Quality of life

A way of thinking that emphasizes how rich a human life one can lead. Quality means quality, and life means life or living, and it is translated as "quality of life" or "quality of life." Abbreviation: QOL.

Although the important purpose of medical treatment is to save lives, it can sometimes result in loss of function. Treatment can make it impossible to perform normal daily activities such as walking, eating, bathing, and defecation. These activities of daily living are called ADL (activities of daily living). In the West, interest in the decline in ADL due to medical treatment has been growing since the 1950s, but in the 1960s, the broader impact of cancer and hypertension, including mental health, was emphasized, and the term QOL became widespread. Being unable to go out due to fear of incontinence, not wanting to go out in public due to severe deformity, becoming bedridden due to side effects of medication, having aftereffects from nerve amputation, etc. are clearly considered to be a decline in QOL. On the other hand, breast-conserving surgery for breast cancer, laparoscopic surgery with small incisions without laparotomy, radiotherapy for prostate cancer, and functional reconstructive surgery in plastic surgery are treatments that improve QOL.

Life-prolonging treatments for incurable cancers and incurable diseases are also being discussed from the perspective of QOL. In recent years, QOL has come to include not only physical functions but also mental fulfillment such as a sense of purpose in life and happiness.

[Tanabe Isao]

Source: Shogakukan Encyclopedia Nipponica About Encyclopedia Nipponica Information | Legend

どれだけ人間的な豊かな生活ができるかを重視する考え方。qualityは質、lifeは生命・生活を意味し、「生活の質」、または「生命の質」と訳される。略称QOL。

　医療は命を助けることが重要な目的ではあるが、そのかわりに機能を失う場合がある。治療により、歩行、食事、入浴、排便などの日常生活が普通にできなくなることがある。これらの日常生活動作をADL（activities of daily living）とよぶ。欧米では1950年代から医療によるADL低下に関心が高まってきたが、1960年代には癌(がん)や高血圧症で、精神面も含めた広い分野の影響が重視され、QOLという言葉が広がった。失禁の不安で外出できない、著しい変形で人前に出たくない、薬の副作用で寝たきりになる、神経切断により後遺症がある、などは明らかにQOLの低下とみなされる。逆に、乳癌(がん)の乳房温存手術、開腹をしない傷の小さな腹腔(ふくくう)鏡下手術、前立腺(せん)癌の放射線小線源療法、形成外科的な機能再建手術などはQOLを高める治療である。

　治らない癌や難病などの延命治療も、QOLの観点から議論になっている。近年、QOLは、身体的な機能だけでなく、生きがいや幸福感など精神的な充実も含めた概念になっている。

［田辺　功］

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