Quality of life and the high-dependency unit.

This study was designed to identify and measure the patients' perspective of the concept quality of life within the context of a high-dependency unit (HDU). Data were collected in two phases. In phase one, 55 patients were interviewed, which resulted in the concept clarification of quality of life as: physical, social, psychological and family/friends. In phase two, 51 patients undertook quality-of-life assessment using validated instruments the Quality of Life Index (Ferrans & Powers 1985) and the Global Quality of Life Scale (Hyland & Sodergren 1997). Post-HDU patients demonstrated improvements upon pre-admission scores in both instruments (the social domain in the quality of life index being the exception), although this only reached statistical significance P<0.05 in the overall index score and within the domains of health and family. When exploring variables of age and severity of illness (Apache 2 score, Knaus et al. 1980) it was the people who were older and physiologically compromised to an increased extent (P<0.05) who demonstrated higher levels of satisfaction with their resulting quality of life. This study has been successful in providing patients with an opportunity to participate more actively in service evaluation and has identified the need for future evaluation of HDUs to move beyond physiological measures, to incorporate the impact that illness leading to admission to an HDU has upon the patients' ability to function and their resulting quality of life.