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Individual quality of life: or ‘‘African’’. To what extent and with find our where improvement or deterioration
what success, this book asks, can methods is taking place in areas that are important
approaches to conceptual- of this kind measure an individual’s quality to the patient, but also to facilitate two-way
ization and assessment of life? communication and decision-making,
The editors make it clear from the improve patient satisfaction and increase
edited by C.R.B. Joyce, Hannah M. McGee outset that in their opinion quality of life is commitment and adherence to therapy.
and Ciaran A. O’Boyle. Published a matter of the unique experience of the Some researchers who favour the
by Harwood Academic Publishers, individual and is therefore not susceptible individual approach have shied away from
Amsterdam. Paperback ISBN 90-5702- to traditional methods of enquiry. They any form of measurement in view of the
425-X, price £15.00, US$ 24.00; propose that individuals should be asked vast number of factors involved and the
cloth ISBN 90-5702-424-1, to express their QoL in their own terms, infinite complexity to which they give rise.
price £34.00, US$ 54.00. rather than to reply to formalized questions This collection of articles should give them
about categories defined and chosen by pause. It provides thought-provoking and
The term ‘‘quality of life’’ (QoL) is fraught others. Drawing on contributions from convincing arguments that individual QoL
with preconceptions, misconceptions and highly respected researchers and academics, can indeed be measured, despite the obvious
general all round confusion. How do you they develop this argument in a systematic difficulties and limitations. Many areas
define it? What is the best way to measure it? manner, focusing on the issues that are still need to be clarified, such as the context in
These and related questions have been relevant to the study of individual QoL, which the assessment is undertaken, the
a driving force behind research during the as well as the measures that are available scaling features, the type of statistical
past decade. Research efforts have produced for this purpose. procedures needed to provide the necessary
a vast array of differing measures, definitions Several of the contributions provide psychometric credibility, and the number
and population studies, accompanied by brilliant accounts of the difficulties that of values to be measured for each individual.
very little theory and, often, a great deal arise with interpreting data produced by However, this exploration of the issues gives
of criticism. Amidst a flurry of attempts to existing research instruments, and highlight clear and encouraging indications of the
work out the perfect way to assess QoL, the need for further theoretical work. The way forward for research. n
the ‘‘best’’ questions and the most accurate difficulties and psychometric pitfalls of
way to score the answers, we may have lost the preferred approach, which focuses on Kate O’Connell
sight of the real issue: the individual’s the individual, are also explored in detail. Research Officer
quality of life. Throughout the book the authors present Department of Psychology
The authors of these 16 chapters a consistent argument that is best illustrated University of Bath
challenge many of the current conventional by the editors’ own QoL instrument, which Claverton Down
approaches to conceptualization and they call the Schedule for the Evaluation Bath BA2 7AY
measurement of QoL which focus on of Individual Quality of Life (SEIQOL). England
population studies rather than the individual. Their description of this measure includes
Assessment has traditionally used standar- its theoretical basis, the practical ways
dized questionnaires, composed of of assessing QoL from the individual’s point
predetermined categories and set responses of view, and some of the difficulties and
that force the respondent to reply to a successes met with in using this approach.
specific set of formalized questions. In Overall, this results in a well-balanced
these circumstances there are no options account of issues related to individual QoL
for choosing and assessing the importance and the problems associated with both group
of issues that individuals themselves find and individual measurement. This in turn
relevant although the researchers may not. serves to highlight the types of questions
So, for instance, the experience of pain researchers should now be tackling.
after surgery may be a major feature of This is an important book for re-
the questionnaire while less obvious factors, searchers, health professionals, students
such as worries about who will look after and academics alike who are dealing with
pets left at home during hospitalization, complex issues of health and well-being.
are overlooked because the researchers While this exciting new approach will have
find them trivial, regardless of whether a valuable role to play in assessing the QoL
the patients do. Responses to questionnaires of individuals, it will also provide new ways
are then analysed quantitatively, with to assess the outcomes of interventions in
individual experiences and perceptions different patient groups. In clinical practice
added up and expressed as a group mean it can be particularly useful for health
for comparison with other groups. The professionals engaged in one-to-one
‘‘group’’ is often as crudely defined as ‘‘sick’’ consultations with patients. They can use
or ‘‘well", ‘‘male’’ or ‘‘female’’, ‘‘Asian’’ individual QoL assessment not only to

1372 # World Health Organization 2000 Bulletin of the World Health Organization, 2000, 78 (11)

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