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Title: Subjective wellbeing : a perspective on health care and health policy
Author: Lee, Henry Adam
ISNI:       0000 0004 5369 0527
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2015
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The nature and resource constraints of modern health care has led to increased reliance on rigorous treatment targets and detailed policy guidelines. Whilst well intentioned, this can shift the focus away from patients themselves and places emphasis on arbitrary measures of output or performance that can relate poorly to how people experience and benefit from health care. Considerable effort and resources are spent on health care interventions, but policy makers and clinicians may be left without a clear understanding of how these treatments actually affect people in the experience of their lives. Subjective wellbeing (SWB) is a broad category of phenomena that includes people's emotional responses, domain satisfactions (e.g., health or work), and global judgements of life satisfaction. Measures of SWB offer a means to gauge the impact of changes and events in the lives of individuals. In recent years, there has been increasing interest in the use of SWB in shaping public policy (e.g. in relation to environmental and economic policies). In my thesis, I examine for the first time the ways in which measures of SWB can be used directly within a health care setting and to inform health policy decisions. In doing so, I have drawn on my understanding of clinical environments and health care systems as a practising clinician to bring a new perspective to the way that SWB is considered and used in health care and to how it can be applied in determining health policy. I explore the use of SWB at both the macro and micro levels of policy making and address the challenges faced when using measures of SWB in these ways. At the macro level, I examine the limitations and challenges of existing methods and examine where using SWB would have the most impact. I also focus on the use of SWB measures at a micro level, setting out a new model of patient experience with reference to SWB. My thesis sets out original methods for SWB data collection developed through innovative empirical work. This work into hernia surgery and on the SWB of the staff and inpatients of an acute NHS hospital has generated new data sets in clinical populations. I discuss the implications of this research and explain how, when and where SWB measures, when used in health care, can be used in health policy. All too often we lose sight of what really matters in life, and the world of heath care is no exception. Through the application of measures of SWB in health care, I offer a novel perspective that ensures a greater focus is placed on the way that patients experience health interventions when developing health policy.
Supervisor: Darzi, Ara; Dolan, Paul Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral