AUTHOR=Stogios Nicolette , Francis Troy , Peiris Rachel G. , Stanimirovic Aleksandra , Rac Valeria , Nolan Robert P. 

TITLE=Empirical evidence for a process-based model of health-related quality of life using network analysis

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1522133

DOI=10.3389/fpubh.2025.1522133

ISSN=2296-2565

ABSTRACT=BackgroundHealth-related quality of life (HRQL) is the perceived impact of a medical condition on one's overall wellbeing. While contemporary assessments are structured to evaluate an individual's HRQL state, we propose a complementary process-based model, which is defined as an appraisal that evolves over time as it reflects and informs a self-regulatory process of adapting to dynamic changes in bio-psycho-social life domains. In support of this approach, we developed a novel HRQL assessment tool called the EUROIA: EvalUation of goal-diRected activities to prOmote wellbeIng and heAlth, which uses self-report data to assess the frequency with which individuals engage in a sample of goal-directed activities in pursuit of living well.MethodsWe conducted a network analysis to evaluate the hypothesis that the EUROIA subscales would demonstrate a meaningful pattern of associations with an established HRQL measure and associated indices of psychosocial functioning and efficacy in self-managing a chronic medical condition.ResultsThe EUROIA is associated with established indices of HRQL in a manner that is theoretically consistent with our process-based model. Stability coefficients (i.e., betweenness, closeness, and strength) of the analysis revealed high reliability for the network.ConclusionThis analysis provides support for the validation of a process-based approach to HRQL assessment, which is represented, in part, by the EUROIA. A process-based approach complements and expands conventional measures of HRQL by focusing on how a patient's capacity to engage in goal-directed activities for living well is affected by their medical condition.