Is Satisfaction a Valid Concept in the Assessment of Quality of Life of People with Intellectual Disabilities? A Review of the Literature

Abstract

The present review examines the definitions of quality of life (QoL) which have developed over the past 3 decades and which reflect the increased awareness of the need to take into account individuals' own perceptions of their life. The concept of satisfaction is frequently used as an important subjective variable in QoL studies, despite the evidence of stability of satisfaction over individuals and over time, which suggests that it should be a measure insensitive to change. This evidence is examined and the idea of such stability being an adaptive psychological mechanism is considered. The use of satisfaction as a measure of QoL in people with intellectual disabilities (IDs) is discussed. The methodological difficulties encountered in assessing the subjective experiences of people with IDs are also discussed. Finally, it is argued that there is a strong argument for the abandonment of measures of QoL in general, and subjective ones in particular, for people with IDs. An alternative approach is suggested.

Psychological Factors Associated with Obtaining Employment

“…When asked to judge how they felt about their life in general on a scale of 1 to 7, the majority of people reported being mostly happy with their life. This is a common finding in many groups; satisfaction with aspects of life is not necessarily correlated with what people actually experience (Hensel 2001). Satisfaction and well‐being scores tend to be consistently high, with most people rating themselves happier than average, and, except under unusual circumstances, there is remarkably little relationship between a person's judgment of satisfaction and the material aspects of their life (e.g.…”

Investigating Organizational Culture: A Comparison of a ‘High’‐ and a ‘Low’‐Performing Residential Unit for People with Intellectual Disabilities

“…This is opposed to Felce's (1997) model of quality of life that highlighted the importance of integrating objective and subjective indicators. A more recent review of quality of life (Hensel 2001) brings into question the validity of the concept because of its reliance on satisfaction as a subjective variable. She provides evidence that satisfaction is a stable psychological function over time and conditions, possibly related to disposition, which is maintained at a high level by a homeostatic or adaptive mechanism (e.g.…”

Subjective quality of life in children with intellectual impairment - how can it be assessed?

“…However, some authors have reservations concerning the relevance of assessing subjective aspects of QoL in people with IIm, and particularly question the use of satisfaction as a reliable indicator of QoL. [40][41][42] They believe assessing only subjective QoL disadvantages vulnerable people, such as those with IIm, as they may express high enjoyment of their lives within a poor environment. People with IIm may be unaware that better quality is possible or consciously aware that they must limit their expectations because of their present circumstances.…”

“…Finally, if children with and without IIm are to be included in the same study, it is important to obtain proxy reports for all children, including those who can complete a self-report, in order to make valid comparisons of QoL across the ability range. 26 + S/P Levi and Drotar (1999) 27 + S/P Parsons et al (1999) 28 + S/P Eiser (1997) 39 + S/P Eiser and Morse (2001) 29 + S/P Britto et al (2004) 30 + S/P Waters et al (2000) 33 + P Antaki and Rapley (1996) 22 + S Felce (1997) 40 + S Antaki (1999) 23 + S Schalock et al (2000) 19 + S Hensel (2001) 41 + S Hatton and Ager (2002) 42 + S Hensel et al (2002) 24 + S Cummins (1993) 17 + S/P Stancliffe (1999) 34 + S/P Schwartz and Rabinovitz (2003) 20 + S/P …”