Developing the Capability Approach to Assess Quality of Life in Patients With Chronic Pain
Posted: 20 Jun 2007
Date Written: June 12, 2007
Between seven and ten percent of the UK population suffers from chronic pain. Previous studies have reported that sufferers experience a self-enforced withdrawal from usual activities related to work, pleasure and family; this withdrawal is a source of major concern, social isolation and hardship.
The aim of this study is to discover how chronic pain impacts on patients' quality of life. QALYs have become the standard outcome measure used for economic evaluations, but may be too narrow a measure to assess the full impact of chronic pain. So-called measures of quality of life, such as the QALY, are being increasingly challenged on the grounds that they measure influences on quality of life, e.g. the symptom of pain, rather than quality of life itself. Pain is subjective, the degree of pain an individual experiences can vary over the course of a day, whereas the impact that this combination of pain and uncertainty has on the individual's daily activities and relationships is more stable and of greater concern to the individual.
This study will avoid focussing solely on health and will consider ability to lead a life that the individual has reason to value. The project involves a practical application of Amartya Sen's capability framework. Capabilities will be presented which are important to individuals with chronic pain and which have been identified through a series of six focus groups involving patients with chronic pain. The questionnaire incorporating these capabilities will be presented, along with preliminary analysis of results from the pilot stage. The questionnaire will be used in the future alongside EQ-5D to enable a comparison of results from the two instruments. Patients themselves will be involved in reviewing the two sets of results.
Keywords: Chronic Pain, Capability, QALYs
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