1.0 Introduction
1.1 Background to the study
The benefits of good health can never be over-emphasized as its importance is evident not only in the life of the individual but to the family unit and the larger society. This accounts therefore, for the reason behind the numerous research on health and the various factors affecting it such as; lifestyle, environment, genetics, nutrition and even diseases. The World Health Organization (2013) defined human health in a broader sense as a state of physical, social and mental well-being and not merely the absence of disease or infirmity. More recently, Alan (2017), defined health as the experience of physical and psychological well being
Quality of life (QOL) on the other hand is a broad multi-dimensional concept that usually includes subjective of both positive and negative aspects of life. Although health is one of the important aspects of Quality of Life, there are other notable aspects such as jobs, housing, neighborhood, etc. The concept of Quality of Life refers to the degree to which one enjoys in the area of being (who one is physical, psychological and spiritual being) belonging (connections with one's environment; physical belonging, social belonging, community belonging) and becoming (achieving personal goals, hopes and aspirations; practical becoming, leisure becoming, growth becoming) the important possibilities of his or her life (Centre for Health Promotion, 2004). One of the central components in the area of being, belonging and becoming is one's perception of his or her own health. Thus, the importance of shedding more light on the concept of Health Related Quality of Life (HRQOL).
The concept of health-related quality of life (HRQOL) and its determinants have evolved since the 1980s to encompass those aspects of overall quality of life that can be clearly shown to affect health–either physical or mental (Centre for Disease Control, 2000; McHourney,1999; Gandek, Sinclair, Kosinski& Ware, 2004). Health-related quality of life (HRQOL) has been identified as a goal for all people across all life stages by leading health organizations (Center for Disease Control and Prevention, 2000; World Health Organization, 2007). HRQOL, that is, quality of life relative to one's health or disease status, is a concern of policymakers, researchers, and health care practitioners (Till, Osoba, Pater & Young, 2000). Especially important is the need to align HRQOL research priorities with the needs and values of patients and their families.
Health Related Quality of Life (HRQOL) therefore, is a multi-dimensional concept that includes domains related to physical, mental, emotional and social functioning. It goes beyond direct measures of population health, life expectancies and causes of death. It focuses on the impact health status has on quality of life (Healthy people, 2002). On the basis of a synthesis of the scientific literature and advice from its public health partners, Centre for Disease Control (2000) has defined HRQOL as “an individual's or group's perceived physical and mental health over time. Health-related quality of life” (HRQL), according to American Thoraic Association, (2003) is an individual's satisfaction or happiness with domains of life, so far as they affect or are affected by “health”. Hence, HRQOL can be distinguished from quality of life in that it concerns itself primarily with those factors that fall under the purview of health care providers and health care-systems, (Wilson & Cleary, 1995). Health related quality of life has been associated with chronic health disorders such as cancer, hypertension, etc. In this study, the concept of health related quality of life will be investigated among hypertensive patients.
Generally speaking, then, assessment of HRQL represents an attempt to determine how variables within the dimension of health (e.g., a disease or its treatment) relate to particular dimensions of life that have been determined to be important to people in general (generic HRQL) or to people who have a specific disease (condition-specific HRQL). Most conceptualizations of HRQL emphasize the effects of disease on physical, social/role, psychological/emotional, and cognitive functioning. Symptoms, health perceptions, and overall quality of life are often included in the concept domain of HRQOL (Ware, 1995).
Individuals' HRQOL offers a multidimensional perspective of their physical, psychological, and social function, (Ware, 1995). For that reason, HRQOL has gained ground as a primary measure of the impact of disease, (Wilson & Cleary, 1995; Ware, 1995). In addition, it can often be used more easily than clinical parameters as a health-related index helping healthcare workers to understand patients' needs and provide them with quality health services. HRQOL in populations with cancer, stroke, CVD, and other chronic diseases has been studied extensively using different methods in recent years. However, previous studies had limitations with respect to identifying features according to disease and generalizing results, because the study subjects were typically compared with healthy subject groups and the studies were not designed as randomized controlled trials. Healthcare teams need to provide intensive and focused programs for people with any of the above-mentioned diseases. Thus, the primary aim of this study was to investigate the health conditions of community-dwelling populations with cancer, stroke, and CVD based on standardized data. The second aim was to identify the difference. In this study, the concept of health related quality of life will be studied among hypertensive patients.