La Libroteca de Sarri - El Hobbit

2.9. Conceptualising QOL

The diversity in QOL research demonstrates that there are many ways to conceptualise themes related to QOL grounded in the multiplicity of fields addressing it. Part of the endeavours undertaken to conceptualise QOL were to understand its traits as a collective or a discrete mean; that is, to grasp the relationship between QOL and other variables. Mallard et al (1997) tested three proposed models that explain this relationship. The first is entitled the ‘Bottom-up model’, which rests on the proposition that particular variables influence the overall QOL of individuals and that QOL as a whole results from the cumulative satisfaction achieved in relevant facets. The second model, ‘Top-down model’, proposes that QOL is a lasting characteristic that shapes the satisfaction of individuals in the underling related facets. The third model called the

‘Bidirectional model’ argues for an integrated view of the former models, in the sense that QOL does influence and contemporaneously is influenced by life factors.

Besides the concern of conceptualising QOL as a collective or discrete mean, several theories have been applied in defining and conceptualising the notion of QOL. Lane (1994) presented what is known as the ‘Relational Theory of QOL’ in which QOL is described as a function of two companion qualities - quality of conditions (QC) and quality of persons (QP) - within the formula QOL=ƒ(QC,QP). Hence QOL is defined neither as a condition, nor a state of mind like happiness or even a quality of person, but rather as the relationship between quality of conditions and quality of persons; or in other terms, the rapport between subjective person-based elements and a set of objective circumstances. According to the relational theory, to build an efficient relationship, every external feature of life should have an internal receptor. Subsequently, opportunities in the environment contribute to QOL only if there are matching receptive properties in the persons involved. These opportunities imply choices, but choices are

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worthless without the cognitive complexity that allows for both rational and imaginative reasoning, on the one hand, and informed desire on the other. This can be achieved throughout strengthening the internal attributions as part of personality development of individuals. According to that, enhancing QOL becomes not only a matter of improving quality of conditions, but also enhancing the capabilities of people to undertake valuable benefits from such conditions (Lane 1994).This opinion was agreed by a number of researchers including, for instance, Royuela (2006), who posited that each individual’s perception of life quality is directly dependent on his capability constraints to exchange and gain.

The concept of capability is best reflected in what is known as the ‘Human Development Theory of QOL’ which represents a developed version of the Relational Theory. The theory suggests that QOL is derived from states of being and opportunities for doing, which are both individually and socially constituted. Without capabilities associated with being (such as health, social connections and self-esteem) and doing (political activity, intellectual challenges, and engaging work), a person is not able to take advantages of the benefits that utilitarian takes for granted. The capacity to purchase commodities is a consideration, but it is only one aspect of a multi-dimensional assessment. The value of commodities lies in their facilitation of social interaction. Each sphere of action should be treated as incommensurate with others, and so progress in one area should not be regarded as a trade-off for moving backwards in another. QOL is determined by the characteristics of each person that enable him or her to function in the world and lead a full life. In that sense it is defined as ‘the satisfaction of an individual's values, goals and needs through the actualisation of their abilities or lifestyle’ (Emerson 1985, p. 282).

Capability is defined as ‘the ability or potential to do or be something, or more technically, to achieve a certain level of functioning’ (Yuan 2001). This applies on the scale of the individual, community or even the surrounding environment. QOL from the standpoint of environment is the degree to which the environment has the capacity to provide resources necessary to meet the needs of human life (Bubolz et al 1979). This capability is seriously degraded by the growing consumption of environmental

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resources, and therefore sustaining it is of great importance in order to achieve better QOL. On the individual and community levels, command over resources is considered one of the major catalysts of capability. By means of control it fosters a higher degree of freedom in dealing with various life events. This in turn enables people to select alternatives that better maximise happiness and improve their life qualities.

The influence of personal characteristics and values in shaping people’s QOL is best explained in what is known as ‘the gap theories of QOL’ according to which QOL could be described as ‘the difference between one’s present life circumstances and a standard to which one compared oneself’ (Day & Jankey 1996). Within this conception, QOL can be understood in terms of the gap between actual status of people and what they desire or expect; or in other terms, the perceived discrepancy between one’s aspirations and achievements (Brown et al 2004). In that sense, it is the accomplishment of personal goals and the fulfilment of needs in accordance with the surrounding conditions that create better life quality (Moons et al 2006). The fulfilment of needs works within a progressive satisfaction of a hierarchy of requirements derived from different perspectives among which is Maslow’s seminal developmental perspective (Turksever & Atalik 2001). From this perspective, overall QOL can be interpreted as a function of a) the degree to which each identified human need is met ‘fulfilment’, and b) the importance of the need to the respondent in terms of its relative contribution to the subjective well-being (Costanza et al 2006). Hence, it is not the conditions themselves that convey the true quality of the setting, but the meaning of those conditions to the people (Marans 2003).

People’s desires and needs as well as their living conditions vary, resulting in each individual having their own assessment criteria built upon particular expectations, which makes satisfaction with different aspects of life relative and influenced by the level of each subject’s aspirations (Lever 2000). Such feelings are mostly built on comparisons where in some instances the gap measured is the distinction made between what one has and what a reference group has. In other cases the difference is between what one has and what is considered the ideal. Others may also measure the difference between what one has and what one wishes to have (Haas 1999; Rojas 2009).

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People’s assessment of a good life always changes and their expectations of what constitutes it do not stop within one particular status. Two philosophical arguments clash here. The first claims that human nature looks continually for improvement, in the sense that a need which is achieved becomes the starting point for new needs in a hierarchy that ranges from the most basic to the most spiritual needs. Easterlin (2003) argues that because of hedonic adaptation, people’s aspirations will always adjust to their changing circumstances and therefore their desires and expectations will keep rising every time to about the same extent as their actual gains, leaving them feeling no more satisfied than before (Vemuri & Costanza 2006). Maintaining an ample means of life quality and life satisfaction is accordingly hard to achieve. Human wants rarely reach the state of complete satisfaction except for over very short periods of time (Lieu 1975).

The second argument refers to the concept of adaptation in an opposing way. That is, because of adaptation, people diminish their requirements to fit with their living conditions. In other words, their expressions of happiness and satisfaction adjust to rather than reflect their actual circumstances. This notion is valid particularly in the case of poor conditions referring to the principle of ‘homeostasis’ which allows people to maintain a certain degree of stability in their satisfaction with their environments, as they adjust their satisfaction according to their resources (Cummins 1999).

Both sorts of arguments lead to the recognition that the personal part of QOL is strongly relative and findings from subjective measures of life quality alone cannot be taken for granted. This in turn results in apparent variances between findings from objective and subjective measures (Michalos 2009). Such variance is claimed to be minimal in the case of degraded environments as individuals will tend to be dissatisfied with this environment and their lives. In such cases the threshold of adaptation is believed to be exceeded where people will no longer be able to adjust with their living circumstances and their subjective QOL will be down-sized to reflect those conditions. In this situation the inner correlation between subjective and objective measures is supposed to be in its higher levels (Cummins 1999).

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