The Functional Quality of Life (fQOL)-Model

Abstract

Quality of life (QOL) is increasingly being suggested as a crucial outcome variable for interventions that aim to maintain or improve health and psychological resources in old age. Currently, two main approaches to measuring QOL can be distinguished: (1) the sQOL approach which measures an individual’s subjective evaluation of his or her overall life situation and QOL; (2) the oQOL approach that infers QOL of an individual from the outside, e.g., via measurement of health impairments. Both approaches, however, are problematic: In the first case, a large majority of individuals report relatively high levels of sQOL that are sometimes in stark contrast to observable impairments (known as the well-being paradox; Staudinger, 2000 ). This suggests that improving impaired resources does not necessarily lead to improved sQOL (although there may be positive effects on the autonomy of these individuals). The second approach is problematic because improved oQOL leads only to an increase in self-reported overall sQOL under very rare conditions – and one cannot assume that an increase in resources necessarily has led or will lead to higher levels of sQOL. Therefore, we propose a new, functional quality of life (fQOL) approach to determine quality of life. It combines the existing approaches by linking the subjective representations of objectively measurable resources to their functional value for pursuing individually meaningful activities and goals. From this model, fQOL-improving interventions as well as methods to evaluate the effectiveness of QOL-interventions can be derived.

Factors influencing the quality of life perceptions of cognitively impaired older adults in a nursing home and their informal and professional caregivers: a mixed methods study

“…Finally, the present study’s functional determinants were qualities, skills, and resources, which enabled OAs to optimally adapt to different situations and maintain their QoLs. 19 , 20 …”

Behavioral and emotional quality of life of patients undergoing inpatient geriatric rehabilitation.

“…First, it must be noted that even after 80 years of QoL research, there is still no reliable and common definition of this construct (Martin et al, 2012; Veenhoven, 2000). However, there seems to be a basic differentiation between the assessment of objective and subjective QoL: On the one hand QoL evaluations from outside on the basis of objectively measurable circumstances (e.g., assessment of health impairments), and on the other hand intraindividual, and thus subjective, QoL judgments (Martin et al, 2012).…”

“…Yet, major improvements with regard to objective resources are not necessarily connected to major improvements in subjective QoL: It has been found that interventions targeting enhanced engagement in physical activity and improved functional ability have, if any, only rather small effects on well-being (Clark et al, 2012; Martin et al, 2012; Netz, Wu, Becker, & Tenenbaum, 2005). This finding of a relatively weak connection between objective and subjective QoL indicators can also be seen as being in agreement with the insights on the well-being paradox that despite deteriorating health, well-being remains stable or does not deteriorate as much as health parameters over a longer period of time (Staudinger, 2000).…”

Quality of life of the very old

“…In doing so, the model offers a new flexibility to address quality of life outcomes beyond the hedonic realm. This includes functional [17] or eudemonic conceptions of quality of life [26] that are likely to be of particular relevance in very old age. The “Functional Quality of Life (fQOL)” model [17] considers the subjective evaluation of the individual’s resources to fulfil meaningful activities and goals.…”

“…This includes functional [17] or eudemonic conceptions of quality of life [26] that are likely to be of particular relevance in very old age. The “Functional Quality of Life (fQOL)” model [17] considers the subjective evaluation of the individual’s resources to fulfil meaningful activities and goals. In our understanding, the conduct of activity may imply a grossly underestimated outcome quality, even if it does not (instantly) resolve in hedonic (e. g. wellbeing, happiness) quality of life outcomes.…”