The nature of Quality of Life: A conceptual model to inform assessment

Issues: The phenomenon of quality of life (QoL) has been subject to ongoing debate and many models have been proposed. Over the latter half of the 20th century QoL models have proliferated, particularly in relation to the population with intellectual disabilities (ID) which have arguably improved living conditions and helped to guard against abuse. While this is a complex phenomenon, there is agreement across a wide literature that QoL has two distinct aspects relating to the individual (whether disabled or not) and the resources necessary for a ‘good’ QoL. Considerable support is also provided for a number of diverse but robust domains. However, how the ‘nature’ of Qol is conceptualised is unclear.

Positions: The article reviews multi-disciplinary research on QoL and goes on to present a theoretical model of the nature of QoL that encompasses identified domains. The model is based on Maslow’s hierarchy of needs (1987) which defines its scope; Sen’s Capability Approach (1985), which elaborates the resource context impacting QoL; and Ryan and Deci’s Self-Determination Theory (2000), which describe person-context interactions important to personally valued QoL . This conceptualisation was framed within four facets – Foundational wellbeing; Psychosocial wellbeing; Status; and Autonomy – each of which have two aspects ‘individual’, describing personal needs that, when fulfilled, are associated with better quality of life, and ‘context’, describing resources necessary to enable individual need fulfilment.

Conclusions: The proposed QoL model demonstrates an intellectually lucid structure supported by literature. It does not attempt a definitive specification of all QoL constituents, but proposes delineation must be determined within the particular circumstances of a proposed assessment. Once determined, an exploratory approach to assessment is proposed. It is suggested this model represents a useful ‘atlas’ on the nature of QoL to guide development of assessments aiming to inform service developments or interventions.