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Updated: Aug 13, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Conceptual model of health-related quality of life
Carol Estwing Ferrans1, Julie Johnson Zerwic, Jo Ellen Wilbur
1University of Illinois, College of Nursing, Chicago, IL 60612, USA. cferrans@uic.edu
Purpose:
To revise the Wilson and Cleary model of health-related quality of life (HRQoL), with suggestions for applying each of the components, and to facilitate the use of HRQoL in nursing and health care.
Organizing Construct:
HRQoL, based on relevant literature over the past 20 years.
Methods:
The original model was revised in three substantive ways: (a) indicating that biological function is influenced by characteristics of both individuals and environments; (b) deleting nonmedical factors; and (c) deleting the labels on the arrows that tend to restrict characterization of the relationships.
Findings:
Theoretical background is provided for each of the major components of the model, and examples of instruments to measure them, were added.
Conclusions:
In quality-of-life research, the current challenge is to devise models to clarify the elements of health-related quality of life (HRQOL) and the causal relationships among them. This revision of Wilson and Cleary's model includes a taxonomy of the variables that often have been used to measure HRQoL. This revision should be useful in research and clinical practice.
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