QUALITY-OF-LIFE ASSESSMENT - A PARADIGM SHIFT IN HEALTH-CARE

The assessment of patient quality of life is assuming increasing impor tance in medicine and healthcare. In addition to their biological effe cts, illnesses, diseases and their treatments can have significant imp act on mobility, mood, life satisfaction, cognition and the ability to fulfil occupational, social and family roles. The emerging quality of life construct may be viewed as a paradigm shift in outcome measureme nt since it shifts the focus of attention from symptoms to functioning . This holistic approach more clearly establishes the patient as the c entre of attention and subsumes many of the traditional measures of ou tcome. This paper introduces the concept of quality of life and descri bes the significant difficulties in definition, measurement and interp retation that must be addressed before such measures can be used as re liable and valid indicators of disease impact and treatment outcomes. It is argued that the unique individual perspective of the patient on his or her own quality of life must be incorporated into outcome asses sments aimed at improving the quality of healthcare delivery in chroni c diseases and in terminal conditions.