Contents



Preface

Quality of life (QoL) is an important construct for health and wellbeing, with applications for clinical care, research, and individual or patient use. An assessment of QoL acknowledges the significance of modifiable and non-modifiable risk factors for health and disease (1, 2). QoL also has broader implications as a social and developmental concept. As defined by the World Health Organization (WHO), quality of life is "individuals' perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns" (3). This definition takes cognizance of the subjective nature of QoL, and its immersion in the context of societal, cultural, and

With growing interest in QoL and the development of more comprehensive approaches to measurement, numerous methodologies and tools have been developed to measure Health-Related Quality of Life (HRQoL) and associated domains. The World Health Organization Quality of Life (WHOQOL) assessment measures this "multi-dimensional concept, incorporating the individual's perception of health status, psycho-social status and other aspects of life" (4). The WHOQOL-100 tool is a cross-cultural instrument that measures domains of physical, psychological, social relationships, environment, and spirituality/religion/

Section 1 of this book, "Quality of Life Indicators and Measurements," introduces the concepts of health-related quality of life (HRQoL) and the measures used in its assessment. Chapter 1, "Modifiers of Health-Related Quality of Life by Biological, Psychological and Social Factors" by Canelo, Lorenzo Gómez, De Sena, and Fernández-Martín, establishes the concept of HRQoL, reviews frequently used tools, and makes recommendations for their application in clinical care. This chapter offers a guide for clinicians, public health practitioners, and researchers.

Quality-adjusted life years (QALYs) measures years of life, adjusted for the QoL during those years. It serves as a measure of longevity and health outcomes (5). In Chapter 2, "Ethical Issues which Have Prevented the U.S. from Maximizing Quality of Life Years", the author Sage Arbor argues the value of QALYs for resource allocation and discusses the societal norms that challenge its effective utilization. The author highlights forces such as age, sex, lifestyle (e.g., smoking, drinking, obesity), cost transparency, and societal and demographic transitions (e.g., war, population

explosion vs. collapse) that present ethical dilemmas for the use of QALYs.

Section 2, "Assessing Quality of Life in States of Chronic Diseases and Psychological Health," addresses HRQoL in the context of chronic diseases, including psychological dimensions and interventions. Chapter 3, "Assessment of Pain, Acceptance of Illness, Adjustment to Life and Strategies of Coping with the Illness in Patients with Pancreatic Cancer" by Religioni, Czerw, Badowska-Kozakiewicz, Budzik, and Deptała, reports on coping strategies and life adjustments for a sample of patients living with pancreatic cancer, the fourth most common type of cancer worldwide. In Chapter 4, "Predictors of Health-Related Quality of Life among Patients with

environmental norms.

personal beliefs (4).
