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The Role of Language in Assessing Quality or Quality-of-Life

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Abstract

The statement below by Skinner is enough to demonstrate that changes in language can result in changes in meaning. This chapter considers the various ways this is true, especially when considering how language is used in a qualitative assessment. This is illustrated by analyzing the language basis of various definitions of quality-of-life or health-related ­quality-of-life (HRQL).

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Notes

  1. 1.

    I have not been able to find a similar list of definitions for the term “quality,” so I will confine this discussion to different definitions of “quality-of-life” or “HRQOL.”

  2. 2.

    Glucksberg (2001) view, of course, has strong resemblance to what Wittgenstein was telling us.

  3. 3.

    For a continuation of this discussion, see Chap. 4’s discussion about objective and subjective indicators of quality-of-life. Also, Raphael (1996) provides an overview of some of the philosophical alternatives relevant for quality-of-life or HRQOL research.

  4. 4.

    The relationship between language used and reality is an important issue which I will address at various places in this book. I will argue that the spoken and written language that I know is deficient in characterizing the experience of quality, especially of the compromised person, and that the more precise language of mathematics, and its analog, a conceptual space, may offer an alternative means of characterizing quality. I will discuss this most directly in Chap. 10. Also, in Chap. 4 (p. 97) I will discuss details about the relationship between objectivity and subjective assessments. I will also argue in Chap. 4 that the assessment process itself tends to optimize the objective character of any observation, independent of its subjective or objective origin. This, however, is not contradicted by my argument here that my sense of reality is a form of constructionism. What is assessed is not necessarily the same as what I consider reality, although it is also clear that the two may overlap.

  5. 5.

    Although I have distinguished between a metaphysical and empirical forms of constructionism, I will use the term “constructionism” from now on to only mean “empirical constructionism.”

  6. 6.

    See the next section and Chap. 3, where this idea of acquired reality is expanded during a discussion of Hayek’s contribution to the understanding of cognitive processes.

  7. 7.

    Miller (1993) states that terms such as encoding, mapping, categorization, inference, attribution, and so on are all examples of appreception. Thus, appreception can be thought of as a “superordinate term” referring to several mental processes.

  8. 8.

    Glucksberg (2001) refers to this as “dual referencing,” where a term may have a concrete reference, such as a law limiting the freedom of a class of citizens, or as a superordinate category referring to a wide range of restraints on a person’s freedom.

  9. 9.

    As an alternative, Steen (1999) describes a linguistic approach to conceptual metaphor analysis. Steen would like to be able to determine if a particular metaphoric expression is a conceptual metaphor (so called one-shot metaphors), without alluding to broader issues. Thus, he is interested in metaphor analysis as opposed to metaphoric understanding. He identified five steps which he suggests are sufficient to do a linguistic analysis of a conceptual metaphor.

  10. 10.

    The association between perceptual processes and affect is important and I will discuss it when I discuss the topic of well-being in Chap. 11.

  11. 11.

    I will discuss the Fernandex-Duque and Johnson (2002) paper in more detail in Chap. 7.

  12. 12.

    Koltko-Rivera (2006) has recently suggested that Maslow had another level to his motivational hierarchy in mind, beyond self-actualization, that he referred to as “self-transcendence.”

  13. 13.

    Patrick and Chiang (2000) have presented an expanded version of this definition which seems designed for broader policy oriented issues and will be discussed in Chap. 8.

  14. 14.

    The reader is probably aware that many investigators fail to differentiate quality-of-life and psychosocial indicators when they describe what they mean by a quality-of-life or HRQOL assessment. One of the reasons for this has to do with the fact that these investigators feel that descriptive statements are sufficient to define quality-of-life or HRQOL, the consequence of which is that there is no operational consequences to using either class of indicators.

  15. 15.

    Feldstein (1991) pointed out that the quote from Barofsky (1990) was originally reported in 1983 at a Conference on Methodology in Behavioral and Psychosocial Cancer Research in response to comments by Wellisch (1984).

  16. 16.

    The Rapkin and Schwartz (2004) definition proposes a complex ­cognitive structure that will be discussed in Chap. 11.

Abbreviations

AIDS:

Acquired immune deficiency syndrome

HRQOL:

Health-related quality-of-life

QWB:

Quality of Well-being Scale (Kaplan and Bush 1982)

SME:

Structure-mapping engine

WHO:

World Health Organization

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  1. Quality of Life Institute, East Sandwich, MA, 02537, USA

    Ivan Barofsky

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Barofsky, I. (2012). The Role of Language in Assessing Quality or Quality-of-Life. In: Quality. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9819-4_2

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