Funderburk F R, Pathak D S, Pleil A M
College of Pharmacy, Ohio State University, Columbus, USA.
Pharm Pract Manag Q. 1998 Jan;17(4):54-66.
Quality of life is a fascinating field to researchers and practitioners alike. To some researchers, quality of life is of interest because it offers untold challenges in constructing instruments and capturing data necessary to answer key questions about health, disease, and treatment. For such researchers, quality of life is about statistical relationships among questions and about using questions to define the physical, social, and emotional domains of health. To other researchers, this field is about finding practical applications in policy and treatment decision making for the information provided by quality of life assessments. To these researchers, the focus of quality of life is on ways to apply knowledge of quality of life differences between groups with and without specific diseases or ways to use knowledge about how treatments affect the quality of life of various patient populations. To practitioners, quality of life is about treatment outcomes that impact individual patients' daily lives. It is the practitioner that Funderburk, Pleil, and Pathak are considering in their paper in this issue of Pharmacy Practice Management Quarterly. These authors give several important messages to practitioners seeking to serve their patients by incorporating quality of life into their practices. The key message in the paper is that to better understand and determine the impact of treatment on a patient's quality of life, it is critical to start with a baseline or reference point relevant to that patient. From that baseline or reference point, treatment decisions can be made and progress, in quality of life terms, can be evaluated. Critical questions in their framework, which is called the INCOMPASS (Individualized Client Oriented Method for Preferred Alleviation of Sickness States) Approach, are "How are you now?" and "How would you like to be?" The authors do not endorse particular quality of life tools in their approach; rather they prescribe certain critical questions that must be answered if information captured by any quality of life tool is to be useful at the patient level. Readers should not be put off by the fancy acronym used in this paper; nor must readers be keen students of quality of life to appreciate its message. The INCOMPASS approach is fundamental to good patient care and can be applied by practitioners with any level of understanding of and appreciation for quality of life assessments.
生活质量对研究人员和从业者来说都是一个引人入胜的领域。对一些研究人员而言，生活质量之所以令人感兴趣，是因为在构建工具以及获取回答有关健康、疾病和治疗的关键问题所需的数据方面，它带来了数不清的挑战。对于这些研究人员来说，生活质量关乎问题之间的统计关系，以及利用问题来界定健康的身体、社会和情感领域。对其他研究人员而言，这个领域是关于为生活质量评估所提供的信息在政策制定和治疗决策中找到实际应用。对这些研究人员来说，生活质量的重点在于应用有关患特定疾病和未患特定疾病群体之间生活质量差异的知识的方法，或者在于利用有关治疗如何影响不同患者群体生活质量的知识的方法。对从业者来说，生活质量关乎影响个体患者日常生活的治疗结果。在本期《药学实践管理季刊》中，芬德伯克、普莱尔和帕塔克在他们的论文中所考虑的正是从业者。这些作者向那些试图通过将生活质量纳入其诊疗实践来服务患者的从业者传达了几条重要信息。该论文的关键信息是，为了更好地理解并确定治疗对患者生活质量的影响，从与该患者相关的基线或参考点入手至关重要。从那个基线或参考点出发，就可以做出治疗决策，并从生活质量的角度评估进展情况。在他们名为INCOMPASS（以个体患者为导向的疾病状态优先缓解方法）方法的框架中的关键问题是“你现在怎么样？”以及“你希望自己怎么样？”作者在他们的方法中并未认可特定的生活质量工具；相反，他们规定了某些关键问题，如果要使任何生活质量工具所获取的信息在患者层面有用，就必须回答这些问题。读者不应被本文中使用的奇特首字母缩略词吓倒；读者也不必是生活质量方面的热心学生才能领会其信息。INCOMPASS方法对于良好的患者护理至关重要，并且任何对生活质量评估有一定理解和认识的从业者都可以应用。
