Evaluating a new methodology for providing individualized feedback in healthcare on quality of life and its importance, using the WHOQOL-BREF in a community population

© 2015, Springer International Publishing Switzerland. Purpose: We conducted an evaluation to find out how a novel quality of life (QoL) intervention containing guided individualized feedback was appraised. The importance of QoL was matched with QoL assessment for each subjective dimension, using graphical feedback. We examined whether this information was acceptable, feasible and valued beyond the clinical context, among the community. Methods: Using a mixed-methods cross-sectional design, the intervention was piloted with 129 participants from communities and registered in primary care. WHOQOL-BREF and WHOQOL Importance scores were graphically matched by dimension. Results were inspected and interpreted with directed guidance to identify good and poor QoL. We report the post-intervention evaluation of feedback, including qualitative themes. Follow-up interviews among those expecting feedback to be helpful explored potential self-management and healthcare uses. Results: After feedback, 65% reported changes in thoughts and perceptions of QoL, often describing insights as self-affirming. Goals or expectations changed for 34%, and motivation to change was reported. Over 50% evaluated the feedback as helpful in the short term or for the future. Follow-up interviews endorsed the value of the feedback and its usefulness in sharing with a healthcare professional (92%), suggesting it would facilitate professionals’ understandings of patients and enable health advice to be targeted. Conclusions: The benefits of using this novel feedback can be extended to the general population, as directed guidance aids interpretation, thereby saving health service costs. This complex pilot intervention needs testing in a blinded fully randomized controlled trial. Beyond independent self-management, graphs could be used during clinical decision-making

Assessing children’s quality of life in health and social services: Meeting challenges and adding value.

The measurement of children's quality of life has an important role to play in improving their experience of health and social services, and in promoting a child‐centred approach to service provision. This article provides a rationale for both the development of robust quality of life measures specifically for children and also the use of these measures in assessing the effectiveness of treatments and policy changes. It highlights recent advances in the development of quality of life measures and provides examples of two instruments that have incorporated these steps to produce reliable and valid measures that are not only comprehensible to children of different age groups, but also meaningful to parents and health professionals. The challenge of matching statistically significant change in quality of life to changes of perceived importance to the individual is also discussed in the light of the advantages to be gained from the increased uptake within health and social care of quality of life measures for children.</jats:p

Explicando o significado do WHOQOL-SRPB

BACKGROUND: WHOQOL-SRPB is an instrument developed to evaluate how spirituality, religiosity and personal beliefs (SRPB) are related to quality of life in health and health care. Recently, Moreira-Almeida and Koenig (2006) questioned several aspects concerning WHOQOL-SRPB including de definition of the construct used in the instrument and the fact that its facets are too broad to be considered spirituality and religiosity. The present study is an answer to these questions, based on the clarification of some concepts behind the development of the WHOQOLO-SRPB. OBJECTIVES: To clarify the concepts behind the development of the WHOQOL-SRPB. METHODS: The questions raised by Moreira-Almeida and Koenig (2006) were discussed based on the objectives and conceptual framework of the WHOQOL-SRPB and also on the pertinent literature. RESULTS: 1) WHOQOL-SRPB is not an instrument developed to evaluate SRPB but Quality of Life construct; 2) personal beliefs may function as a strategy to cope with life problems, since they give meaning to human behavior and hypothetically influence quality of life; 3) SRPB is a coherent construct and may be considered an independent construct specially concerning psychological well-being; 4) the concepts included in the WHOQOL project were considered genuine cross-cultural concepts through international consensus and this is one of its major strengths. CONCLUSIONS: WHOQOL-SRPB should be seen as an important contribution to the study of the relationship between quality of life and spirituality, religiosity and personal beliefs.CONTEXTO: O WHOQOL-SRPB é um instrumento que foi desenvolvido para avaliar que forma espiritualidade, religião e crenças pessoais (SRPB, sigla em inglês) estão relacionadas à qualidade de vida (QV) na saúde e na assistência à saúde. Recentemente, Moreira-Almeida e Koenig (2006) questionaram vários aspectos relativos ao WHOQOL-SRPB entre eles a definição do construto utilizado no instrumento, bem como o fato de suas facetas serem muito amplas para serem consideradas espiritualidade e religiosidade. OBJETIVOS: Clarificar os conceitos subjacentes ao desenvolvimento do WHOQOL-SRPB. MÉTODO: As questões levantadas por Moreira-Almeida e Koenig (2006) foram discutidas baseados nos objetivos e marco conceitual do WHOQOL-SRPB, bem como, a literatura pertinente. RESULTADOS: 1) o WHOQOL-SRPB não é um instrumento desenvolvido com o objetivo de avaliar o construto SRPB, mas sim qualidade de vida; 2) crenças pessoais podem funcionar como uma estratégia para se conseguir lidar com os problemas, pois dão significado ao comportamento humano e, hipoteticamente, influenciam a QV; 3) SRPB é um construto coerente e pode ser considerado um construto independente de bem-estar psicológico, 4) os conceitos incluídos no projeto WHOQOL foram considerados genuinamente transculturais por consenso e isso é um de seus pontos fortes mais relevantes. CONCLUSÕES: O WHOQOL-SRPB deve ser visto como uma importante contribuição ao estudo da relação entre qualidade de vida e espiritualidade, religiosidade e crenças pessoais