Exploring subjective constructions of quality of life in patients, carers and the healthy general public: a Q-methodological study

Purpose: To explore similarities and differences in perceptions of quality of life (QoL) outcome, among different groups of populations, including patients, informal carers and the healthy general publics. Methods: This study used Q-methodology, which combined both qualitative and quantitative components, to investigate the subjective constructions of QoL across the groups. We developed a list of 35 Q-sample items and collected a total of 151 Q-sort data for use in the standard by-person factor analytic procedure designed for Q-methodology. We also conducted post-sort interviews and obtained qualitative information about why the participants ranked the statements in certain ways. Results: We were able to identify four distinct viewpoints: Factor 1: Eat, sleep and other basic needs; Factor 2: Positive relationships, belongings and well-being; Factor 3: My own physical and mental health first; Factor 4: Physical health is the foundation of well-being. While Factor 4 was equally valued across all three categories of participants, Factor 2, which places a high value on positive relationships, was predominantly represented by carers. In contrast, patients tended to emphasise Factor 3, which focuses on individual feelings—particularly emotional and physical distress. Items related to pain, discomfort, and sleep were consistently identified as the most important across all four identified views. Conclusions: This study presents the similarities and differences of the subjective constructions of QoL across patients, carers and the healthy general publics. It implies the variances of preferences in evaluating QoL, and such variances can consequently affect the measurement and evaluation of QoL.