1Department of Psychology, Panteion University, Athens, Greece
2General Hospital “Sotiria”, Athens, Greece
*Corresponding author:
Paraskevi Theofilou
Department of Psychology
Panteion University
Athens, Greece
E-mail: theofi@otenet.gr
Received August 06, 2012; Accepted August 08, 2012; Published August 10,
2012
Citation:Theofilou P (2012) Assessing Health - Related Quality of Life using
the Missoula - Vitas Quality of Life Index (MVQOLI). J Clin Trials 2:e104.
doi:10.4172/2167-0870.1000e104
In recent years, much attention has been focused on exploring the
impact of physical and mental illness on overall quality of life (QOL).
The switch to the measurement of psychosocial issues in addition to
biomedical measures has been shown to play an important role in
ensuring positive patient outcome from both a clinician’s and patient’s
perspective, and is an important outcome measure when evaluating
treatment [1-3]. In addition, ongoing evaluation of QOL in normal
healthy individuals and specific general populations, such as the
elderly, has also received attention. It has previously been argued that
due to the subjective nature of an individual’s ‘quality of life’, this is a
difficult concept to measure and to define, but that in general terms it
may be viewed as a multidimensional concept emphasizing the selfperceptions
of an individual’s current state of mind [2-4].
Health Related Quality of Life (HRQOL) is concerned specifically
with health aspects while also accounting for general QOL components.
HRQOL has been understood in several different ways and so has been
measured using a variety of instruments [5,6]. McDowell and Newell
[7] for example suggest that there is little difference between general
health and QOL, and that the two can be measured in similar ways. On
the other hand, Mathers and Douglas [8] draw the distinction between
observable objective measures of health status, such as in a clinical
profile and an individual’s perception about the quality of their life. A
range of definitions for HRQOL have been applied in the development
of HRQOL instruments, for example, an individual’s definition of
their overall satisfaction with life, or, a sense of personal psychological,
physical and social well-being in being self-determining, independent
and satisfied with control of disease processes [5,9,10].
At the current time, there are in excess of 1000 instruments [11],
designed specifically for the measurement of QOL. Some of these
are generic, for use in the general population and can be applied to
a number of conditions; others are disease specific, pertaining to a
particular pathology. It is important to note however, that QOL might
be experienced differently and encompass different values within and
across different cultural groups and country populations; in addition
there are often discrepancies between QOL evaluations from people
with a form of somatic or psychiatric illness, and the general public
[11]. Further, frequency of use does not necessarily mean the best or
most appropriate use, and there are many publications purporting to
measure HRQOL that have not in fact employed instruments with
robust psychometrics or valid collection methods. As it is said before,
various QOL measurement tools have been designed but most may
not be ideal for use in palliative care patients, whose QOL assessment
should focus on areas for which palliative care is most effective, such as
psychosocial and spiritual problems [12,13].
In response to the need for a QOL measure that assesses the
individual experience of people nearing the end-of-life (EOL), Byock
and Merriman [13] created the Missoula - VITAS Quality of Life Index
(MVQOLI). The MVQOLI is an assessment instrument that gathers
patient - reported information about QOL during advanced illness.
Maintaining optimal QOL is a core goal of palliative and hospice
care, and information gathered via the MVQOLI assists health care
professionals in identifying and addressing patient concerns that affect
QOL. The MVQOLI has been used in many different healthcare settings
including hospice, hospital, home health, long-term care (including
assisted living), outpatient palliative care, disease management and
pre-hospice programs [14].
The framework of the MVQOLI is based on Ira Byock’s work
regarding growth and development at the end of life and the concepts
of landmarks and tasks of life closure [14]. The MVQOLI asks
patients about 5 dimensions or domains of QOL: symptoms, function,
interpersonal, well-being and transcendence. The instrument is
specifically designed to assess the patients personal experience in each
of these dimensions, hence the MVQOLI items are constructed with
highly subjective language and no scores appear on the version of the
tool seen by patients [15,16]. The tool seeks to describe the qualitative
and subjective experience of QOL in a way that can be quickly
interpreted by professional caregivers.
The MVQOLI has been translated into English as well as Spanish
language respectively. Recently, Theofilou et al. [16] have translated it
into Greek language and now it is under validation.
Theofilou P, Kapsalis F, Panagiotaki H (in press) Greek version of MVQOLI - 15: Translation and cultural adaptation. International Journal of Caring Sciences.
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