There is an increasing policy drive for nurses to encourage and operationalise self-management and collaborative partnerships with people with long-term conditions. Central to this is a development of understanding of the premises to a good quality of life. This presentation reports on a project in which the quality of life of people with Multiple Sclerosis (MS) was assessed. In parallel, the researchers examined the meaning attributed to the term in policy documentation such as the NSF for Long-Term conditions (2005) (Lhussier 2009).
It emerges that quality of life is premised upon an understanding of six oppositional pairs of:
• Life and death (because to talk about ‘quality of life’ is to assume a clear and fundamental difference between the two concepts)
• Health and disease (because people with long-term conditions are often assumed to have a poorer quality of life)
• Independence and dependence (because maintaining independence is one of the key aim of health care practice in long-term conditions)
• Empowerment and disempowerment (because patient empowerment is a key policy driver)
• Certainty and uncertainty (as the uncertainty of an illness trajectory impacts greatly on people’s perception of their quality of life)
• Ability and disability (because disability is to be avoided for as long as possible in MS)
Drawing on the data collected, this presentation aims to expose and critique these six oppositional pairs so that understanding of quality of life in long-term conditions can be enhanced and contextualised. Thus this presentation does not aim at solving definitional or measurement issues,
but at engaging practitioners in critical thinking about such a key concept as quality of life. Such an engagement in questioning of pre-understandings is crucial for nursing practice to evolve and adapt to changing population needs, as the prevalence of long-term conditions continues to increase
