Quality of Life Measurement and Alcoholism: A Nursing Perspective

  • J. H. Foster
Reference work entry


The measurement of  Quality of life (QOL) has become of increasing interest to researchers and policy makers since the late 1980s. In the field of alcohol dependency research in this area is still relatively uncommon. In nursing what is usually measured is  health-related quality of life (HRQOL). Research has shown there is only a moderate correlation between clinicians/nurses assessment of HRQOL and their patients, hence the importance of the subjective view of the patient when assessing “treatment effectiveness.” Initially this chapter will look at some of the philosophy underpinning the measurement of QOL. Nurses will often encounter drinkers who do not recognize they have an alcohol-related problem, rarely will patients present to primary and often secondary care with a primary alcohol problem, though there are many conditions where alcohol consumption is implicated. These are briefly considered and a number of  screening tools are introduced to help the nurse recognize problem drinkers in their practice. Thus HRQOL is only really meaningful when an individual accepts they have a level of alcohol dependency. At present an alcohol-specific HRQOL measure does not exist thus it is assessed by a battery of questionnaires headed by a generic HRQOL measure. The gold-standard generic HRQOL measure is the SF-36 and it should be used by nurses. However it cannot be used alone as contains no measure of sleep or social isolation, both of which have been shown to be associated with poor outcomes. The chapter summarizes some of the evidence to date regarding the measurement of HRQOL in alcohol dependent individuals and provides pointers for the nurse wishing to conduct HRQOL measurements either as part of routine practice or research. It concludes with an optimistic message. If the nurse can help the patient to either stop or reduce their drinking then there are big short-term improvements in HRQOL scores which are maintained thereafter. This is a group of patients that are rewarding to work with and HRQOL measurement is a “worthwhile nursing endeavor.”


Nottingham Health Profile Hazardous Drinking Addiction Severity Index Alcohol Dependent Individual Present Health Status 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


alcohol dependent individuals


alcohol quality of life questionnaire- 9 items


alcohol problems questionnaire


addiction severity index


alcohol use disorders identification test


American Psychiatric Association diagnostic and statistical manual-IV


EuroQOL (European quality of life questionnaire)


fast alcohol screening test; GHQ, general health questionnaire


hospital anxiety and depression scale


health related quality of life


life situation survey


Nottingham health profile


the Paddington alcohol test


primary health care European project on alcohol


quality of life


severity of alcohol dependence questionnaire




visual analogue scale


World Health Organization quality of life questionnaire. (brief version)


  1. Akvardar Y, Akdede B, Ozerdem A, Eser E, Topkaya S, Alptekin K. (2006). Psychiatry Clin Neuro. 60: 693–699.CrossRefGoogle Scholar
  2. Allan C. (1995). Alcohol Alcohol. 30: 145–151.PubMedGoogle Scholar
  3. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. American Psychiatric Association Publications, Washington DC.Google Scholar
  4. Balon R. (2005). Depress Anxiety. 30: 1–10.CrossRefGoogle Scholar
  5. Beich A, Thorsen T, Rollnick S. (2003). Br Med J. 327: 536–542.CrossRefGoogle Scholar
  6. Bowling A. (1995). Measuring Disease: A Review of Disease-Specific Quality of Life Measurement Scales.Open University Press, Buckingham, England.Google Scholar
  7. Brooks R with the EuroQOL Group. (1996). Health Policy. 37: 53–72.PubMedCrossRefGoogle Scholar
  8. Bush K, Kivlahan D, McDonnel M, Fihn S, Bradley K. (1998). Arch Int Med. 16: 1789–1795.CrossRefGoogle Scholar
  9. Calsyn D, Saxon A, Bush K, Howell D, Baer J, Sloan K, Malte C, Kivlahan D. (2004). Drug Alcohol Depend. 76: 165–171.PubMedCrossRefGoogle Scholar
  10. Chubon R. (1987). Evaluat Health Prof. 10: 1034–1038.Google Scholar
  11. Chubon R. (1995). Manual for the Life Situation Survey. University of South Carolina Press, CO.Google Scholar
  12. Cichetti D. (1994). Psychol Assess. 6: 284–290.CrossRefGoogle Scholar
  13. Cohen J. (1992). Psychol Bull. 112: 155–159.PubMedCrossRefGoogle Scholar
  14. Cohn TJ, Foster JH, Peters TJ. (2003). Addict Biol. 8: 455–462.PubMedCrossRefGoogle Scholar
  15. Cummins R. (1997a). The Comprehensive Quality of Life Scale-Intellectual Disability, 5th ed. (COM-QOL-ID5) Manual. Deakin University School of Psychology, Toorak.Google Scholar
  16. Cummins R. (1997b). Assessing quality of life. In: Brown R (ed.) Quality of Life for People with Disabilities: Models, Research and Practice, 2nd ed. Stanley Thornes, Cheltenham.Google Scholar
  17. da Silva Lima A, Fleck M, Pechansky F, de Boni, Sukop P. (2005). Qual Life Res. 14: 473–478.PubMedCrossRefGoogle Scholar
  18. Davidson K. (1995). Br J Psychiatry. 166: 199–204.PubMedCrossRefGoogle Scholar
  19. Dolan P. (1997). Med Care. 35: 1095–1108.PubMedCrossRefGoogle Scholar
  20. Drummond C. (1990). Br J Addict. 85: 357–366.PubMedCrossRefGoogle Scholar
  21. Foster JH. Sleep quality of life and alcohol misuse. In: Martin C. (ed.) Identification and Treatment of  Alcohol Dependency. Elsevier, Amsterdam (Published 2008).Google Scholar
  22. Foster JH. (2004). Nurs Times. 100(42): 40–43.PubMedGoogle Scholar
  23. Foster JH. (2005). Nurs Times. 101(26): 32–36.PubMedGoogle Scholar
  24. Foster JH. (2006). Clin Effective Nurs. 95S: e295–e301.CrossRefGoogle Scholar
  25. Foster JH. (2007). Quality of Life in Alcoholics: A Longitudinal Study. Nova Science Publishers, New York.Google Scholar
  26. Foster JH. (2008). Drug Educ Prev Pol. 15: 1–6.CrossRefGoogle Scholar
  27. Foster JH, Heather N. (2005). Nurs Times. 101(35): 38–42.PubMedGoogle Scholar
  28. Foster JH, Marshall EJ, Hooper R, Peters TJ. (1998a). Addict Biol. 3: 321–332.CrossRefGoogle Scholar
  29. Foster JH, Marshall EJ, Peters TJ. (1998b). Addict Biol. 3: 333–343.CrossRefGoogle Scholar
  30. Foster JH, Marshall EJ, Peters TJ. (2004). Alcohol Clin Exp Res. 28(8): 46A.CrossRefGoogle Scholar
  31. Foster JH, Peters TJ. (1999). Alcohol Clin Exp Res. 23: 1044–1051.PubMedCrossRefGoogle Scholar
  32. Foster JH, Peters TJ, Kind P. (2002). Addict Biol. 7: 55–65.PubMedCrossRefGoogle Scholar
  33. Foster JH, Powell JE, Marshall EJ, Peters TJ. (1999). Qual Life Res. 8: 255–261.PubMedCrossRefGoogle Scholar
  34. Gilmore I, Sheron N. (2007). Br Med J. 335: 1271–1272.CrossRefGoogle Scholar
  35. Ginieri-Coccossis M, Liappas I, Tzavellas E, Triantafillou E, Soldatos C. (2007). In Vivo. 21: 99–106.PubMedGoogle Scholar
  36. Goldberg D, Hillier V. (1979). Psychol Med. 9: 139–145.PubMedCrossRefGoogle Scholar
  37. Goode D (ed.). (1994). Quality of Life for Persons with Disabilities: International Perspectives and Issues. Brookline Books, Cambridge.Google Scholar
  38. Gunther O, Roick C, Angermeyer M, Konig H. (2007). Drug Alcohol Depend. 91: 253–264.CrossRefGoogle Scholar
  39. Gunther O, Roick C, Angermeyer M, Konig H. (2008). Drug Alcohol Depend. 92: 291–295.PubMedCrossRefGoogle Scholar
  40. Heather N, Peters TJ, Stockwell T (ed.). (2003). International Handbook of Alcohol Dependence and Problems. Wiley Publications, Chichester, UK.Google Scholar
  41. Hodgson R, John B, Abbassi T, Hodgson RC, Waller S, Thom B, Newcombe R. (2003). Addict Behav. 28: 1453–1463.PubMedCrossRefGoogle Scholar
  42. Hodgson RJ, Alwyn T, John B, Thom B, Smith A. (2001). Alcohol Alcohol. 37: 61–66.Google Scholar
  43. Hughes K, Anderson Z, Morleo M, Bellis M. (2007). Addiction. 103: 60–65.PubMedCrossRefGoogle Scholar
  44. Hunt S, McKenna S, McEwen J. (1994). The Nottingham Health Profile User’s Manual. Galen Research Publications, Manchester, England.Google Scholar
  45. Hunt S, McEwen J, McKenna S. (1986). Measuring Health Status. Croon Helm, London.Google Scholar
  46. Hunt S, Sonja M, McEwen J, McKenna S. (1985). Effect Health Care. 2: 151–160.Google Scholar
  47. Jenkinson C, Coulter A, Wright L. (1993). Br Med J. 306: 1437–1444.CrossRefGoogle Scholar
  48. Kind P. (1982). Int J Epidemiol. 11: 271–275.PubMedCrossRefGoogle Scholar
  49. Kind P, Carr-Hill R. (1987). Soc Sci Med. 25: 905–910.PubMedCrossRefGoogle Scholar
  50. Land K. (2000). Social Indicators. (Accessed 29 April 2008).
  51. Lauer G. (1999). Concepts of quality of life in mental health care. In: Priebe S, Oliver P, Kaiser W (ed.) Quality of Life in Mental Health Care. Wrightson Biomedical, Philadelphia, PA.Google Scholar
  52. Malet L, Lorca P, Beringuer B, Lehert P, Falissard B. (2006). Alcohol Alcohol. 41: 181–187.PubMedGoogle Scholar
  53. Martin C. (2005). Curr Psychiatry Rev. 1: 69–73.CrossRefGoogle Scholar
  54. McDowell I, Newell C. (1987). Measuring Health: A Guide to Rating Scales and Questionnaires. Oxford University Press, New York.Google Scholar
  55. McKenna M, Chick J, Buxton M, Howlett H, Patience D, Ritson B. (1996). Alcohol Alcohol. 31: 565–576.PubMedGoogle Scholar
  56. McKenna S, Hunt S, McEwen J. (1981). Int J Epidemiol. 10: 93–97.PubMedCrossRefGoogle Scholar
  57. McLellan T, Kushner H, Metzger D, Peters R, Smith I Grissom G, Pettinati H, Argeriou M. (1992). J Subst Abuse Treat. 9: 199–213.PubMedCrossRefGoogle Scholar
  58. Morgan M, Landron F, Lehert P. for the New European Alcoholism Treatment Study. (2004). Alc Clin Exp Res. 28: 64–77.CrossRefGoogle Scholar
  59. Noll H. (2000). Social Indicators and Social Reporting: The International Experience. (Accessed 29April 2008).
  60. Paton A. (1996). Alcohol Alcohol. 31: 231–234.PubMedGoogle Scholar
  61. Patrick D, Deyo R. (1989). Med Care. 27(Suppl.): S217–232.PubMedCrossRefGoogle Scholar
  62. Patton R, Hilton C, Crawford MJ, Touquet R. (2004). Alcohol Alcohol. 39: 266–268.PubMedGoogle Scholar
  63. Pelc I, Ansoms C, Lehert P, Fischer F, Fuchs W, Landron F, Preto A, Morgan M. (2002). Alc Clin Exp Res. 26: 29–38.CrossRefGoogle Scholar
  64. Plant M, Plant M. (2006). Binge Britain.- Alcohol and the National Response. Oxford University Press, Oxford.Google Scholar
  65. Poikolainen K. (1999). Prev Med. 28: 503–509.PubMedCrossRefGoogle Scholar
  66. Primary Health Care European Project on Alcohol (PHEPA). (2005). Integrating Health Promotion Interventions for Hazardous and Harmful Alcohol Consumption into Primary Health Care Professionals’ Daily Work- Strategy for England. (Accessed 29 April 2008).
  67. Rapley M. (2003). Quality of Life Research-A Critical Introduction. Sage Publications, London.Google Scholar
  68. Reinert D, Allen J. (2002). Alc Clin Exp Res. 26: 272–279.CrossRefGoogle Scholar
  69. Reinert D, Allen J. (2007). Alc Clin Exp Res. 31: 185–199.CrossRefGoogle Scholar
  70. Saatcioglu O, Yapici A, Cakmak D. (2008). Drug Alc Rev. 27: 83–90.CrossRefGoogle Scholar
  71. Saunders J, Aasland O, Babor T, de la Feunte J, Grant M. (1993). Addiction. 88: 791–804.PubMedCrossRefGoogle Scholar
  72. Shafer A. (2006). J Clin Psychol. 62: 123–146.PubMedCrossRefGoogle Scholar
  73. Stockwell T, Hodgson R, Edwards G, Taylor C, Rankin H. (1979). Br J Addict. 74: 79–87.CrossRefGoogle Scholar
  74. Stockwell T, Murphy D, Hodgson R. (1983). Br J Addict. 78: 145–155.PubMedCrossRefGoogle Scholar
  75. Testa M, Nackley J. (1994). Annual Rev Pub Health. 15: 535–559.CrossRefGoogle Scholar
  76. The Alcohol Harm Reduction Group. (2003). No Half Measures- A Report on the Impact of Alcohol Misuse on the Work of Emergency Service and Emergency Healthcare Workers. The Alcohol Harm Reduction Group. (Accessed 29 April 2008).Google Scholar
  77. The WHOQOL Group. (1993). The WHOQOL Study Protocol. WHO, Geneva.Google Scholar
  78. The WHOQOL Group. (1995). Soc Sci Med. 41: 1403–1409.CrossRefGoogle Scholar
  79. Ware J, Snow K, Kosinski M, Gandek B. (1993). SF-36 Health-Survey: A Manual and Interpretation Guide. The Health Institute New England, Medical Centre, Boston.Google Scholar
  80. Wilk A, Jensen N, Havighurst T. (1997). J Gen Int Med. 12: 274–283.CrossRefGoogle Scholar
  81. Williams B, Drummond C. (1994). Drug Alc Depend. 35: 239–243.CrossRefGoogle Scholar
  82. Wolfensberger W. (1994). Lets hang up “Quality of Life” as a hopeless term. In: Goode D (ed.) Quality of Life for Persons with Disabilities: International Perspectives and Issues. Brookline Books, Cambridge.Google Scholar
  83. Zigmond A, Snaith R. (1983). Acta Psychiatrica Scand. 67: 361–370.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • J. H. Foster
    • 1
  1. 1.Department of Health and Social Sciences, Archway CampusMiddlesex UniversityLondonUnited Kingdom

Personalised recommendations