objective for many populations, which depended on self-reported details regarding wellbeing, which includes worldwide health status, prevalence of some chronic illnesses, plus exercise limitations. For Healthy People 2020, quality of life is essential to every one of the four overarching objectives. Retrieved from

Four Goals

  1. Attain high quality, longer lives totally free of disease that is preventable, injury, disability, along with early death.
  2. Achieve health equity, eliminate disparities, and also enhance saving all organizations.
  3. Create physical and social environments which promote health that is good for all.
  4. Promote quality of daily life, healthy development, and good actions throughout all life phases.

Healthy People 2020 highlights the benefits of health-related quality of well-being and life by along with it as among the initiative ‘s four overarching objectives, “promoting quality of daily life, healthy development, along with health behaviors throughout all life stages.” Additionally, it was started as among the HP 2020 four foundation health methods. Retrieved from


The significance of quality of well-being and life as a public health problem isn’t brand new. Since 1949, the world Health Organization (Who) has mentioned that health is “a state of complete actual physical, psychological, and cultural wellbeing without simply an absence of infirmity.” and disease .In 2005, Who recognized the benefits of analyzing as well as enhancing people’s quality of life in a place paper. Because individuals are able to longer than in the past, scientists have transformed the manner they analyze wellness, looking past causes of morbidity and death to look at the connection of wellness on the quality of a private lifestyle. When quality of life is within the context of disease and health, it is known as health-related quality of life (HRQOL). Health Related Quality of Life Essay. Researchers nowadays concur HRQOL is multidimensional and also has domains which are associated with physical, emotional, mental, and social functioning and also the interpersonal context where individuals live. Retrieved from

Healthy People 2020 is approaching the measurement of health-related quality of well-being and life originating from a multidisciplinary viewpoint which entails three complementary as well as associated domains:

1 – Mental health and self-rated physical

2 – Overall well-being

3 – Participation in society


Self-Rated Physical and Mental Health

HRQOL is a multidimensional and subjective concept that includes aspects of physical, mental, and personal health. For Healthy People 2020, the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Items have been identified as valid and reliable measures of mental health and self-reported physical and are now being considered to monitor these two domains across the decade. PROMIS is an NIH Roadmap initiative designed to create an electronic system to collect self-reported HRQOL data from diverse populations of people with an assortment of demographic characteristics and chronic diseases. Currently HHS monitors HRQOL in the United States by administering selected Other HRQOL items and promise on the Behavioral Risk Factors Surveillance System (BRFSS), the National Nutrition and Health Examination Survey (NHANES), and the National Health Interview Survey (NHIS). Retrieved from


The PROMIS product banks include much more than 1,000 self-report questions covering numerous HRQOL domains which have undergone thorough qualitative and quantitative analysis by both experts and patients, fifteen  item global HRQOL scale was created to evaluate selected physical as well as mental health symptoms, which includes functioning and common health perceptions.12 The products had been derived from HRQOL item banks which offer much more accurate indicators of domain specific HRQOL. All products had been evaluated in diverse and large samples. Specific items include fatigue, emotional distress, pain, along with social activities.


Overall well-being

Individuals with increased levels of well-being judge the life of theirs as going very well. Most people feel very healthful and full of power to take on the daily activities of theirs. Health Related Quality of Life Essay. People are engaged, interested, and satisfied with the lives of theirs. Individuals have a feeling of accomplishment from the activities of theirs and judge the lives of theirs to become significant. Individuals are much more frequently content or perhaps cheerful than depressed or even anxious. Individuals get together with the others and experience great interpersonal interactions. Personal factors, social conditions, and community locations influence well-being.

Well-being thinks the physical, psychological, and social facets of a person’s life.

Physical wellbeing: Relates to vitality and vigor, feeling really healthful and filled with energy.

Psychological well-being; Includes being satisfied with one is life; balancing negative and positive emotions; accepting one is self; finding objective and meaning in one is life; looking for personal development, autonomy, and then competence; thinking one is life & amp; situations are under one ‘s management and generally experiencing optimism.

Social wellbeing: Involves providing and also receiving quality assistance from loved ones, friends, and even others.

Participation in society

Social participation could be evaluated through a determination on the degree to which individuals experience barriers to complete participation due to the current health state of theirs and also the planet. Participation in society consists of education, employment, along with civic, community, and leisure activities, in addition to family role participation. Participation is calculated in the context of a person’s existing health state and within the individual’s present social and physical environments, thus capturing a far more objective construct on the HRQOL concept.


In 2010 had a rise the proportion of adults that self-report better or good health. Between the 78.8 as well as 79.1 % of adults self-reported good or better brain health within 2010 (age modified to the year 2000 regular population). National Health Interview Survey (NHIS), CDC/NCHS was utilized as information resources. Retrieved from

Evidence-based information and recommendations related to Health-Related Quality of Life & Well-Being. Health Related Quality of Life Essay.

Well-Being and life.

I would like to expose one example which shows the value of the Health-Related Quality of Live as well as Well Being.

Yoga for Improving Health Related Quality of Life, Mental Cancer-Related and Health Symptoms in women Identified as having Breast Cancer. Two review authors independently collected information on results and methods. They expressed results as standardized mean variations (SMDs) with ninety-five % self-confidence intervals (CIs) and also conducted random effects model meta-analyses. They assessed potential danger of publication bias through visible evaluation of funnel heterogeneity and plot symmetry between studies by utilizing the Chi2 test and also the I2 statistic. They conducted subgroup analyses for existing treatment status, time after diagnosis, stage of type and cancer of yoga intervention. Breast cancer is probably the most common cancer among females worldwide. This systematic review sought to evaluate whether yoga is able to improve quality of life, mental health, as well as symptoms regarding cancer in females having an examination of breast cancer. It identified twenty-four research and also discovered that yoga was better compared to no treatment in enhancing quality of life and decreasing exhaustion and sleep disturbances. Additionally, it discovered that yoga was much better for lowering fatigue, anxiety, and depression in females when compared with educational or psychosocial interventions like counseling. These results suggest that females having an examination of breast cancers is able to use yoga as supportive treatment for raising the quality of theirs of mental health and life, additionally to regular cancer treatments. (Cramer, et al., 2017)

The authors concluded that moderate quality evidence supports the recommendation of yoga as a supporting treatment for improving health-related quality of life and also decreasing exhaustion and sleep disturbances when as opposed with no treatment, and also for reducing depression, fatigue and anxiety, when compared with psychosocial/educational interventions. Very low-quality research indicates that yoga may be as helpful as some other exercise interventions and may be used as a substitute to other workout programmers. (Cramer, et al., 2017)

HRQL importance in Clinical Practice

The increasing value of HRQL estimation is realized by clinicians, medical policymakers, drug regulatory companies as well as pharmaceutical companies all over the world in choosing optimum treatment option for individuals, policy framing, new medication approval and choosing pharmaceutical advertising policies. Health Related Quality of Life Essay. Physicians are rising utilizing HRQOL to determine the consequences of chronic illness within their people to know how an illness disrupts an individual’s everyday life. (Ghosh, 2010)

HRQL analysis is employed by public health expert to recognize subgroups with bad physical or maybe mental health for far better equitable distribution of healthcare information. Drug regulatory agencies worldwide providing much more focus on quality of life information from medical trials in order provide faster endorsement to a brand-new drug. Pharmaceutical companies also assert superiority of the product of theirs and judge marketing cost primarily based on quality of living information produced from trials. (Ghosh, 2010)



Based on the above mentioned exposed, the health-related quality of life and wellbeing has great value in the lives of ours. It’s great influence on our social, physical, and personal advancement. Health is much more than the lack of disease; it’s a source that enables individuals to realize the aspirations of theirs, satisfy the needs of theirs and also to deal with the planet to live a long, effective, and productive life. In this specific sense, health makes it possible for personal, economic, and social development fundamental to wellbeing. Retrieved from


  • Cramer, H., Lauche, R., Klose, P., Lange, S., Langhorst, J., & Dobos, G. J. (2017). Yoga for improving health‐related quality of life, mental health and cancer‐related symptoms in women diagnosed with breast cancer. Cochrane Library, n.p.
  • Ghosh, R. K. (2010). Health-related quality of life and its growing importance in clinical practice. The New Zeland Medical Journal, n.p.
  • Health People 2020 (2018). Health-Related Quality of Life & Well-Being. Office of Disease Prevention and Health Promotion, n.p.
  • Health-Related Quality of Life (HRQOL) (October 2018).Centers for Disease Control and Prevention. Retrieved from

Health Related Quality of Life Essay