Quality of Life: The Concept and Interventions

Abstract

Quality of life is one of the positive psychology concepts that gained popularity and acceptance in the second half of the twentieth century. Quality of life is a multifaceted concept that refers to the overall general happiness due to his subjective and objective evaluation of all aspects of his life. The quality of an individual’s life has multiple determinants, including values, goals, culture, and environment, in which the individual lives, desires, needs, and others. And the multiplicity of definitions of quality of life in the light of the theoretical approaches to its study led to the lack of agreement on a single definition of the concept of quality of life. An increasing number of studies have clarified the benefits of counseling interventions to improve the quality of life of members of society in all its groups, as well as the effectiveness of quality-of-life interventions in developing the positive traits of an individual’s personality. There is still an urgent need to study the impact of intervention strategies to improve the quality of life, especially for people with chronic diseases.

1. Introduction

Enjoying life, feeling upbeat and cheerful, having good physical and mental health, being content in all respects, and giving meaningful life purpose are all examples of having a high quality of life. The concept of quality of life related to positive psychology started to gain popularity in the latter half of the twentieth century.

According to global health experts, a person’s perspective of their living circumstances in the context of the culture and value system in which they live, as well as how this perception relates to goals, aspirations, and interests, makes up their quality of life. The concept of quality of life refers to the continuation of brainstorming and interest in creativity and innovation. It also means remaining appropriate in line with habits, skills, and tendencies relevant to emotion creation and emotional work, performance and learning climates, and a perspective on continuous improvement of performance as a way of life for individuals to meet their needs and desires in a balanced way [1, 2].

Arnout [3] mentioned that people’s quality of life and physical and psychological health had been impacted by climate change because of the growing strains and issues people face in the twenty-first century. To empower people to live healthy and happy, interventions are required to increase their quality of life. In this chapter, we go through the concept of quality of life and interventions that can be used to enhance people’s quality of life.

Many researchers (such as [4, 5, 6, 7, 8, 9, 10]) stressed that counseling programs could improve the quality of life. Thus, the followers of psychological studies notice a tremendous and growing interest in studying and improving the concept of quality of life. Arnout [3] pointed out that many countries have been interested in improving the quality of life of their citizens and made it one of the sustainable development goals (e.g., the Kingdom of Saudi Arabia’s program to improve the quality of life).

2. The concept of quality of life

One of the topics that have not often gained widespread attention is quality of life, whether at the level of scientific application or in terms of broad applicability in our daily lives. Quality of life is prevalent in many scientific fields. It is sometimes used to describe improvements in the quality of the material and social services offered to society’s citizens and to define people’s awareness of the degree to which these services can meet their diverse requirements. However, despite the concept’s modernity in handling, the users have yet to agree on a precise definition for this concept [11, 12, 13, 14, 15, 16].

The definition of the concept of quality of life differed from one researcher to the next due to differences in research specialization, theoretical orientation, and research objectives to be attained in each researcher’s study of the quality of life in humans with this term. On the one hand, it is challenging to reach an accord on quality of life since it is seen as an ambiguous notion and because there is not a broad consensus on a specific definition [16, 17, 18, 19, 20, 21].

Numerous philosophers and academics have historically expressed an interest in the study of quality of life, according to Zuna et al. [22]. The Greek philosophers Plato and Aristotle first thought of the quality of life. As a result, many perspectives developed, each based on his field of specialization [23, 24, 25]. Because psychologists have neglected positive psychology for a long time, there is an increasing interest in investigating the quality of life and the related factors, such as life satisfaction, happiness, the meaning of life, self-efficacy, and meeting needs [1, 2].

Emerson claimed that a person’s quality of life is based on how content they are with their values, goals, and wants resulting from developing their abilities and potential or adopting a particular way of living. According to Proshanky and Fabian [24], a person’s quality of life is a function of the actual environmental conditions in which they live and how they feel and experience those surroundings. Tartar et al. [21] mention that quality of life is a complicated idea that includes a person’s behavioral and cognitive talents, psychological health, capacity to interact with his surroundings, and social and professional responsibilities. Taylor and Bogdan reported that a person’s quality of life is based on how happy they are on the inside and how satisfied they are with their life’s circumstances and fortune. Reidulf et al. reported that a person’s quality of life is determined by how much they use the real opportunities in their existence; feeling content and achieving some benefits are two components of that satisfaction.

Felce and Perry [26] defined the quality of life as the overall general happiness that results from the subjective and objective evaluation of physical, material, social, and emotional happiness side by side after a person’s level of personal development and his purposeful activities, all of which are evaluated in terms of the person’s value system. Similarly, Schalock defined quality of life as the demands that a person wishes or desires in their life that are connected to eight aspects of that person’s life: bodily happiness, self-orientation, social security, and social rights. According to the World Health Organization, a person’s understanding of where they fit into the society and system of values in which they live as well as how they relate to their own goals, standards, expectations, and interests make up their quality of life. Furthermore, “quality of life” is a multifaceted concept that depends on a person’s values and includes both subjective and objective indicators, according to Hass.

Quality of life refers to a person’s life in general rather than one specific component without the other, according to Hegerty et al. Rejeski and Mihalko [12] defined quality of life as the assessment or emotional, cognitive appraisal of a person’s satisfaction with their life. Schalock et al. [14] mentioned that the notion of quality of life had become a focus of research and application in the last 20 years in the domains of education, special education, physical and behavioral health care, social services (for the elderly and those with special needs), and families. In light of this, he contends that even if the quality of life was divided into many dimensions, these measurements should display the composite or overall image of the quality of life. The person’s physical, social, and psychological quality of life is affected by their personal experiences, beliefs, and perceptions of themselves, others, and the world in which they live [16, 27, 28].

There are several main trends in the theoretical perspective in defining the quality of life. According to the philosophical perspective, the idea of quality of life led to the placement of the concepts of happiness within the well-known pragmatic trilogy. This trilogy holds that an idea cannot become a belief unless it demonstrates its success on the practical level or the immediate value rather than the cash value (utilitarianism). The practical level is closer to the ideas of happiness and personal well-being than to any other idea. Another philosophical perspective views the quality of life as “a paradox of reality in the sense of imaginary and dreamy happiness in which a person lives in a state of freedom from the captivity of reality and soars into an ideal space that pushes man to transcend that stifling reality and let go for moments of a rich creative imagination.” According to this perspective, the quality of life is “a state of freedom from the captivity of reality in which a person lives in a state of imaginary and dream” [1, 2, 26, 29, 30, 31].

Also, the term “quality of life” is defined from a social perspective, focusing on the family and society, interpersonal interactions, cultural norms, population, money, work, workplace demands, and other social elements. Numerous societal measures of people’s quality of life include happiness, satisfaction with oneself and others, positive social relations, awareness of the feelings of others, control of emotions, the internal control of behavior, personal and social responsibility, participation in cooperative work, loyalty and belonging to family, city, and country, personal, social, health, family, and professional compatibility, and optimism [18, 19, 24].

A basic definition of quality of life in the medical field was provided by Walker and Rosser, who stated that it is a concept that encompasses a wide range of physical and psychological characteristics and limitations that describe a person’s capacity for performance and satisfaction of his work-related desires. This means that quality of life refers to health-related issues, such as the impact of disease and available treatment on health beliefs and a better quality of life [6, 25, 32].

Also, the Encyclopedia of Psychology describes the quality of life as a psychological concept into seven axes: emotional balance consists of controlling positive and negative emotions, such as sadness, depression, anxiety, and psychological stress. A dynamic notion, psychological well-being also involves many beneficial psychological elements and is related to an effort to track: How do people view or value the various facets of their psychological lives? How much do people feel they influence certain parts of their daily lives, for instance? How much do people believe their personal lives are meaningful and valuable? How much do people feel they have mutually beneficial social interactions with others? [1, 26, 27, 33, 34].

We can conclude that the concept of quality of life is multidimensional and differs from person to person depending on how they view elements of life, such as religious, psychological, medical, and social dimensions. According to this viewpoint, a person’s quality of life is defined as living in good physical, mental, and emotional health to a degree of acceptance and satisfaction, being strong-willed and steadfast in the face of pressures, having high self and social efficiency, and being satisfied with his family, career, and community life [35, 36].

3. Quality of life interventions

The most valuable human asset is probably one’s health. Despite the apparent importance of health, studies of people’s preferences for various states of life reveal that almost everyone ranks health as the most essential. The first of two recurrent themes in definitions of health is early death, and the second is quality of life. Al-Ghamdi [37] mentioned that health psychologists have recently understood how crucial it is to assess and improve the quality of life. Numerous serious illnesses, such as arthritis, heart disease, diabetes, and digestive issues, are rated according to how they affect people’s quality of life and life expectancy, affecting their mental health. For example, a person with heart disease could encounter restrictions on living activities due to their condition, and illness or incapacity might also make it less attractive. The degree to which a person’s quality of life improves following therapy for specific disorders can also be used to evaluate the effectiveness of the treatment [16, 19, 32].

Societies today face many stresses and daily quarrels that affect citizens’ quality of life. Quality of life is essential in interacting with individuals and their positivity with others and the society around them. Therefore, the availability of quality of life to a large extent has a positive impact on society, where individuals are more positive and more involved in achieving society’s goals and contributing to their progress and prosperity. Quality of life is one of the critical topics related to mental health and positive psychology, which helps individuals adapt to the different situations they are exposed to in their daily lives.

Given the importance of the quality of life for individuals and societies to achieve sustainable personal and community development, the researchers sought to design programs based on behavioral therapy, cognitive-behavioral therapy, meaning therapy, reality therapy, and others to improve the quality of life for individuals.

By reviewing the literature about quality of life in the Arab world, a growing literature has examined the effectiveness of interventions in improving the quality of life for different individuals, such as mothers of cancer patients, as Abu-Ghazaleh’s study [38]. Also, students such as El-Safty’s study findings [39] demonstrated a program’s ability to improve the social life of senior students. Al-Wolani’s study [40] discovered the value of training in improving university students’ quality of life. In addition, for the individuals with special needs and their siblings with down syndrome, the study conducted by Al-Ghamdi [37] sought to determine the efficacy of a counseling program in enhancing the quality of life for common siblings with down syndrome and its influence on the growth of adaptive behavior skills for mentally challenged siblings with down syndrome. The findings showed that the counseling program enhances common siblings with down syndrome quality of life.

Mustafa’s study revealed that a counseling program could improve blind people’s quality of life. Additionally, Ayesh [41] demonstrated that the counseling program increased the quality of life for newlywed wives between the ages 25–35. The Shaheen study [42] likewise sought to determine the efficacy of a training program in improving the quality of life for gifted kids, and the outcomes demonstrated the program’s success in doing so. According to Al-Aour [43] and Al-Najaheh’s study, counseling programs are successful at fostering optimism and improving students’ quality of life. The goal of Al-Jawaziyyah’s [44] study was to evaluate how well a counseling program may enhance the quality of life for secondary school teachers. The findings of Muhammad’s study from 2019 demonstrated the value of a psychology curriculum based on an esthetic approach in helping secondary school pupils develop the aspects of their quality of life. The Al-Sibai study’s findings from 2019 also show how a program’s ability to foster emotional intelligence can enhance the quality of life for kids who struggle with reading. According to a recent study by Nasr [45], there is convincing evidence that moms of children with cerebral palsy experience psychological stress and a lower quality of life. The results demonstrated the program’s success in enhancing the experimental group’s quality of life and reducing psychological stress (Table 1).

Authors	Year	Interventions	Participants	Results
Hammerlid et al.	1999	A psychosocial intervention.	Patients with head and neck cancer.	Improve the patient quality of life.
Davis et al.	2001	A cognitive intervention consisting of training in face-name associations, spaced retrieval, and cognitive stimulation.	Patients’ probable Alzheimer’s disease.	Although the slight improvement in cognitive functions, improvement does not generalize to the patient quality of life.
DeSouza and Neary	2003	A nurse-directed intervention NDI.	Diabetic adults	Effectiveness of the NDI in improving the quality of life of diabetic adults.
Blissmer et al	2006	A clinical weight loss intervention.	Overweight and obese adults	Increase in the physical and mental composite indices as well as physical functioning, general health, vitality, and mental health indicators.
Giese-Davis et al.	2006	A 6-month peer counseling intervention.	Diagnosis breast cancer	Peer navigation may halt a decline in quality of life.
Grave et al.	2007	Community occupational therapy	Dementia patients and their caregivers.	Improvement in patients’ quality of life (effect size 1.3) and caregivers’ quality of life (effect size 1.2).
Meguro et al.	2008	A comprehensive approach to donepezil and psychosocial interventions.	Patients with Alzheimer’s disease.	Improving the patient’s quality of life.
Hoe et al.	2009	A cognitive interventions.	People with dementia living in care homes.	Improvement in cognition and mood may lead to increased QoL.
Koff et al.	2009	A proactive integrated care.	Patients with COPD.	Increased in patients’ quality of life.
Lewis et al.	2010	A home telehealth.	Obstructive pulmonary disease.	Improving patients’ quality of life.
Imayama et al.	2011	A dietary weight loss and exercise interventions.	Overweight/obese postmenopausal women.	A combined diet and exercise intervention has positive effects on quality of life and psychological health.
Lee et al.	2011	A nurse-led cognitive behavior therapy.	Patients with breast cancer undergoing radiotherapy.	The quality of life of the experimental group was significantly higher than that of the control group.
Gard et al.	2012	A yoga-based program	Adults	Positive effects on improving quality of life.
Naumann et al.	2012	A counseling and an exercise intervention.	Breast cancer survivors.	Improving patients’ quality of life.
Badger et al.	2013	Two telephone-delivered interventions.	Latinas with breast cancer and their supportive partners.	Both Latinas with breast cancer and their SPs significantly improved virtually all dimensions of quality of life.
Kroenke	2014	A distance therapy—telemedicine or e-health approaches.	Patients outside the conventional in-person office-based visit.	Positive effects on improving quality of life.
Baruth et al.	2015	A physical activity program, through a 12-week home-based walking intervention plus brief telephone counseling.	Early-stage breast cancer survivors	Effect sizes were generally in the small to medium range in improving quality of life.
McDowell et al.	2015	A telemonitoring interventions.	Chronic obstructive pulmonary disease.	Improvement in several quality-of-life domains.
Rogers et al.	2015	A BEAT Cancer combined supervised exercise, face-to-face counseling, and group discussions with tapering to home-based exercise.	Breast cancer survivors	BEAT Cancer intervention significantly improved quality of life.
Abu-Ghazaleh	2016	A counseling program.	Mothers	Improve in mother’s quality of life.
El-Safty	2016	A recreational sports program.	Elderly	Effectiveness of the program to enhance the elderly’s quality of life.
Al-Wolani	2016	A happiness training program.	University students	Improving all domains of students’ quality of life.
Ayesh	2017	A counseling program.	Ordinary siblings	Improve the quality of life and fraternal relations.
Al-Ghamdi	2017	A counseling interventions	Teachers	Improving teachers’ quality of life.
Mustafa	2017	A counseling program	Blind adolescents	Improving the quality-of-life level.
Al-Aour	2018	A cognitive counseling intervention.	Adolescents	Effective intervention in improving quality of life.
Al-Jawaziyyah	2019	A realistic counseling program.	Married women	Improving women’s marital quality of life.
Al-Sibai	2019	A training program based on emotional intelligence skills.	Female students with learning difficulties in reading.	Effectiveness of the program to improve students with learning difficulties in reading quality of life.
Mohamed	2019	A psychology program based on the esthetic approach.	Secondary school students	Effectiveness of the program in improving students’ quality of life.
Dantas et al.	2020	An intervention group.	Older adults in a primary care setting in Brazil.	Improvement in several quality-of-life domains.
Cian et al.	2021	A counseling interventions.	COVID-19 patients	Improvement in several quality-of-life domains.
Gustafson et al.	2021	A web-based eHealth intervention.	Older adults with multiple chronic conditions.	Improved the quality of life.

Table 1.

A review of studies that examined the effectiveness of quality-of-life interventions.

It is clear from the results of the above studies that interventions to improve the quality of life among Arab citizens are effective for all groups of individuals of all ages and demographic characteristics. Also, these studies indicated that there is still a need for studies on quality-of-life interventions in the Arab world, especially for individuals who suffer from chronic diseases, patients with different types of cancer, diabetes patients, people with various mental and physical disabilities, and adults with psychological problems, Alzheimer’s disease, and Dementia.

In developed countries, such as Europe and the United States of America, studies have found the effectiveness of quality-of-life interventions with different groups of individuals. Many studies revealed the effectiveness of interventions in improving the quality of life among cancer patients [17, 34, 46].

Many studies found that quality-of-life interventions, such as peer-led education, telephone and videophone, counseling and cognitive interventions, peer-counseling, and nurse-led cognitive-behavior therapy, are effective for breast cancer patients and breast cancer survivors [13, 18, 20, 47, 48, 49, 50, 51, 52, 53, 54, 55]. Also, [29] improved patients’ quality of life with chronic conditions through integrated care interventions.

There is a growing literature on the effectiveness of quality-of-life interventions for patients with chronic obstructive pulmonary disease [25, 56, 57, 58, 59, 60, 61].

The results of several studies indicated the effectiveness of interventions in improving the quality of life for dementia and Alzheimer’s patients [8, 9, 62]. The study by Qian et al. [63] and Chen et al. [5] found a statistical effect of interventions to improve COVID-19 patients. Also, there is increasing theoretical literature indicating the effectiveness of interventions to improve overweight/obese women [4, 64] and also improve diabetes patients [65].

Interventions can also improve the quality of life among older people [7, 10, 32], as well as interventions are effectively to enhance young adults’ quality of life [6].

4. Conclusions

There are growing studies on quality-of-life interventions. And the studies conducted on the effectiveness of quality-of-life interventions in European and American countries were on large scale, and they included different samples of normal individuals who suffer from physical, mental, and psychological diseases. In the Arab countries, studies of quality-of-life interventions were less comprehensive for specific types of individuals, especially patients. In general, most of these studies used the experimental and quasi-experimental quantitative methodology. However, we still need to use the mixed research methodology further to expand the study of the interventions’ effectiveness.