Introduction
Quality of life is the quality of an individual’s daily life indicates the assessment of quality of wellbeing and lack of wellbeing. Wellbeing of a person maybe in terms of physical and psychological aspects. In healthcare, health related quality of life (HRQL) is the assessment which shows how the wellbeing of an individual may be affected in the future by any disease, disorders or disabilities. This paper is a concept analysis of health related quality of life in young people who are suffering with chronic illness. Concept analysis is a way of deriving conceptual hierarchy from a collection of objects and their properties. Each concept in the hierarchy will be observed to hold a common set of properties.
Sections of this concept analysis paper will include:
- Aim: Describing the objective of the paper
- Literature Review: Discussion about scholarly articles on HRQL in young people with chronic illness. This section is to exhibit the gained knowledge about the concept.
- Uses: Uses of the selected concept.
- Defining attributes: Defining attributes of the selected concept.
- Model cases: Model cases explaining the selected concept.
- Alternate cases: Alternate cases (borderline, related, contrary, invented, or illegitimate) explaining selected concept.
- Antecedents and Consequences
- Empirical Referents
- Conclusion
Aim
The main objective of this paper is to perform a concept analysis and develop a definition applicable for young people suffering from chronic illness. Obesity is one of the common chronic illnesses observed among children and adolescents. There are many known health complications which are mainly due to obesity. The reasons for obesity and measures to be taken to control it will be discussed with the support of scholarly journals.
Literature Review
Obesity can be explained as a medical state in which, fat accumulates in the body to an extent that it may have adverse effects on health and leads to reduced life expectancy. It can be caused commonly by excessive food intake, lack of physical activity and genetic susceptibility. Few cases of obesity maybe primarily by genes, psychiatric illness, endocrine disorders. Obesity increases the likeliness of heart diseases, sugar, osteoarthritis, sleep apnea and certain type of cancers. Only nearly, 1% of the obesity cases are due to genes and other disorders. More calorie intake contributes to major reasons for obesity. A person is said to be obese, if the Body Mass Index (BMI) is above 30 kg/m2. Anything above 40 kg/m2 is considered as Class III obesity. According to National Health and Nutrition Examination Surveys (NHANES) (2009-2010), approximately 69% of adults are overweight or obese, with more than 78 million adult Americans considered obese.
Childhood obesity is increasing at an alarming rate in America since three decades. In 2010, nearly 18% of American children and young adults between the ages of 6-19 were considered obese. While genetics, individual behavior and surroundings play a role in obesity, rise in consumption of fast foods is partly to be blamed. Being obese in childhood has both short term and long-term impacts. Obese children are more prone to diseases like prediabetes, high cholesterol, high blood pressure, sleep apnea, heart diseases, bone and joint problems. Obesity does not affect physical health alone, but also affects the child’s mental health. They tend to have an inferiority complex and a sense of alienation from their peers.
Policymakers state that an aggressive action is to be taken to control the obesity epidemic in United States. Ann Ferris, Ph.D., a professor in medicine at the University of Connecticut Health Center and director for the Center for Public Health and Health Policy, is conducting a study to reduce consumption of sugar-sweetened beverages among low- income preschoolers, who have higher consumption rates and higher rates of obesity compared to those of high- income families. A school recently established a policy banning vending machines, and limiting snacks to fruits and vegetables. “Students are not allowed to have soda, and teachers are requested not to use sweets as reward in class.”, said Giraud, one of the teachers. Many schools, local governments and hospitals around the country have implemented similar policies to reduce the increasing rates of obesity. Several state and local governments have started implementing an excise tax on sugar-sweetened beverages. Researchers say, governments can help reduce obesity by providing supermarkets and farmers’ markets with incentives to offer healthier food in low-income areas, because low-income families are more prone to obesity.
Uses
Concept analysis on health related quality of life of young people with chronic illness has many significant uses like understanding the impact of illness, use of medical facilities in the treatment, compare HRQL of obese people and normal people. Two important uses will be discussed as follows.
- Impact of Chronic Illness. A recent study was conducted to investigate the impact of being obese and overweight on health related quality of life in western Sweden. It was found that, obese men in the age group of 16-34 rated their health lower compared to normal men of same age group on physical and mental health scales of SF-36. On the other hand, obese women of same age group rated their health worse than normal women of their age. It was found that massively obese men and women suffer from poor levels of HRQL. It was also found that, the impact of overweight and obesity differs by age and sex.
- Use of Medical Facilities. This study was conducted to investigate the scores of primary care in hospitals for people with one or more chronic illness. This report was useful to predict future hospital utilization and mortality. Survey participants were mainly senior patients who were dwelling in a community and were treated in primary care clinics. On the whole, non-responders of the survey were found to be older age with higher mortality rate and comorbidity score compared to those who responded. It is believed that this preemptive intervention of this study would change the course of disease in the population.
Defining Attributes
Considering HRQL as a National Health Standard may bridge the boundaries between social, mental and medical services. Most of the recent federal policy changes focus on the significance of measuring HRQL in order to support public health’s traditional measures of morbidity and mortality. It is related to both self-reported chronic diseases and their risk factors.
- Measuring HRQL. Measuring HRQL can help in determining the burden of diseases, injuries and disabilities which can be prevented. It gives an insight into the relationship between HRQL and associated risk factors. This measurement will help in monitoring the progress of nation’s health objectives. There are two basic approaches to measuring health related quality of life; generic instruments and specific instruments. Generic instruments provide HRQL in a generalized way. They include health profiles and health utility generating instruments. This approach is not mutually exclusive. Specific instruments measure HRQL of specified diseases, patient groups and areas of function. They are mutually exclusive in all ways. Each method has its own positives and negatives. Questionnaires which are self or interviewer administered can be used to measure HRQL of patients at a certain point of time. Longitudinal changes in HRQL can be noticed when measure over a period of time. This measurement primarily helps in patient management and policy decisions.
- Well-Being Measures. Well-being indicators measures when people possibly feel healthy, happy and satisfied. Most of the HRQL indicators miss to measure this factor. Positive evaluations of an individual’s life can include positive emotions in everyday life, participations in social life, satisfying relationship and overall satisfaction with his/her life. HRQL is reflected on every individual’s assessment of their health and social life. Social participation includes employment, civic, social and leisure activities. By operating HRQL through the aspect of participation, the quality of life will no longer be directly related to health or functional status. Instead it will depend on the ability of person to participate and mingle with the society and surrounding environment. The objective of this participation measure is to evaluate the individual’s ability to live a long and productive life. It is based on the principle that, a person with functional limitations can still live a long, productive and happy life.
Model Cases
- Drug Addiction as Chronic Disease. Substance use disorders (SUD) are more often viewed as chronic conditions. The models which were used to treat chronic conditions are being adopted for addictive conditions. These models indicate the impact of disease and medical service for well-being of the patient. From this point of view, treatment for drug addiction aims at a broad goal of recovery which in other words may be described as abstinence and improved quality of life. However, addiction has been categorized as a chronic disease lately and field of treatment to improve quality of life is still under developed.
- Severely Obese Children and Adolescents. A cross sectional study of 106 children and 57 adolescent males in the age group of 5-18 was taken as subject of study. Results showed that obese children and adolescents reported significantly low HRQL when compared to healthy children and adolescents. Severely obese children and adolescents were reportedly suffering from low HRQL in all aspects physically and mentally. Some of them were found to have more than one chronic disease including pre-diabetes, sleep apnea, and cancer. They were also observed to have low HRQL in psychosocial and physical functioning factors.
Apart from the government policies and actions, each individual should take steps to reduce obesity or over weight. Some of the steps are:
- Take out time to set a plan for meals that can be quickly made at home
- Plan and have a set of healthy snacks on-hand
- Buy lean meat and fish. Try to eat fish at least 3 times a week
- Bring home fruits and vegetables.
- Gain knowledge and compare food labels (nutrition details)
- Find a good time of day to exercise. Exercise is essential for weight management.
In work places, health of employees can be taken care of by banning soda and coffee vending machines and replace it with fresh juice or green tea. Limit snacks to salt-free nuts, fruits, vegetables rather than fries and pastries. An awareness session can be arranged to educate all people about the risks of obesity and how to stay healthy.
A healthy, balanced diet is the key to healthy body. Eating a balanced diet means choosing food from all food groups. It also includes consumption of saturated fats, Trans fat, cholesterol, salt, sugar and alcohol in moderate quantities. Balanced diet is required to take in all the nutrients that the body needs at recommended levels. Obesity is not connected just with the physical body health; it is also connected to the mental health of a person. Stress and pressure can result in weight gain, though food consumption is less. Therefore, it is necessary to ensure that there is no stress or any issues that bothers the mind and health. If under pressure, take time to calm down yourself by doing things, which you really enjoy. It may be activities like listening to music, going on a ride or holiday, speaking to someone, playing, exercising, spending quality time with family, etc. A healthy body and healthy mind keeps a person happy.
The key to success is to achieve a balance between the calories consumed and calories used up. Experts suspect that, a person gets more prone to diseases when the body weight is slightly more than the ideal weight. Some of these conditions have long-term effects on their health. Healthy diet and regular adequate physical activity are necessary for the maintenance of good health through the life course. Overall, 2.7 million deaths are due to low fruit and vegetable intake, and 1.9 million deaths due to physical inactivity. Unhealthy diets and physical inactivity are major factors for the likeliness of chronic diseases. The reasons for reduction in physical activity of people maybe blamed partially on the growing technologies and trends. Very few children walk or cycle to school. Most of the time is spent sitting at home playing games, eating, watching TV, using elevators, using cars for transportation, etc., There are also evidences to show that increasing levels of physical activity can reduce the risk of chronic diseases like osteoarthritis, diabetes, heart diseases, etc., to a considerable level. Physical activity need not necessarily be expensive. Walking is the most recommended form of physical activity, which is free, can be done in urban areas, parks or anywhere feasible rather than going to gym or pools or any other specific facilities. Experts recommend half hour of moderate-intensity walking on most of the days. It gives energy to work and keeps oneself active all through the day. Physical activity can also help preventing wrong habits and behavior with children and young adults.
References
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