Human Occupation. Introduction to the theory and practice of occupational therapy

The definition of the concept of quality of life (QOL) has long been debated with contributions varying according to the different scientific disciplines, including social sciences, psychology, geography, philosophy, health economics, advertising, medical science, and history (Bowling 1995; Faruqhar 1995, Liddle & McKenna 2000). Taking into account the difficulty of defining QOL (Bowling 1995) this essay will critically discuss the suggestion that "...the experience of quality of life is not dependent upon the quantifiable, material conditions of life but upon subjective, qualitative factors: the content of life" (Hammell 2004, p299). Beginning with a brief definition of the concept QOL in relation to the concept of human occupation and the philosophy of occupational therapy (OT), it will be discussed whether quantifiable conditions in terms of socio-economic resources and measurable physical function are appropriate indicators for QOL. The discussion will then move towards the question of a suitable approach to QOL measurement and explain the implications for the role of OT. In an attempt to define the concept of QOL, Zhan (1992) proposes an example of a conceptual model which speaks of four measurable dimensions of QOL, namely: "life satisfaction, self-concept, health and functioning and socio-economic factors" (Zhan 1992, p796), and suggests, in consensus with Liddle & McKenna (2000), that QOL is both, a subjective as well as an objective concept. Niemi et al (1988) prefer to define QOL as referring to "a person's subjective wellbeing and life satisfaction", which includes health, material well-being, interpersonal relationships", as well as "personal development", work and recreation (Niemi et al, cited in Mayers 2000, p591).