The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that (...) satisfying one's preferences, or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject (...) him- or herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)

Quality improvement mechanisms increasingly use outcome measures to evaluate health care providers. This move toward outcome measures is a radical departure from the traditional focus on process measures. More radical still is the proposal to shift from relatively simple and proximal measures of outcome, such as mortality, to complex outcomes, such as quality of life. While the practical, scientific, and ethical issues associated with the use of outcomes such as mortality and morbidity to compare health care providers (...) have been well rehearsed, the specific concerns associated with the use of quality of life measures in quality of care research have received little attention. As with much research on quality of life there is a tendency to assume that the disadvantages are outweighed by the general virtue of “listening” to patients. In this paper we disagree with this assumption and argue that quality of life is a process, not an outcome. (shrink)

The Quality of Life: Aristotle Revised, by KrautRichard. Oxford: Oxford University Press, 2018. Pp. x + 249.

Richard Kraut presents a new theory of human well-being. Kraut's principal idea, Aristotelian in spirit, is that 'external goods' have at most an indirect bearing on the quality of our lives. A good internal life - one with quality emotional, intellectual, social, and perceptual experiences - is what well-being consists in.

Under the Second Demographic Transition, alternative forms of living arrangement are on the rise. The aim of this article is to compare quality of life in children living in married and cohabiting families. We present the results of representative research conducted in Slovakia in 2018 (N = 1,010 respondents). We tested whether children brought up in traditional married families had better material resources and healthcare, fewer behavioural problems, better peer relations and spent more leisure time with their parents (...) than children brought up by cohabiting parents. We also investigated whether number of children in the family and net monthly household income affected the children’s quality of life. The results show that there were almost no differences in quality of life between children brought up by married and by cohabiting parents and that number of children in the family and level of net monthly household income affected only the child’s material resources. (shrink)

Due to advances in medicine, a malignant neoplasm is a chronic disease that can be treated for a lot of patients for many years. It may lead to profound changes in everyday life and may induce fear of life. The ability to adjust to a new situation may depend on temperamental traits and stress coping strategies. The research presented in this paper explores the relationships between quality of life, PTSD symptoms, temperamental traits, and stress coping in (...) a sample of patients diagnosed with cancer. One hundred and twenty nine participants aged 24–81 years, 69 females diagnosed with breast cancer and 60 males diagnosed with lung cancer completed Formal Characteristics of Behavior – Temperament Inventory, Coping Inventory for Stressful Situations, PTSD Inventory, and Quality of life SF-36 questionnaire. Higher level of emotional reactivity and higher level of perseveration was associated with lower emotional quality of life. Higher level of emotion oriented-coping and higher level of avoidant-distracted coping was associated with higher level of PTSD symptoms. Emotion-oriented coping and avoidant-distracted coping are ineffective in dealing with stress in the case of patients diagnosed with cancer, because they are associated with a higher level of PTSD symptoms. The significance of temperamental traits for quality of life in the situation of the patients is marginal. Control of specific factors concerned with current health and treatment status is needed the future research. (shrink)

Medical decision making relies heavily on the notion of the quality of a person's life in providing a reason to utilize one therapy over another or to withhold certain therapies altogether. The concept of quality of life, however, lacks clear definition as well as consensus on its constitutive elements. ;Chapter one engages a basic controversy in the literature: whether 'quality of life' should be understood as a subjective concept, or whether objective "lists" can help (...) us assess a person's quality of life. Chapter two examines whether anthropological data might provide guidance. While it is often argued that anthropological data supports relativism, John Finnis argues that anthropological data supports universalism which, in turn, bolsters objectivist claims. I argue that anthropological data may plausibly be interpreted to support either subjective or objective accounts, and thus, does not settle our approach to quality of life. ;Chapter Three examines objective list theories, in particular those of Bernard Gert and John Finnis. I find Gert's account to be problematic because it seems incomplete. Finnis's criteria, too, seems ultimately indefensible. Thus, I conclude that while objectivist claims may offer insight into human values and motivations, existing accounts are flawed. Chapter Four examines subjective accounts of quality of life. I focus on "preference satisfaction" accounts. While these accounts provide intuitively plausible descriptions, they fall victim to a host of difficulties. Perhaps the best example of this is the "fleeting preferences" problem, which undermines our confidence in making life-and-death decisions on the basis of quality of life considerations. ;The concluding chapter offers that much progress can be made by understanding quality of life in terms of finding meaning in life. Thus, the quality of one's life is determined by how much purpose and meaning is found in that life. While this notion is not without its problems, it does capture the complex elements of the kinds of cases in which we are particularly interested, and combines some of the best features of both the objective and subjective accounts. (shrink)

In recent years, there has been a growing emphasis on researching quality of life,particularly within families that include members with disabilities. Family Quality ofLife (FQOL) has gained prominence in special education as researchers seek to understandand improve the well-being of these families. This study aims to present findingson the quality of life of parents raising children with disabilities.Using a quantitative research approach and the validated BCFQOL tool, wesurveyed 205 parents. The results were unexpectedly positive, showing (...) generally higherlevels of quality of life among participants. However, challenges were identified in specificdimensions such as “Emotional well-being,” and “Material well-being”. (shrink)

Substitute decision-makers for severely disabled neonates who can be kept alive but who will require constant medical interventions and will die at the latest in their teens are faced with a difficult decision when trying to decide whether to keep the infant alive. By and large, the primary focus of their decision-making centers on what is in the best interests of the newborn. The best-interests criterion, in turn, is importantly conditioned by quality-of-life considerations. However, the concept of (...) class='Hi'>quality of life is logically and ethically different for patients with a developing as opposed to a developed awareness. Unfortunately, this difference is ignored by current quality-of-life considerations, there are no quality-of-life measures that take this difference into account, and decision-making proceeds entirely without acknowledging this fact. This note outlines why this is a problem and why there is a need for a new set of tools that incorporates this distinction if the substitute decision-makers are to apply the best-interest criterion in a meaningful way. (shrink)

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, through (...) interviews using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’st-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n= 65.8; 95%CI, 63.5–68.1vs. n= 73.9; 95%CI, 67.5–80.3;p= 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n= 10.9; 95%CI, 9.6–12.2vs. n= 5.1; 95%CI, 2.5–7.7;p= 0.01). A weak negative correlation (r= 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile. (shrink)

Only in recent years have the German bioethical and biopolitical debates begun to decline due to rationalization concerning stem cell research or the pre-implantation diagnosis related to the ethical status of the beginning of human life. This is due to the fact that in these contexts we have to ask whether quality of life assessment is ethically acceptable in principle. A fundamental premise in the current debate is that quality of life assessment and human dignity (...) are incompatible. In this paper four different standards of quality of life assessment are distinguished (the naturalistic, the social, the interpersonal and the personal standard). Then an interpretation of human dignity is developed which rests on the essential feature of human beings to develop the capacity for personal autonomy. Finally it is argued that human dignity in this sense is compatible with quality of life assessments based on the personal and the interpersonal standard. (shrink)

into treatment decisions is viewed as pernicious by some who claim that these presuppose the Nazi position that those who are ‘devoid of value’ must be exterminated. ‘Quality of life’ judgments are said to deny the equal value of human beings and to assume that some lives are not ‘worthy to be lived’. It is argued that the analogy misconstrues the senses of ‘value’ and ‘quality’ employed by Naziism and a ‘quality of life’ position. This (...) leads the analogizers incorrectly to claim that both views assimilate the value of human beings to the value of their condition. A ‘quality of life’ position is grounded in recognition of the logical priority of the value of human beings as self-reflective evaluators and agents, which is a matter of kind, not degree. The ‘quality of life’ is explicated in terms of the standards of well-being of individuals, which are derived from their basic human needs and their individual priorities and goals. The use of ‘quality of life’ judgments is morally required to ensure that considerations of justice and individual autonomy govern treatment decisions. The purported analogy misconstrues the views of both the Nazi position and a ‘quality of life’ position and so is seriously misdirected. CiteULike Connotea Del.icio.us What's this? (shrink)

The use of quality of life (QOL) outcomes in clinical trials is increasing as a number of practical, ethical, methodological, and regulatory reasons for their use have become apparent. It is important, then, that QOL measurements and differences between QOL scores be readily interpretable. We study interpretation in two contexts: when determining QOL and when basing decisions on QOL differences. We consider both clinical situations involving individual patients and research contexts, e.g., randomized clinical trials, involving groups of patients. (...) We note the ethical importance of such understanding: proper interpretation and communication facilitate health care decision making. Communication that facilitates interpretation is of moral significance since better communication can attenuate ethical problems and inform choices. Much of what is communication worthy about QOL assessments is determined by the particular QOL instrument used in the assessment and how it is administered. In practice, these choices will be driven by the purpose of the assessment, but, it is argued, to maximize understanding, we should combine the information garnered from traditional standardized QOL instruments, from individualized QOL assessments, and from a recently proposed dialogic paradigm, where QOL is determined by shared conversation regarding the interpretation of texts. And, while some studies can surely succeed using abbreviated methods of administration (e.g., postal surveys may suffice for certain purposes), we will focus on methods of administration involving interviewer–respondent interaction. We suggest that during the QOL elicitation process, interviewer and respondent should engage in a two-way conversation in order to achieve a shared understanding of the “answers” to QOL “questions” and, finally, to reach a shared interpretation of the individual’s QOL. (shrink)

One of the fundamental aims of nursing is to safeguard or promote patients' "quality of life." Perspectives on Quality of Life examines existing ways of defining the concept and argues that nurses need to adopt a fresh approach, which more accurately reflects patients' concerns and helps them to develop practical ways of promoting the well-being of people in their care. Part One provides an analysis of statistical approaches to quality of life, including social indicators, (...) the Quality Adjusted Life Year (QALY), and the medical outcomes literature. Part Two proposes an alternative, qualitative approach to organizing care, which respects the patients' choice and individuality. Part three presents the findings of new research into the quality of life of older people in hospital wards. (shrink)

Persons with profound intellectual and multiple disabilities cannot speak about their Quality of Life, which makes it necessary to involve others. In current approaches, these ‘others’ are seen as assessors trying to describe QoL as objectively as possible, which involves a reduction of their experiences, through which they develop knowledge on the QoL of the person with PIMD. The objective of this paper is to give caregivers’ knowledge on the QoL of a person with PIMD a theoretical basis (...) that values these experiences. We will argue that caregivers should be seen as witnesses, not assessors, and their statements on QoL as testimonies, not assessments. Audiences judge the trustworthiness of these witnesses intersubjectively, which implies a relationship characterized by trust and suspicion. Trust supports the witness to tell in her own words about the QoL of the person with PIMD; it demands receptivity, indicating that both the witness and the audience are willing to reconsider their perspective on QoL. Suspicion is necessary too, which helps the witness to critically approach her own interpretations and supports her to create more trustworthy testimonies. We conclude that the concept of witnessing helps to acknowledge caregivers’ experiential knowledge of QoL of a person with PIMD, which may also apply to other persons who cannot speak about their own QoL. We hope that our study will empower caregivers to give testimonies on QoL of a person with PIMD, which is crucial when complex decisions about the life of this person have to be made. (shrink)

In recent years a number of commentators have discussed the importance of measuring quality of life in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to (...) choose what we should do from the broader universe of what we can do.The challenges to measuring QL are formidable. Researchers debate whether to measure general QL or disease-specific QL; whether to focus on functional status such as the patient's ability to walk and dress himself, or on the value people ascribe to that functional status; whether to seek the values of the general public, or to concentrate on people actually affected by a given disease or disability. (shrink)

Purpose: This article aims to highlight key indicators of residents' quality of life in a specific contemporary building in Kruja, Albania. -/- Design/Method/Approach: A questionnaire with 30 questions was prepared for the inhabitance, and the Binary or Tobit probabilistic models were taken into consideration as part of the methodology, to conclude. The study will further analyze the implications of the inhabitants and their behavior in a specific contemporary building in the city of Kruja. It was examined the statistical (...) significance of each variable (questions) in the models elaborated with EViews 8 software. The stable models that are associated with the “Log-likelihood” statistics were statistically significant at a significance level of p < 5%, or with 95% confidence, based on the model tests. -/- Findings: The study concluded that the most statistically significant quality of life indicators part of the questionnaire is related to the typology of the apartments, methods of cooling during summer, present living conditions, apartment improvement, apartment orientation, and time spent in the living room. Furthermore, the study reveals that most of the quality-of-life indicators (part of the questionnaire) are not statistically important, so they will not be considered part of the models created in the article. The study reveals that increasing the living space and improving orientation is crucial to enhance the satisfaction of apartment inhabitants. When apartment sizes increase and orientation is improved, residents are more likely to opt for fans over air conditioners to reduce electricity costs and avoid installing additional cooling facilities during summer. They believe that better living conditions require larger apartments, additional water supply, increased electrical costs, and more time spent in the living room. The inhabitants also emphasize the importance of reducing moisture levels, decreasing window opening frequency, and increasing time spent with family. Interestingly, a one-degree improvement in summer cooling methods (e.g., switching from air blowers to air conditioning) corresponds to a one-degree improvement in winter heating methods (e.g., switching from gas to electricity), leading to a heightened need for clean electric heating. Overall, the study emphasizes the importance of meeting the physical and spatial needs of the residents to enhance their overall satisfaction and quality of life. Urban policies significantly impact housing affordability, quality, transport systems, environmental sustainability, and social equity, affecting overall living standards and economic growth. Cities must create well-designed policies that consider residents' needs and study findings to ensure sustainable development and citizen welfare. -/- Theoretical Implications: Gujarati’s (Basic Economics) theory was developed in the article. -/- Practical Implications: This study will serve as an indicator to analyze the further improvements that might occur in the specific building (not just in the city of Kruja), considering the main quality of life indicators. -/- Originality/Value: The article will serve as a base for further analysis of resident’s behavior and their social impact in the community in order to be aware of their needs for further developments in the construction field. -/- Research Limitations/Future Research: The findings depend profoundly on the type of building the residents are living in. The research stream that can be inspired by the research is strongly related to mathematical regression models, statistics, and probability. -/- Paper Type: Empirical . (shrink)

The term "quality of life" has a long history in the bioethics literature. It is usually used in one of two contexts: in resource allocation discussions in the hope of arriving at an objective measure of the worth of an intervention; and in end-of-life discussions as a concept that can justify the forgoing of life-sustaining treatment. In both contexts, the term has valid uses as it is meant to measure the efficacy of a treatment. However, the (...) term has the unfortunate rhetorical problem that it often seems to be a judgment on the life of a human being. As such, it is highly inflammatory. We suggest that a return to a rhetoric that suggests a judgment on the treatment rather than the person is needed. (shrink)

The technological advances in medicine, including prolongation of life, have constituted several dilemmas at the end of life. In the context of the Belgian debates on end-of-life care, the views of Muslim women remain understudied. The aim of this article is fourfold. First, we seek to describe the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward withholding and withdrawing life-sustaining treatments. Second, we aim to identify whether differences are observable among middle-aged and elderly (...) women’s attitudes toward withholding and withdrawing life-sustaining treatments. Third, we aim to explore the role of religion in their attitudes. Fourth, we seek to document how our results are related to normative Islamic literature. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women living in Antwerp and with experts in the field. We found an unconditional belief in God’s sovereign power over the domain of life and death and in God’s almightiness. However, we also found a tolerant attitude, mainly among our middle-aged participants, toward withholding and withdrawing based on theological, eschatological, financial and quality of life arguments. Our study reveals that religious beliefs and worldviews have a great impact on the ethical attitudes toward end-of-life issues. We found divergent positions toward withholding and withdrawing life-sustaining treatments, reflecting the lines of reasoning found in normative Islamic literature. In our interviews, theological and eschatological notions emerged as well as financial and quality of life arguments. (shrink)

Objective: Quality of Life is an important predictor of patient's recovery and survival in lung cancer patients. The aim of the present study is to identify 1-year trends of lung cancer patients' QoL after robot-assisted or traditional lobectomy and investigate whether clinical and sociodemographic variables may predict these trends.Methods: An Italian sample of 176 lung cancer patients undergoing lobectomy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 at the pre-hospitalization, (...) 30 days, 4 months, 8 months, and 12 months after surgery. Sociodemographic and clinical characteristics were also collected. The individual change over time of the 15 dimensions of the EORTC QLQ-C30 and the effects of pre-surgery scores of QoL dimensions, type of surgery, perioperative complications, and age on patients' QoL after surgery were studied with the individual growth curve models.Results: Patients had a good recovery after lobectomy: functioning subscales improved over time, while most of the symptoms became less severe over the care process. Perioperative complications, type of surgery, pre-surgery status, and age significantly affected these trends, thus becoming predictors of patients' QoL.Conclusion: This study highlights different 1-year trends of lung cancer patients' QoL. The measurement of pre- and post-surgery QoL and its clinical and sociodemographic covariables would be necessary to better investigate patients' care process and implement personalized medicine in lung cancer hospital divisions. (shrink)

ObjectiveTo determine the factors associated with quality of life and depressive symptoms in Peruvian university students during the COVID-19 pandemic.MethodsMulticentre study in 1,634 students recruited by convenience sampling. The quality of life was assessed with the European Quality of Life-5 Dimensions at three levels and depressive symptoms with the Patient Health Questionnaire-9. To assess factors associated with QoL and depressive symptoms, linear regressions and fitted regressions were used, with robust coefficients of variance information.ResultsA 345 (...) reported problems in performing daily activities, 544 reported pain and discomfort, 772 were moderately/very anxious or depressed. Furthermore, 207 had moderate-severe and severe depressive symptoms. Men reported better QoL than women and fewer depressive symptoms. Ayacucho’s residents had more depressive symptoms than Ancash’s residents and Piura’s residents had fewer depressive symptoms than Ancash’s residents. Students who left home during quarantine reported more depressive symptoms.ConclusionProblems performing daily activities, pain and discomfort, as well as mild to severe depressive symptoms were found in more than three-quarters of the sample. Authorities could consider depression care to improve quality of life in regions where high rates of infection occurred during the pandemic. (shrink)

The odds of encountering a senior citizen selling on the street have increased. The claim that they have no choice but to work and sell on the street, despite the dangers, illnesses, and psychological issues they may face, to provide for their family’s needs is very evident. Therefore, this study explores the quality of life, lived experiences, challenges, and coping mechanisms of senior citizen street vendors in Bulacan, Philippines. The study employed Heideggerian Phenomenology and Interpretative Phenomenological Analysis (IPA). (...) Moreover, the following themes arise (1) Golden years, (2) Socially connected, and (3) Unknown journey. These themes highlighted the experiences and challenges faced by the participants. Moreover, it is highly suggested that local government agencies enhance and strictly monitor the existing program that alleviates mental and physical health concerns and senior citizens' safety and financial assistance. (shrink)

Work done within the realm of what is sometimes called ‘descriptive ethics’ brings two questions readily to mind: How can empirical findings, in general, inform normative debates? and How can these empirical findings, in particular, inform the normative debate at hand? Brick et al 1 confront these questions in their novel investigation of public views about lives worth living and the permissibility of withdrawing life-sustaining treatment from critically ill infants. Mindful of the is-ought gap, the authors suggest modestly that (...) their data ‘may be useful when constructing guidelines for clinical practice’. In this commentary, I consider some potential limitations on the generalisability of these data in the context of policy and clinical practice, limitations which may in turn serve as directions for future empirical research. The authors’ study presented participants six case scenarios, five of which involved the possibility of withdrawing life-sustaining treatment from critically ill infants. The results revealed that “[a]lmost all respondents agreed that at some level of quality of life, life may be of no benefit or worse than death for an infant” and that “participants significantly favoured withdrawal of treatment for the most severe cases.” One salient detail in these scenarios …. (shrink)

Ethics and Qualities of Life looks at what enters into ethical judgment and choice. Interpretation of a case and of what the options are is always a factor, as is a sense of the possible values at stake. Intuitions also enter in, but often are unreliable. For a long time it seemed only fair that oldest sons inherited, and struck few people as unfair that women were not allowed to attend universities. A moral judgment is putatively part of a (...) moral order in a society that any reasonable person would accept. But what counts as "reasonable" is generally contestable. The unreliability of intuitions leads naturally to ethical theory. Kantian, contractualist, and consequentialist theories all have some important truth in them, but not the whole truth. Contractualism lacks the resources required for a fully determinate account of what counts as "reasonable". Broad general rules are important to Kant and are at the center of everyday morality. But can Kantian ethics explain why they have to have this central role? Our evolving social contract now contains elements that once would have seemed counter-intuitive to most people. But could consequentialists have predicted with entire confidence the consequences of social changes that we now think were desirable? The last part of this book contains a double argument. One is that ethical theory is employed by humans in a state of semi-ignorance of relevant factors, grasping at likely truths and evolved intuitions. The other is that consequentialist considerations have a major role at the fundamental level, but much more in justification or criticism than in ethical discovery. (shrink)

Meaning in life has been widely recognized as a hallmark of psychological well-being and positive youth development. The goal of this study was to validate the Korean version of the Meaning in Life in Children Questionnaire utilizing the framework suggested by the Standards for Educational and Psychological Testing. Data were obtained from 277 fifth graders aged 10–11 in three elementary schools in Seoul and Gyeonggi through a paper-and-pencil survey. We translated the MIL-CQ, a 21-item self-report measure developed based (...) on Frankl’s “meaning triangle,” into Korean. Psychological well-being measures were also assessed. Validity and reliability data were collected. The content of domains and items was appropriate for measuring MIL among children. A three-factor model consisting of attitude, creativity, and experience pathways was extracted via exploratory factor analysis, and a three-factor hierarchical model including attitude, creativity, and experience as first-order factors and MIL as a second-order factor was confirmed via confirmatory factor analysis. Higher levels of MIL were related to higher levels of satisfaction with life, self-esteem, positive affectivity, and lower levels of negative affectivity. All item fit statistics were acceptable based on the Rasch model. The analysis of the measurement invariance of each item showed that the responses to one item varied by gender, suggesting that additional items might facilitate better measurement of MIL in children. This study provides validity and reliability evidence that K-MIL-CQ is appropriate for measuring MIL among South Korean elementary school students. (shrink)

This paper explores the relationship between disability and quality of life and some of its implications for bioethics and healthcare. It focuses on the neglected perfectionist approach that ties well-being to the flourishing of human nature, which provides the strongest support for the common view of disability as a harm. After critiquing the traditional Aristotelian version of perfectionism, which excludes the disabled from flourishing by prioritizing rationalistic goods, I defend a new version that prioritizes the social capacities of (...) human nature and the goods of personal relationship. This relationship-centered perfectionism is able to accommodate and explain disabled thriving. I also show how these issues have important implications for specific bioethical debates and clinical practices, using a cluster of issues related to Down syndrome as timely illustrations. My goal is to sketch a perfectionist theory that gives a more plausible account of the relationship between disability and well-being, and that provides better practical guidance in cases involving judgments about the quality of disabled lives. (shrink)

Objective The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test score were computed. To (...) assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006). Significance To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)

The aim of the article is to examine differences in the quality of life as well as gratitude, meaning in life and positive orientation to life between diocesan and religious seminarians and secular students. The influence of religiosity on quality of life and subjective well-being is the subject of numerous studies, but seminarians have rarely been included in them. The present research was carried out for the first time with a group of diocesan and (...) religious seminarians in Poland and secular students. The study involved 296 participants—98 diocesan seminarians, 96 religious seminarians and 102 secular students in the control group. Results showed significant differences in the quality of life. Religious and diocesan seminarians scored higher than the control group members in the psychophysical, personal, psychosocial and metaphysical spheres. In addition, in terms of gratitude, and the presence of meaning in life, religious and diocesan seminarians achieved higher scores than the control group but lower scores in searching for the meaning in life. There were no significant differences between diocesan and religious seminarians except that only diocesan seminarians obtained significantly higher scores on positive orientation to life than the control group. Overall, results support the idea that seminarians have higher quality of life and subjective well-being than secular students. Research implications are discussed. (shrink)

BackgroundIn the last 2 weeks of January 2021, Portugal was the worst country in the world in incidence of infections and deaths due to COVID-19. As a result, the pressure on the healthcare system increased exponentially, exceeding its capacities and leaving hospitals in near collapse. This scenario caused multiple constraints, particularly for hospital medical staff. Previous studies conducted at different moments during the pandemic reported that COVID-19 has had significant negative impacts on healthcare workers’ psychological health, including stress, anxiety, depression, (...) burnout, post-traumatic stress symptoms, and sleep disturbances. However, there are many uncertainties regarding the professional quality of life of hospital nurses and physicians. To address gaps in previous research on secondary traumatic stress, we focused on healthcare workers working in hospitals affected by a major traumatic event: the third wave of COVID-19.ObjectivesThe aim of the present study was to identify the contribution of personal and work-related contextual variables on professional quality of life of healthcare workers.MethodsCross-sectional study with a web-based questionnaire given to physicians and nurses working in a hospital setting. A total of 853 healthcare professionals participated in the survey assessing professional quality of life compassion satisfaction, secondary traumatic stress, and burnout. Factors of professional quality of life were assessed using regression analysis.ResultsMost of the participants showed moderate or high levels of compassion satisfaction, whereas the majority of them experienced moderate levels of burnout and secondary traumatic stress. The analyzed variables demonstrated no differences between professionals who were directly or not involved in the care of COVID-19 patients. Parental status was found to be a significant factor in compassion satisfaction. Female gender was significantly associated with more susceptibility to secondary traumatization. Factors that may potentially contribute to burnout include years of professional experience and the number of work hours per week.ConclusionThe COVID-19 pandemic has created a new challenge for the healthcare system. Burnout and secondary traumatic stress can lead to medical errors and impact standards of patient care, particularly compromising compassionate care. It is therefore recommended that hospitals develop psychoeducational initiatives to support professionals in dealing with barriers to compassion. (shrink)

Engagement with the historical and theoretical underpinnings of measuring quality of life (QoL) and patient‐reported outcomes (PROs) in healthcare is important. Ideas and values that shape such practices—and in the endgame, people's lives—might otherwise remain unexamined, be taken for granted or even essentialized. Our aim is to explicate and theoretically discuss the philosophical tenets underlying the practices of QoL assessment and PRO measurement in relation to the notion of person‐centredness. First, we engage with the late‐modern history of the (...) concept of QoL and the act of assessing and measuring it. Working with the historical method of genealogy, we describe the development of both QoL assessments and PRO measures (PROMs) within healthcare by accounting for the contextual conditions for their possibility. In this way, the historical and philosophical underpinnings of these measurement practices are highlighted. We move on to analyse theoretical and philosophical underpinnings regarding the use of PROMs and QoL assessments in clinical practice, as demonstrated in review studies thereof. Finally, we offer a critical analysis regarding the state of theory in the literature and conclude that, although improved person‐centredness is an implied driver of QoL assessments and PROMs in clinical practice, enhanced theoretical underpinning of the development of QoL assessments is called for. (shrink)

Sufism has two main dimensions: vertical (God’s pleasure) and horizontal (harmony with nature, society and local wisdom). In reality, many Sufis are considered less concerned about the balancing between vertical and horizontal dimensions. The research explores the concepts and practices of hybrid Sufism undertaken by Kyais (religious leaders) and their followers in improving quality of life. Ethnography was used for exploring the mindset and activities of Kyai and his followers. This study involved four Kyais in Java and Kalimantan, (...) Indonesia. Research data were obtained through participant observations, in-depth interviews and documentation. The data were analysed by Spadley’s ethnographic steps as follows: (1) domain analysis, (2) taxonomy analysis, (3) componential analysis and (4) cultural-thematic analysis. The results showed that hybrid Sufism could improve quality of life. Hybrid Sufism can better appreciate and interpret local wisdom with an attitude of preserving nature and a positive understanding of worldly wealth, increasing the hard work ethos to achieve material–spiritual qualities. Contribution: This article shows that hybrid Sufism encourages the life of Sufis in harmony between vertical and horizontal aspects. This understanding and lifestyle give rise to respect for others, being friendly to the environment and interpreting life and local wisdom. (shrink)

A new word has recently entered the British medical vocabulary. What it stands for is neither a disease nor a cure. At least, it is not a cure for a disease in the medical sense. But it could, perhaps, be thought of as an intended cure for a medicosociological disease: namely that of haphazard or otherwise ethically inappropriate allocation of scarce medical resources. What I have in mind is the term ‘QALY’, which is an acronym standing for quality adjusted (...) life year. Just what this means and what it is intended to do I shall explain in due course. Let me first, however, set the scene. (shrink)

The author analyzes the lessons for ethics consultants presented by McCrary and colleagues in their case, “Elective Delivery Before 39 Weeks’ Gestation: Reconciling Maternal, Fetal, and Family Interests in Challenging Circumstances.” Clinical ethics cases that involve different specialists representing the best interests of different parties in a case, such as this case involving neonatologists and perinatologists, are complex and time-consuming. The author concludes that ethics must insure the interests of the fetus and future person are not subsumed to the interests (...) of those with a voice, without deliberate reflection and strong ethical justification. (shrink)