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ORIGINAL RESEARCH article

Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1522133
This article is part of the Research Topic The Intersection of Psychology, Healthy Behaviors, and its Outcomes View all 49 articles

Empirical Evidence for a Process-Based Model of Health-Related Quality of Life Using Network Analysis

Provisionally accepted
Nicolette Stogios Nicolette Stogios 1Troy Francis Troy Francis 2,3*Rachel G Peiris Rachel G Peiris 4*Aleksandra Stanimirovic Aleksandra Stanimirovic 2,3*Valeria Rac Valeria Rac 2,3*Robert P Nolan Robert P Nolan 5*
  • 1 The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
  • 2 Toronto General Research Institute (TGRI), Toronto, Ontario, Canada
  • 3 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  • 4 Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  • 5 Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    Background: Health-related quality of life (HRQL) is the perceived impact of a medical condition on one's overall well-being. 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 biopsycho-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 well-beIng and heAlth, which uses selfreport data to assess the frequency with which individuals engage in a sample of goal-directed activities in pursuit of living well.We 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.The 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.This 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 goaldirected activities for living well is affected by their medical condition.

    Keywords: health-related quality of life, Network analysis, patient-reported outcomes, Process-based approach, Chronic Heart Failure, Chronic Kidney Disease

    Received: 04 Nov 2024; Accepted: 02 Jan 2025.

    Copyright: © 2025 Stogios, Francis, Peiris, Stanimirovic, Rac and Nolan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Troy Francis, Toronto General Research Institute (TGRI), Toronto, M5G 2C4, Ontario, Canada
    Rachel G Peiris, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, M6J 1H4, Ontario, Canada
    Aleksandra Stanimirovic, Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Ontario, Canada
    Valeria Rac, Dalla Lana School of Public Health, University of Toronto, Toronto, M5T 3M7, Ontario, Canada
    Robert P Nolan, Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, M5T 1R8, Ontario, Canada

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.