Aboriginal and Torres Strait Islander peoples' perceptions of quality of life and wellbeing and how they are measured: a systematic review protocol

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Abstract

Review objective

The objective of this review is to:

Review objective

1. Identify tools used to measure quality of life (QoL) and wellbeing in Aboriginal and Torres Strait Islander Australian peoples.

Review objective

2. Identify and synthesize Aboriginal and Torres Strait Islander peoples' perceptions of QoL and wellbeing.

Background

The concept of QoL is recognized as being both multidimensional and vague.1 Theoretical conceptualizations of QoL are diverse and make identification of a common definition difficult. The lack of consensus is due in part to the multidisciplinary application of the concept which is compounded by multiple interpretations and measurements.2 The Australian Centre on Quality of Life3 provides a comprehensive list of well over a thousand instruments that have been developed for measuring QoL across a range of disciplines in the general population.

Background

Two broad perspectives to QoL exist. The first is distinguished by the global context in which it operates4 and is evidenced by the inclusion of socioeconomic status and the range of other social factors identified as being essential for meeting the needs of both individuals and communities.5 The World Health Organisation Quality of Life (WHOQoL) group adopts this broader more global perspective incorporating the social features in its definition of quality of life.6

Background

The second perspective, health related quality of life (HRQoL) includes those factors that are directly attributable to health conditions and/or their associated interventions.7 Generic HRQoL instruments such as the Medical Outcome Study Short Form 36 (SF-36), the EuroQol 5D (EQ-5D) and the Sickness Impact Profile8 enable comparison between groups of patients with different diseases, while there are also numerous instruments used to measure specific health conditions.

Background

QoL instruments are generally based on the perspective of western societies and in many cases language is simply translated for use in culturally and linguistically diverse countries.9 There are a number of problems with this process, not the least being the tacit assumption that culture and context have minimal impact on the applicability of the measures.10 The use of generic HRQoL instruments can also result in inadequate evaluation of subjective experiences of particular diseases and interventions11 and may have little or no relevance to certain patient groups and subsequent health outcomes. Evidence demonstrates that simply translating western diagnostic tools into other contexts fails to capture and measure critical concepts relevant to the new population.12 It is important that any QoL measure not only captures an individual's perceptions, but also their philosophical and conceptual notions of QoL and wellbeing in the context of their culture and value systems.13

Background

The use of western diagnostic tools to measure Indigenous peoples' QoL has implications for Indigenous peoples generally14 and for Aboriginal and Torres Strait Islander peoples specifically. Unlike western cultures in which understandings and perceptions of health and wellbeing are derived from a biomedical model regarding physical functioning and perceptions of health,15 Australian Aboriginal and Torres Strait Islander peoples' view of health pervades the social and cultural context in which many live and their ways of being.16

Background

For many Australian Aboriginal and Torres Strait Islander peoples, there are complex relationships between natural and spiritual worlds involving interconnections between themselves, their community structures and their environment.17 Their creation beliefs shape their lives, spirituality, values, attitudes, concepts, language and their relationships to the physical and material world.18 Although supernatural intervention and sorcery may be considered a cause of illness, there is also the perception that personal illness or injury is a manifestation of the struggles in maintaining the balance between their spiritual, physical and emotional wellbeing and the world around them.19

Background

While there have been a number of studies which have attempted to conceptualise QoL and wellbeing from Aboriginal and Torres Strait Islander peoples' perspectives, to our knowledge this is the first systematic literature review which specifically aims to bring together and better understand the findings from these studies. Therefore, this systematic literature review will focus on understanding Australian Aboriginal and Torres Strait Islander peoples' definition of QoL, inclusive of wellbeing. In addition, this systematic literature review will also identify the instruments and/or measures that have already been specifically developed to measure Australian Aboriginal and Torres Strait Islander peoples' QoL.

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