Quality of life: What, how, why?: The view of healthcare professionals

Although ‘quality of life’ is thought to be an important concept in healthcare, there is a lack of agreement about what this term means. This paper arises from a study which made the idea of quality of life itself the object of enquiry. We report findings from qualitative interviews with 47 healthcare professionals working with stroke and elderly care patients, which sought their views of the meaning and uses of quality of life. Most defined quality of life in terms of happiness/life satisfaction. Poor health and disability were assumed to reduce quality of life; interviewees represented their work as aiming to improve patient quality of life through improving health. Most regarded formal quality of life measurement as a research tool but not feasible or appropriate in routine care. However, conversations and observations of patients and carers were represented as informal ways of judging patient quality of life, and were generally regarded as a useful or essential part of the therapeutic relationship. Such assessments were said to take place routinely and to provide opportunities for patients/carers to express their wishes, and for ‘real’ patient needs to be identified. This runs counter to evidence of low levels of patient/carer participation in decision‐making and discharge. The real value of the quality of life concept remains unproven but we suggest that in the context of our interviews it was used by professionals to reflect on the nature of the therapeutic encounter and to articulate ideas about healthcare practice.