The measurement of health-related quality of life: Major dimensions identified by factor analysis

The measurement of quality of life is becoming more important in the evaluation of medical technologies and pharmaceuticals. Particularly when the several available therapies have similar effects on survival, quality of life measures may help decide which should be the therapy of choice. The Recovery Study utilized a multidisciplinary array of indicators of health-related quality of life and recovery. This paper reports factor analyses of 58 outcome measures on a study group of 469 persons who had undergone coronary artery bypass or cardiac valve surgery 6-months previously. The factor analyses revealed 5 orthogonal dimensions. We have named them: low morale, symptoms of illness, neuropsychological function, interpersonal relationships, and economic-employment. The data argue that health-related quality of life is a multidimensional construct, and that these dimensions can be measured quantitatively with relatively simple interview and questionnaire approaches. The next research step is to determine whether the five dimensions of post-operative quality of life have different pre-operative predictors, and whether intervention on these predictors can improve the recovery and rehabilitation process.