Quality of life assessment in non-Western cultures

Abstract

The introduction of quality of life (QOL) assessment has shifted clinical focus away from symptom measurement towards assessment of functional areas important to the patient. Most QOL instruments were conceptualized and developed primarily in Western society, and have not been validated against non-Western indigenous beliefs of what it means to have quality of life. As a result QOL assessment has cultural limitations. Only by awareness of these limitations can one validly interpret QOL findings from non-Western cultural groups. This article highlights the main areas for attention: concept and construct of QOL, peoples' baseline and expectations of QOL, coping mechanisms and communication of QOL. A literature review from 1966 to present of QOL in non-Western cultures revealed that many studies comparing cross-cultural QOL scores do not consider such cultural limitations. In addition the most popular QOL cross-cultural assessment tool, the WHOQOL, does not consider all factors. We conclude that only through true appreciation and understanding of the cultural limitations of QOL can one validly interpret results from non-Western QOL assessments.

Earthquake survivors' quality of life and academic achievement six years after the earthquakes in Marmara, Turkey

“…More recently, QOL has been used increasingly to assess improvements in perceived well-being (Cass et al, 1999;Collinge et al, 2002). The concept of QOL is defined by the World Health Organisation (WHO) as:…”

“…Broadly speaking, QOL assessments include the physical, cognitive, emotional and sociological aspects of life (Collinge et al, 2002).…”

A concept analysis of quality of life

“…In contrast, other researchers add cognitive functioning (Wilson et al, 2001) or the mental capacity to evaluate oneÕs own life (Meeberg, 1993). Collinge et al (2002) agree with the addition of cognitive functioning but substitute an emotional domain instead of psychological functioning. Horton (2002) identifies the domains of physical, psychological, and spiritual health as key to QOL for patients with advanced cancer.…”

“…The subjective nature of QOL is commonly cited in the literature (Ager, 2002;Cohen et al, 1996;Collinge et al, 2002;Ferrans, 1990;Ferrans, 1996;Gill and Feinstein, 1994;Hacker, 2003;Hill, 2002;King et al, 2002;Rotstein et al, 2000;Scherer and Cushman, 2001;Shephard and Franklin, 2001;WHOQOL Group, 1995;Wilson et al, 2001). In Sweden, Rahmqvist (2001) confirms the value of patientsÕ perspectives and subjective feelings when designing health programs.…”

“…According to Marshall (1990), Collinge et al (2002) and the WHO (2004) peopleÕs roles are culturally engrained. Efficace and Marrone (2002), Ferrell et al (1998) and Horton (2002) believe that spiritual well-being is also instrumental in determining QOL.…”