Developing attributes for a generic quality of life measure for older people: Preferences or capabilities?
Developing attributes for a generic quality of life measure for older people: Preferences or capabilities?
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DOI：
10.1016/j.socscimed.2005.08.023
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发表时间：
2006-04-01
影响因子：
5.4
通讯作者：
Coast, J
中科院分区：
文献类型：
--
作者：
Grewal, I;Lewis, J;Coast, J
目前联合王国在为老年人提供保健和社会照顾方面的政策表明，需要加强一体化。然而，经济学家协助资源分配决策的尝试非常注重健康，专注于使用与健康相关的生活质量指标。本文报告了一项尝试，旨在确定一个新指数的属性，该指数明确关注老年人的生活质量，而不是健康或其他对生活质量的影响。调查人员特意挑选了40位年龄在65岁或以上的私人住户，与他们进行了深度访谈，以了解他们对生活品质最重要的因素的看法。数据分析采用Framework定性分析。最初的讨论往往集中在影响生活质量的因素上，包括活动、关系、健康、财富和环境。进一步的探讨和分析，提出了依恋、角色、享受、安全和控制五个概念属性。数据还表明，告密者的生活质量受到追求这些属性的能力的丧失的限制。例如，降低生活质量的不是健康状况不佳本身，而是健康状况不佳对每个信息提供者的能力的影响，比如说，独立的能力，这是很重要的。Amartya Sen关于功能和能力的研究与此特别相关。利用这项工作，可以将这五个概念属性解释为一组功能-这对21世纪英国的老年人很重要-但注意到实现这些功能的能力似乎很重要。这表明，进一步发展这一措施应侧重于能力指数，而不是基于偏好的效用。(c) 2005 Elsevier Ltd版权所有。
Current UK policy with respect to the provision of health and social care for older people suggests that greater integration is required. Economists' attempts to assist resource allocation decisions, however, are very health focused, with concentration on the use of health-related quality of life measures. This paper reports an attempt to deter-mine attributes for a new index clearly focusing on quality of life for older people rather than health or other influences on quality of life. In-depth interviews were conducted with 40 purposively selected informants aged 65 and over in private households to explore their views about what is important to them in terms of quality of life. Data were analysed using Framework qualitative analysis. Initial discussions tended to concentrate upon factors influencing quality of life including activities, relationships, health, wealth and surroundings. Further probing and analysis suggested five conceptual attributes: attachment, role, enjoyment, security and control. The data also suggested that the quality of informants' lives was limited by the loss of ability to pursue these attributes. So, for example, it is not poor health in itself, which reduces quality of life, but the influence of that poor health upon each informant's ability to, say, be independent, that is important. Amartya Sen's work on functioning and capability is particularly pertinent here. Using this work, it is possible to interpret the five conceptual attributes as a set of functionings-important for older people in the UK in the 21st century - but noting that it is the capacity to achieve these functionings that appears to be of importance. This suggests that further development of this measure should focus on an index of capability rather than preference-based utility. (c) 2005 Elsevier Ltd. All rights reserved.