measures of subjective health status and quality of life. It has then described how the
shift from mortality rates to quality of life reflects a shift from implicit to explicit value, an
increasing subjectivity on behalf of both the subject being studied and the researcher,
and a change in the definition of health from a biomedical dichotomous model to a more
complex psychological one. Further, it has explored definitions of quality of life and the
vast range of scales that have been developed to assess this complex construct and their
use in research.ASSUMPTIONS IN HEALTH PSYCHOLOGY
The measurement of health status highlights some of the assumptions in health
psychology:1 The problem of methodology. It is assumed that methodology is separate to the
data being collected. Accordingly, it is assumed that subjects experience factors as
important to their quality of life even before they have been asked about them. It is
possible that items relating to family life, physical fitness and work may only become
important once the individual has been asked to rate them.
2 The problem of the mind–body split. Although much outcome research examines
both mortality and quality of life, it is often assumed that these two factors are
separate. Therefore, research explores the impact of an intervention either on an
individual’s quality of life or on their longevity. Very little relationship assesses the
impact of quality of life itself on longevity. Therefore, factors influencing the mind are
deemed to be separate to those influencing the body.
3 The problem of progress. Mortality rates were very much in vogue at the beginning
of the last century whereas quality of life measures are in vogue at the end of the
century. This shift is mainly regarded as an improvement in the way in which we
understand health status. However, rather than being an improvement, perhaps it
simply reflects a change of the way in which we make sense of what health is.? QUESTIONS
1 Mortality rates are the most accurate measure of health status. Discuss.
2 The views of the subject get in the way of measuring health. Discuss.
3 The views of the researcher get in the way of measuring health. Discuss.
4 To what extent is quality of life a useful construct?
5 Should all outcome research include an assessment of quality of life?FOR DISCUSSION
Consider the last time you felt that your quality of life was reduced. What did this
mean to you and would this be addressed by the available measures?394 HEALTH PSYCHOLOGY