QUALITY-OF-LIFE - A PROCESS VIEW

The use of quality of life assessments in clinical trials and general medical settings has proliferated, though the conceptualization of qua lity of life, and the cognitive processes underlying its judgement, ha ve been neglected. To meet the needs of outcome assessments, available assessment tools currently mix function, affect, and quality of life items within the same scales. A process-oriented approach to quality o f life disentangles determinants of quality of life (such as affect an d function) from judgements of quality of life. The process model addr esses three issues: (1) how patients attribute symptoms, emotions, and functioning to disease or treatment; (2) how individuals interpret an d assign meaning to physical and emotional sensations; and (3) how pat ients integrate their assessments into overall quality of life judgeme nts. Thus, in this model, the very same symptoms can be interpreted by one patient as detracting from quality of life, while another patient may see them as positively contributing to quality of life. Studies o f quality of life and cancer are used to illustrate the model.