TOWARD A GENERAL-MODEL OF HEALTH-RELATED QUALITY-OF-LIFE

A health-related quality of life (HRQOL) model that fitted data collec ted in previous studies from two separate samples-patients with chroni c physical illness and patients with chronic mental illness-was adapte d and tested on a representative sample drawn from the normal populati on. This model, which implied that both physical and mental health inf luenced number of friendships, personal growth, and job satisfaction, fitted the data very well. However, an alternative model reversing the directions of the pathways so that friendships, personal growth, and job satisfaction affected physical health and mental health, with the latter two having a mutual effect on each other, fitted the data even better. This suggests that, although a medical model of HRQOL may be m ore important when it comes to alleviating illness, a psychosocial mod el of HRQOL may be more important when it comes to maintaining health and preventing illness. Moreover, the fact that essentially the same f ive-factor structural model fits three distinct populations, healthy a nd unhealthy, suggests that there may be a general model of quality of life applicable to all populations. The implications of these finding s for clinical theory, policy, and practice are discussed.