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Quality of Life (QoL): Are patients speaking the same language as doctors?

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04 January 2006

Quality of Life (QoL): Are patients speaking the same language as doctors?

One of the primary reasons there is such a great abundance of weblogs on living with diabetes is how it affects a person’s Quality of Life (QoL). This is also a term used frequently in scientific research and in studies which assess clinical outcomes in chronic disease. Diabetes is at the forefront; many researchers are trying to figure out the relationship between a diabetic’s QoL, their health status, avoiding complications, and helping doctors to manage compliant versus noncompliant patients. My question is: What comes first? The chicken or the egg?

A simple definition for Quality of Life is a person’s ability to enjoy life and pursue happiness. A Health Care Provider (HCP) or scientist may view QoL in a different way. QoL as defined by the CDC goes something like this:

“to measure the effects of chronic illness in their patients to better understand how an illness interferes with a person's day-to-day life…”

which may be important in determining which treatment option is best. "Treatment option" is key here, because after dx, a doctor is skilled mostly in a broad capacity to prescribe. Whether or not the doctor takes QoL variables into consideration is the luck of the draw. I believe most HCP’s define QoL purely as a question of physical status, ie, vital stats. Many HCP's infer that impaired health leads to impaired Quality of Life and excellent health leads to an excellent Quality of Life. See Article. My blood sugar control may be on target, but regardless of my well-being or “high” health status, my QoL is perceived by me to be somewhat low. This is why we all would sacrifice many things in our lives for a cure. Right? I would argue that a person’s access to relevant information, power to choose best treatment plan, and an ability to self-coach, negotiate and resolve issues daily with a chronic illness are all strong indicators of a more positive health status, but not necessarily indicators of an excellent QoL. For individuals, what is the best way to define QoL? And is QoL an indicator of positive medical outcomes? Or is our Quality of Life adversely affected by diabetes regardless of medicine (well..obviously not discounting the fact we are still alive!)? And finally, is QoL an indicator of a diagnoses for diabetes to start with?

What are your thoughts on how to assess Quality of Life and living with diabetes? There are millions of papers out there…some good, some not so. I have listed a few below. More importantly, I am attaching one of the most widely used QoL Assessment Tests for patients with diabetes. It is called the SF-36. Take it for free here and get an immediate score and interpretation. (Fill out the log-in registration -- it will just take a few seconds). My score was: Physical = 56 and Mental = 53 out of 70. What does it mean really? “That I am doing better than most ….”

Articles you may want to check out:
UKPDS 37
Interpreting the SF-36
One group of doctors noted that the SF-36 made modest gains in positively impacting the medical outcomes of patients’ HbA1c and so they made two additions to the the questionaire here.
Another test for young adults with diabetes ADDQol (no online testing available)

6 Comments:

Blogger Andrea said...

My score was 53 on the Physical health summary (or about average)and 32 on the Mental health Summary (less than average)...which doesn't really surprise me. The last few weeks, I've been a lot more down on myself, maybe b/c of the holidays- I don't know, so I wasn't shocked to see that reflected ini my Mental health score.

2:16 PM  
Blogger Elizabeth Snouffer said...

Dear Andrea,

We usually travel back to the USA for Xmas and I strongly believe that my scores (the test asks qualitative questions based on past 4 week period)were higher than normal this time of year because we stayed at home...
Thanks for your post!

2:23 PM  
Blogger Kerri. said...

I clocked in at 56 for Physical and 53 for Mental.

Bought balloons due to excitement. :)

2:40 PM  
Anonymous Angus said...

Don't think the QoL test told me much. Need more specific questions. According to them, my QoL is fine, but IMO that is because I have accepted that there are some things I have had to change. Compare my QoL to pre-diagnosis, and I think there is no question I was able to have a lot more fun back then.

9:41 PM  
Blogger Megan said...

I was average on both (48 physical, 51 mental). I'm sure I was lower than I otherwise would have been because I've had a lung infection the last two weeks that results in high bs, breathing problems, and a decrease in my social life, all which lowered my score.

11:24 PM  
Blogger Type3 said...

Man, I got a 44 on the Mental and now I'm totally depressed... Not really. I was actually surprised that I was on the low side, because I've been feeling great lately. I think it's skewed because I've been struggling with a work assignment over the last 2 weeks and so I was feeling anxious because of it. I'm gonna take it again in 4 weeks. (I turned in the assignment today.)

I got a 58 on the physical. I'm huge.

7:41 AM  

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