Sprangers Mirjam A G, Schwartz Carolyn E
Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands.
Health Qual Life Outcomes. 2008 Nov 2;6:89. doi: 10.1186/1477-7525-6-89.
The field of health-related quality of life (HRQOL) could benefit from a broadening of perspectives to include recent advancements in research on adaptation, positive psychology, and genetics. These advances shed new light on the extent to which HRQOL is changeable or fixed. The objective of this paper is to integrate these insights and to discuss their implications for HRQOL research. We describe the Hedonic Treadmill theory, which asserts that positive events only temporarily affect happiness since people quickly return to hedonic neutrality. New empirical evidence suggests important revisions of this theory, providing a more optimistic picture of the possibility for change. Advances in positive psychology show that relatively simple interventions have the power to induce a sustainable increase in levels of happiness. Finally, a small but growing number of studies have found independent genetic influences in well-being, life satisfaction, perceived health, and even HRQOL. Given the increasing empirical evidence that HRQOL can be sustainably enhanced and is in part genetically determined, it may be useful to consider HRQOL as a concept that has state (environmental) and trait (genetic) components. This distinction will allow us to explore new pathways of improving theory, methods, and clinical practice. The overarching novel questions concern the extent to which HRQOL components are environmentally or genetically determined, and which factors lead to lasting improvement. This distinction begs for new research approaches, such as time-sampling techniques and interdisciplinary research investigating the genetic variants of HRQOL. Distinguishing between those aspects that are amenable to change from those that are relatively fixed and stable will help better target specific support interventions.
健康相关生活质量（HRQOL）领域可从拓宽视角中受益，将适应、积极心理学和遗传学研究的最新进展纳入其中。这些进展为HRQOL在多大程度上可变或固定提供了新的见解。本文的目的是整合这些见解，并讨论它们对HRQOL研究的影响。我们描述了享乐跑步机理论，该理论认为积极事件只会暂时影响幸福感，因为人们很快就会回到享乐中性状态。新的实证证据表明该理论需要重大修正，为变化的可能性描绘了一幅更乐观的图景。积极心理学的进展表明，相对简单的干预措施有能力可持续地提高幸福水平。最后，越来越多的研究发现基因对幸福感、生活满意度、感知健康甚至HRQOL有独立影响。鉴于越来越多的实证证据表明HRQOL可以得到可持续提高且部分由基因决定，将HRQOL视为一个具有状态（环境）和特质（基因）成分的概念可能会有所帮助。这种区分将使我们能够探索改进理论、方法和临床实践的新途径。首要的新问题涉及HRQOL各组成部分在多大程度上由环境或基因决定，以及哪些因素会带来持久改善。这种区分需要新的研究方法，如时间抽样技术和跨学科研究，以探究HRQOL的基因变体。区分哪些方面易于改变，哪些方面相对固定和稳定，将有助于更好地针对特定的支持干预措施。
