Chapter

Quality

pp 199-246

Date:

Symptoms and HRQOL Assessment

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Abstract

Should symptoms be included in an HRQOL assessment? This chapter addresses this issue using the research literature based on the assessment of fatigue and pain. It will become apparent that it is possible to assess the qualitative consequences of a symptom without having to relate it to HRQOL. Thus, a symptom, if qualified, can be a quality indicator. To achieve this first requires a shift in the semantics of symptoms with the incorporation of emotive determinants of symptoms (e.g., a shift from pain intensity to pain burden), and if this is followed by a valuation, then the components of a qualitative hybrid construct would be in place. I also discuss the role of modularity and how it can help in predicting different outcomes between symptoms, using fatigue, depression, and HRQOL as the model. Also discussed is the issue of how to assess pain in the compromised person.