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One Size Doesn't Fit All: Clinician Perspectives on Using Health-Related Quality of Life for Service Evaluation in
Laura Ryan1, Caitlin Brandenburg1,2, Karen Spence3
1Allied Health Research, Gold Coast Hospital and Health Service, Southport, Australia.
Rationale:
Health-related quality of life (HRQoL) offers a framework for assessing the impact of health conditions and treatments on a patient's overall well-being. It also holds the potential to evaluate the effectiveness of hospital and health services. However, this approach lacks evidence to fully support its widespread adoption.
Aims And Objectives:
To explore current HRQoL practices and clinician attitudes toward standardising HRQoL instruments for service evaluation across a diverse range of in-scope community health services.
Methods:
Semi-structured interviews were conducted with 20 senior clinicians from community health services. An interview guide was used, and interviews were recorded, transcribed, and analysed using content analysis to identify key themes and insights.
Results:
The average interview time was 20.1 min (SD = 4.6). While some HRQoL instruments were used, others had been discontinued due to limitations in relevance or effectiveness. Informal HRQoL assessments were commonly used alongside other instruments to gather broader insight into patient well-being. There was support for a holistic approach to service evaluation, emphasising comprehensive, contextually relevant assessments that are user-friendly and evidence-based. However, participants also raised several limitations to using HRQoL for service evaluation, such as the potential for misleading information, implementation difficulties, and risks to patient care. Participants identified 33 potential domains to be measured to demonstrate service success, with the most frequently cited being mental health, social connections, ability to perform daily activities, leisure pursuits, mobility and feeling supported.
Conclusion:
Findings underscore the need for balanced and meaningful assessment instruments that accurately capture the full scope of patient well-being for evaluation purposes. No single HRQoL assessment instrument is likely to address the needs of services providing care for patients with complex and varied conditions. It is essential to use assessment instruments tailored to individual patient cohorts, resonating with clinicians and patients.
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