Quality of Life - everyone wants it, but what is it?

"Quality of life" has quickly become a catch-all term, but closer examination reveals a great confusion over what it actually means. Once a term largely used by health-care professionals – now everyone from economists and advertising executives cares about offering good “quality of life.” But what does it really mean, and how can businesses, as well as physicians, help to improve it, if nobody can clearly define this elusive concept?

An Attempt to Standardize
In order to assess situations and decide on suitable intervening strategies, global organizations such as the United Nations and the World Health organization try to formulate definitions in order to standardize complex issues such as ‘health’, ‘happiness’, ‘human rights’, ‘wealth’, and much more.

For example, the World Health Organisation’s (WHO) attempt at defining ‘Quality of Life’ (QOL) looks as follows: “An individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.”

Note that word: ‘perception’. We’ll come back to that in a moment.

Now, in order to make that definition a bit more specific, some indicators are mentioned. Among the dimensions of material living conditions are Income and Jobs and Housing Conditions. The immaterial dimensions of the quality of life include Health, Education, Environmental Quality, Personal Security, Civic Engagement and Work-Life Balance.

But even this attempt only shifts the problem further along. After all, what yardstick is going to be used to assess each situation? Whilst scientists may resort to rating scales to measure, say, pain, or the quality of sanitation within a community, or use scoring systems to quantify disabilities, trying to measure "quality of life" this way has proven to be very complex and subject to disagreements at best, and near impossible at worst.

Is it possible that the fact that Quality of Life cannot be simply reduced to a definition is the very thing that defines it?

Quality of Life: a Subjective Experience
Even a meta-analysis of scientific papers over the past 20 years confirms that a precise, clear and shared definition of Quality of Life is a long way off. Usually, researchers don't even attempt to define the concept, using it instead as an indicator.

Among the observations made about "quality of life" is that it encompasses:

a. life satisfaction, which is subjective and may fluctuate.

b. multidimensional factors that include everything from physical health, psychological state, level of independence, family, education, wealth, religious beliefs, a sense of optimism, local services and transport, employment, social relationships, housing, and the environment.

c. cultural perspectives, values, personal expectations and goals of what we want from life.

d. not just the absence of disease but the presence of physical, mental and social well-being. This stresses the need for multidisciplinary medical teams who can develop a perspective on psychosocial needs and not just physical care.

e. our interpretation of facts and events, which helps to explain why some disabled people can report an excellent "quality of life" while others can't.

f. our level of acceptance of our current condition, and our ability to regulate negative thoughts and emotions about that condition.

The use of words throughout these observations, such as subjective, fluctuate, beliefs, sense of optimism, interpretation, and level of acceptance clearly demonstrate that Quality of Life is a matter of personal experience. Add to that our ability to regulate negative thoughts and emotions about our current condition and it becomes clear that we ourselves, each one of us, are in charge of our Quality of Life.

Your Quality of Life – your Choice
You are in charge of your Quality of Life because, although you may not always be aware of this, you are in charge of your beliefs, of your level of acceptance, of how you interpret the facts and of your ability to regulate negative thoughts and emotions. In other words, Quality of Life is, to a large degree, a matter of your personal choice.

Beliefs, Values, Rules and Human Needs
Beliefs Some personal beliefs you have are supporting you in who you want to be, and how you experience the quality of your life, whilst some of them could be holding you back. Your beliefs about the world and your place in it affect everything you do and expect. The strength of this fact lies in your ability to replace any beliefs that limit you.

Values Did you know that it is your personal value system that sets the course of your life? Like a rudder, they steer your ship. We are not aware of it, but the number-one cause for internal conflict for most people is a conflict in their personal values.

Rules Rules are the criteria you assign to your values. Your rules decide what needs to happen for you to experience your values. By means of the rules you employ, you make experiencing your values easy or difficult.

Human Needs What lies at the foundation of fulfillment? We do know when our needs are not met, but we may not always know what they are, exactly. The classic model of Maslow’s Hierarchy of Needs presented us with a solid foundation. But did you know that there is a precarious balance between your different needs?

Quality of Life – External Circumstances vs Internal Attitude
To a large degree, you are in charge of what you believe, of your life’s values, of the rules you live by and of how you experience and meet your needs. In short, you are really in charge of how you shape and experience your Quality of Life.

It is human nature for us to think that our life’s limitations are set by external circumstances: the economy, politics, joblessness, our age, gender, other people’s behaviour and so on. And it is very understandable that we find cause for our personal problems with … the economy, the environment, the government, health care, and so on.

But the fact that Quality of Life, as we have seen, is a matter of personal experience, subject to optimism, interpretation of facts, acceptance, perception, and perspective, shows that our strongest limitations are set by our own personal beliefs about the world, about who we are and about what we feel we deserve. Our strongest limitations are inner limitations, of which we are fully unaware. The real power of this truth lies in the fact that ultimately, you are responsible for your interpretations, perceptions, optimism, and choices. And with that, you are responsible for your Quality of Life.

The aim of presenting this view is not to disregard the struggles of being burdened by everyday matters of survival. Neither would it be to deny or even diminish the pain associated with traumatic life experiences, disability, chronic illness, betrayal, loss and a host of other life-depleting experiences. But in each scenario, there is a hidden gap, a space or a crack, where light enters and where we have the freedom to choose how we will live with our fate.

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