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values and standards of the culture of which they are a part. An example
might be the particular rankings of social status in a given culture or the
status symbols that one covets in order to be considered a respected mem-
ber of that culture.
EVIDENCE-BASED QUALITY OF LIFE CONCEPTS
AND MEASURES
Quality of life measures may be generic while assessing QoL across different
populations or different issues, or they can focus on specific issues or pro-
blems. Neither approach independently or directly influences life satisfaction
or subjective well-being (SWB) or happiness, because they depend on how
they are cognitively perceived and individually evaluated ( American
Psychiatric Association, 2000; Diener & Larsen, 1993; Michalos, 1991 ).
A search of the Institute for Scientific Information (ISI) database from
1982 to 2005 revealed over 55,000 academic citations utilizing the term
“quality of life” spanning a wide range of academic disciplines. Quality of
life has also been included in broader areas of discourse concerning eco-
nomic prosperity and sustainability. It has been generally assumed that
more income and consumption are the primary reasons for a better
quality of life. The notion of a primary or major emphasis on financial
well-being has been challenged by several authors, notably Sen
(1985) and Nussbaum (1995) . It has also been challenged in a fair
amount of
the psychological
research (e.g., Diener & Lucas, 1999;
Easterlin, 2003 ).
QoL research has focused more often on objective measures of QoL
that are quantifiable indicators, such as economic and health indices
obtained from the United Nations Human Development Index (UN
Development Programme, 2012) . For example, objective measures fre-
quently include factors of economic production, literacy rates, and life
expectancy. These measures can usually be gathered without directly sur-
veying or interviewing the individuals being assessed. Objective indicators
of QoL have generally been used independently or in combination to
form summary indexes such as the UN Human Development Index
( Sen, 1985; UNDP, 2012 ). It is acknowledged that these measurements
only provide a brief assessment of how certain physical and social QoL
needs are met. They often represent a narrow and sometimes biased view-
point. Although useful, this does not always allow an opportunity to
incorporate many measures that contribute to QoL that are sensitive and
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