Toward an Interdisciplinary Framework For Examining Quality of Life

Stephen C. Cosmas, Virginia Polytechnic Institute and State University
A. Coskun Samli, Virginia Polytechnic Institute and State University
H. Lee Meadow, Virginia Polytechnic Institute and State University
ABSTRACT - Quality of life is an important concept in the study of human behavior. Its value is further enhanced when the concept is viewed from an interdisciplinary perspective. This paper presents a synthesis of quality of life research and provides a preliminary interdisciplinary framework for consumer researchers to examine and utilize the quality of life concept.
[ to cite ]:
Stephen C. Cosmas, A. Coskun Samli, and H. Lee Meadow (1980) ,"Toward an Interdisciplinary Framework For Examining Quality of Life", in NA - Advances in Consumer Research Volume 07, eds. Jerry C. Olson, Ann Abor, MI : Association for Consumer Research, Pages: 582-587.

Advances in Consumer Research Volume 7, 1980     Pages 582-587

TOWARD AN INTERDISCIPLINARY FRAMEWORK FOR EXAMINING QUALITY OF LIFE

Stephen C. Cosmas, Virginia Polytechnic Institute and State University

A. Coskun Samli, Virginia Polytechnic Institute and State University

H. Lee Meadow, Virginia Polytechnic Institute and State University

ABSTRACT -

Quality of life is an important concept in the study of human behavior. Its value is further enhanced when the concept is viewed from an interdisciplinary perspective. This paper presents a synthesis of quality of life research and provides a preliminary interdisciplinary framework for consumer researchers to examine and utilize the quality of life concept.

INTRODUCTION

Liu (1975) stated that the Quality of Life concept (QOL) is merely a new name for an age old concern. For an individual or for a group of individuals, QOL indicates a set of wants, that if fulfilled satisfactorily would provide happiness and satisfaction (Withey 1975). But since wants vary across individuals, and these wants are often difficult to establish or measure adequately, the QOL concept has not been well-established, or well-defined (Campbell, Converse and Rogers 1976; Ackoff 1976; Gerson 1976; Schneider 1976; Arndt 1978; Mulvihill 1978). Yet, the fact than an acceptable QOL construct has not been developed which can take into account variations does not mean one could not be developed (Liu 1975).

Gerson (1976) has pointed out three separate approaches which have been used to conceptualize QOL: individualist, transcendental, and commitment and negotiation. The first two approaches may be considered "static" in that they focus on individuals at a point in time. The third approach may be considered "dynamic" as the process of negotiations between individuals and society is conceived to be an ongoing proposition. In addition, such outcomes pinpoint the "sovereignties" of individuals in settings. Sovereignties are commitments made by individuals within and among settings, while patterns of commitments are examined by the joint allocation of money, time, skill and sentiment (Gerson 1976).

Without particularly ascribing to any one of the three conceptual approaches to the QOL concept, it would seem that the third process of commitment and negotiation is a more fruitful approach to the study of QOL. The reason for this is that the study of individuals, regardless of whether one is studying QOL or any other social phenomenon, is best viewed over time in the context of individuals' interactions with their environment. In this way, individuals can be viewed at both a point in time (e.g., health status), and over a period of time (e.g., through the stages in the family cycle). This will reorient the research which has during the past decade and a half been concerned with the technical aspects of measuring the QOL (e.g., income).

Before a preliminary framework for examining QOL can be developed, it is necessary to review relevant past research avenues. In pursuing the interest in the QOL, social scientists and economists have dwelled upon a variety of measures which can be grouped into approximately five areas.

1.  Social Indicators (Bauer 1966; Andrews 1973; Land and Felson 1976)

2.  Economic Measures (Morgan and Smith 1969; Bratt 1971; Moon 1977)

3.  Life Satisfaction (Neugarten, Havighurst and Tobin 1961; Spreitzer and Snyder 1974; Chatfield 1977)

4.  Life Styles (Booz-Allen 1973; Wells and Cosmas 1977)

5.  Measures of Equal Opportunities to Consume (Samli 1967; Samli and Palubinskas 1972)

Unfortunately, with the exception of the life satisfaction research, the other approaches have not been utilized to examine QOL in any systematic manner. Thus, it becomes necessary to examine the five approaches individually as to their applicability to measuring quality of life, so that a proper framework could be developed.

This paper attempts to conceptualize a framework which could provide direction and prioritization for future QOL research attempts by consumer behaviorists. In so doing, equal emphasis is put on normative and positive qualities of QOL. Without positive features, which detect the current state of affairs accurately, it is not possible to develop normative measures. Specifically, this paper examines three areas:

1.  What are the key approaches to measuring the QOL?

2.  How applicable are these approaches?

3.  Can the key approaches be synthesized so that one particular model may be developed?

Thus, this paper is an exploration of the state of the art with significant orientation towards future research. As such, this paper raises many issues and makes related assertions, rather than providing empirical verification in answering many of the questions about quality of life.

THE KEY APPROACHES TO THE STUDY OF QOL

As mentioned earlier, five specific approaches to measuring the QOL have been identified. This section presents a brief discussion of each approach. For a more detailed discussion, see Samli, Cosmas, and Meadow (1978).

Social Indicators

Social indicators (SIs) basically refer to group of criteria measuring social conditions (Land and Felson 1976). These criteria were designed to measure the well-being of people and the quality of the environmental setting in which they live (Liu 1975). While these attempts in developing SIs were quite general and in the direction of measuring the objective evidence of social well-being, other attempts branched off into more specific areas of life quality. As the branching-off process proceeded, more and more attempts were made to measure the subjective evidence or perceptual quality of life (Andrews 1974; Withey 1975; Campbell 1976). Table 1 illustrates some of the key criteria used in SI literature which relate to the individual and the environment.

The upper section of Table 1 presents the objective SIs both from an environmental and individual perspective. The lower section of Table 1 illustrates SIs which have been termed subjective. These and many others have been utilized by SI researchers in measuring individual perception indications of life quality (Zapf 1975). Since most are essentially self-explanatory, a detailed discussion has been omitted. However, it should be noted that the labels of objective and subjective have been deemed by some SI researchers as misleading and somewhat arbitrary.

It is the authors' position that the real contribution of social indicators has arisen from the search for objective criteria. Since there are numerous objective indicators available, it is necessary to screen them on the basis of their usefulness to research efforts. There are three major criteria which can be used to screen the best indicators: measurability, social importance, and policy importance (Clark 1973).

Although valuable, SIs have serious limitations, among which are: (1) vagueness of concepts, (2) possible conflict with political ideology, (3) their usefulness and applicability, and (4) limitations in conceptualization and methodology (Sheldon and Freeman 1970, Gross and Straussman 1974; Zapf 1972); they are important to QOL research. The question then arises of how they would fit into a conceptual research framework. This question is not readily apparent, but attempts will be made to integrate them. Yet, one thing is readily apparent; SI research relating to either objective and/ or subjective criteria is not sufficient, in and of itself, to assess quality of life (Day 1978). The authors feel the reason for this is that SIs are not comprehensive enough for valid and reliable measurement of such a complex phenomenon as QOL. In addition, SIs deal with only one aspect of QOL, i.e., they are primarily concerned with the availability of social goods as they relate to QOL.

TABLE 1

SOCIAL INDICATOR CRITERIA

Economic Measures

Economic well-being or economic well-offness is perhaps the oldest way of assessing QOL, though not the most definitive. There have been many approaches to measuring this phenomenon (e.g., Morgan and Smith 1969; Wingo 1973; Liu 1977; and Moon 1977 among many others).

Among these many attempts, Moon's (1977) approach is perhaps the most meaningful in regard to QOL. As a theoretical foundation, Moon asserts that a measure of potential consumption is a better measure than the current annual money income, as a measure of economic status. In addition, Liu (1977) maintains that "income beyond a certain level, bears little ascertainable relationship to the quality of life." These two theses modify the role of economic measures in the evaluation of QOL.

Moon (1977) further states that in order to derive an empirical approximation of the potential consumption measure, a number of adjustments should be made to annual money income, as a measure of economic status. These adjustments are fourfold:

1.  a computation for net worth which includes home equity,

2.  the estimated cash value of three in-fund transfers: Medicare, Medicaid and public housing,

3.  the subtraction of an estimate of income and payroll taxes paid,

4.  the addition of the estimated intra-family transfers

Further, the economic measures to determine QOL can be used singularly or in combination with the following groups: current annual money income, potential consumption, and micro and/or macro criteria.

Yet, as with SIs, economic measures by themselves are not sufficient criteria for determining the QOL. They tend to suffer from two serious shortcomings: (1) they typically are too far removed from the individual level, i.e., they are more appropriate as aggregate measures, and (2) they view QOL as primarily a result of economic criteria which are marginally less important as individuals reach a desired status.

Life Satisfaction

This complex concept finds its origin in numerous attempts to measure the psychological well-being of older people (Neugarten, Havighurst and Tobin 1969). Life satisfaction is a rating approach in analyzing people's perception of the quality of their own lives (Neugarten, Havighurst and Tobin 1961; Adams 1969; Withey 1975; Clemente and Sauer 1976).

Originally, the life satisfaction rating focused upon the measurement of an individual's internal frame of reference (Neugarten, Havighurst and Tobin 1961). In attempting to measure the internal frame of reference of the psychological well-being, interviewers were used, and two separate rating scales were developed and called Life Satisfaction Ratings (LSRs). Both of these scales included five key polar factors: zest vs. apathy; resolution vs. fortitude; goal achievement vs. failure to achieve; positive self concept vs. negative self concept; and positive mood tone vs. negative mood tone (Neugarten, Havighurst and Tobin 1961).

Subsequently, most LSR studies have compared LSRs with a wide array of possible correlates in order to completely analyze, measure and compare the state of life satisfaction. The correlates found can be categorized into three separate groups: engagement; life adjustment; and health and socio-economic status. Each group of correlates reflects some measure of the world in which individuals live, and represent attempts at extending LSR usefulness. Table 2 presents a summary of these variables as they fit into life satisfaction measurement.

The first group, the engagement correlates (referring to individual's interactions with others) were researched by Tobin and Neugarten (1961). Their research indicated life satisfaction was positively correlated with the quality of interactions, i.e., when life satisfaction is positive then the individual will have positive interactions. Similarly, social life space (those others in the individual's interaction world) was positively correlated with life satisfaction as measured by the number of interactions with others as observed by interviewers.

The third correlate, social roles (others' behavioral expectations about others) had a positive correlation with life satisfaction as measured by the number of social roles engaged in by an individual. Finally, perceived life space showed a negative relationship to life satisfaction as measured by an individual's concept of life space, not rater judgment.

The second group, life adjustment correlates have been examined by Kurtz and Kyle (1977) and Kurtz and Wolk (1975) and includes seven levels of health and strength, economic conditions of individuals, establishment of new relationships, death of spouse, retirement activity, living arrangements, and dependence on others. Here, Kurtz and his co-authors found that there was a statistical relationship between LSRs and life adjustment correlates.

TABLE 2

COMPONENTS OF LIFE SATISFACTION RESEARCH

The third and final group, health and socio-economic status are perhaps the most popular of the LSR correlates. Here, there are seven general categories of correlates that have been examined: self assessed health, economic sufficiency (Spreitzer and Snyder 1974), socio-economic conditions (1973), personal background, informal kin interaction, informal nonfamilial participation (Edwards and Klemmack 1973), and health status (Palmore and Luikart 1972; Edwards and Klemmack 1973).

Despite great promise, two serious shortcomings can be attributed to LSR research: (1) there has not been a consensus as to how the individuals' perceptions of their life should be measured, and (2) the subjective nature of the technique in eliciting responses is open to questions of reliability (Neugarten, Havighurst and Tobin 1961; Clemente and Sauer 1976). However, life satisfaction does provide a partial measure of QOL, and some of the key components, as determined by these authors which could be used in a QOL model are shown in Table 3. As an additional note, there has been related research which could be a possible subset of life satisfaction research, i.e., consumer satisfaction/ dissatisfaction (CS/D) research. This research as articulated by Andreasen (1977) represents to some degree an aspect of QOL, but it has been omitted due to the fact that these authors feel its contribution to an overall measure would be minimal.

Life Styles

The concept of life style (LS) refers to "the distinctive or characteristic mode of living in its aggregative and broadest sense, of a whole society or segment thereof." The concept is concerned with "the unique ingredients or qualities which describe the way of life of some culture or group, and distinguish it from others." This concept, therefore, "is the result of such forces as culture, values, resources, symbols, license, and sanction" (Lazer 1964).

TABLE 3

KEY COMPONENTS OF LIFE SATISFACTION

One of the most common means of measuring life styles is through the measurement of a person's activities, interests and opinions (AIO's) (Hustad and Pessemier 1971; Reynolds 1973; Wells 1974 and 1975; Wells and Cosmas 1977). The use of AIO's to measure consumer's life styles was developed early in research on consumers from the work of Pessemier and Tigert (1966) and Wilson (1966).

Some of the key measures of activities, interests, and opinions are such factors as: (1) a person's activities in work, leisure, the community, shopping and sports; (2) a person's interests in home, family, shopping, fashions, and achievements; and (3) a person's opinions about self, significant others, social issues, advertising and products (Plummer 1974). From this perspective, life style research offers to add many insights into a person's QOL. In understanding QOL, it is necessary to make provisions for how people allocate their time and resources or what pattern of commitments they make. It may be that people of different life styles have different perceptions of QOL. If this is true, it may be necessary to determine what components of people's life style affect what aspects of their QOL.

Despite its potentials, life style research has a number of problems when it is considered for application to QOL assessment. A serious issue has been a common and acceptable definition (Ferber and Lee 1974). Methodological problems are equally serious (Cosmas 1977). The conceptual make-up and contents of the instruments used in life style research are still open to criticism in terms of their validity and reliability (Reynolds 1973; Wells 1974). Finally, life style is only one aspect of quality of life. It indicates the subjective values and preferences of an individual or group but does not make any reference to what the general QOL is or what it should be. As such, life style research provides a component (but only a component) of a QOL assessment activity.

Equal Opportunity to Consume

Equal opportunity to consume (EOC) implies that the quality of one's life is, at least partially, conditioned by the opportunity (or lack of it) that the individual has in obtaining economic goods and services. The opportunity to acquire goods and services is conditioned by a group of factors which have been developed by Samli (1972). These factors are:

1. Consumer protection. This essentially involves protection against unfair and unlawful trade practices. It implies that an access to legal protection and legal services is extremely important for preserving as well as promoting QOL.

2. Consumer information. It is already extremely difficult in a complex society to be a consumer. Specifically, one area of this complexity arises from the gathering of consumer information as to how to spend limited resources and gain protection from questionable business practices. This task is difficult for the average consumer, but especially difficult for a disadvantaged consumer who may have very limited means, mobility, and options.

3. Consumer choice. This involves the right to be able to select from a variety of products to fulfill one's needs in maintaining a quality of life. Although partially, it is a matter of education in order to find the right product or the right service, it is also up to the society to provide options.

4. Consumer communication outlets. It is most important that in a complex society consumers have names of key people and offices to call to register complaints as well as to receive advice and guidance. Existence of an adequate mechanism through which the rights of the individuals can be asserted by providing redress for legitimate grievances is still not as yet in existence. In recent years a variety of innovations such as free legal service for the poor, consumer class action suits and arbitration procedures have been initiated (Samli 1972). However, the awareness of some consumers of these innovations and their ability to take advantage of these is quite limited. Thus, it becomes clear that consumers do not necessarily have equal opportunity to receive communications which may lead to varying levels of input and overall QOL.

In looking at the above factors, it can be seen that they represent a means of assessing aspects of an individual's QOL not covered in other areas. However, there are two main problems associated with EOC: (1) lack of quantification, and (2) a lack of field tested results.

TOWARD A SUGGESTED FRAMEWORK

Each of the different approaches discussed so far, makes a contribution to the measurement of QOL. However, it is also apparent that none of the approaches by themselves can wholly explain the complex phenomenon of QOL. Thus, it is necessary to address the problem with a more comprehensive framework than is provided by the individual approaches. These authors maintain that by combining key aspects of the five approaches, it is possible to develop a model which would capture the essence of the concept of quality of life, while insuring sufficient coverage of the aspects so as not to overlook important facets. This combination involves both the normative and positive aspects of QOL and the most fruitful non-overlapping measures of each approach.

FIGURE 1

CONCEPTUAL QOL FRAMEWORK

This possible framework is illustrated in Figure 1. In this framework, it is hypothesized that QOL can be measured by a combination of the five approaches mentioned. In addition, this combination will result in a measure of QOL that will not lead to a case where the sum of the parts is less than the whole. The framework is also hypothesized to be able to measure QOL from both a macro and micro level. For a more detailed description of what aspects could be included in the general framework, a partial list of key independent variables are presented in Table 4.

The proposed conceptualization of a framework is ascerted to be comprehensive enough to assess the complex concept of QOL. Yet, it is at a simplified enough stage to be an initial step in an operationalization.

Conclusions

The framework suggested in this paper is still of a general nature. The attempt here was not to provide a fully conceptualized model, but a notion of a possible framework that would be comprehensive enough to be useful to researchers in terms of developing a workable QOL model.

The obvious next step in determining if the framework suggested is useful would be to begin a process of operationalizing and measuring to determine if the essence of QOL has been captured. This would involve determining how to integrate the various measurement approaches to QOL both at a macro and micro level.

TABLE 4

POSSIBLE KEY VARIABLES IN ASSESSING QOL

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