The concept of what constitutes quality of life (QoL) is controversial (Koller & Lorenz, 2002) and whether it can be meaningfully measured even more so. The following attempt at defining QoL emphasises the difficulties in defining what most people feel they instinctively understand: 'Quality of life can be defined as the individual's perception of their position in life, in relation to their goals and to the value-system which they have accepted and incorporated in to their decision-making' (Sartorius, 1993). There is a more limited concept of health-related QoL that is limited to the effects that health or its absence has on life. The World Health Organisation (WHO) has given definitions of and explained how disease can lead to impairment, which leads to disability and which in turn may lead to handicap (WHO, 1980).
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