Human beings continually strive to create meaning in their lives and they struggle to achieve happiness by pursuing the things that they value (Diener et al., 2003). Speculation about how to achieve ‘the good life’ or ‘good quality of life’ (QoL) is probably as old as humankind. According to Socrates: ‘You should put the highest value, not on living, but on living well’. However, it is only in recent decades that there has been a growing interest in assessing QoL in healthcare (SAC, 2002) and conceptualizations of QoL in healthcare have been heavily influenced by earlier developments in the measurement of functional health status in medicine and the evolution of social indicators in the social sciences (Prutkin & Feinstein, 2002).

The concept of QoL began to appear in the social science literature in the 1920s (Wood-Dauphinee, 1999). The development of population indices was influenced by the social indicators movement, which emphasized the need to focus on social factors that influence satisfaction (Erickson, 1974; Andrews & Withey, 1976; Campbell, 1976). Most of these early measures were based on experts' ratings of objective phenomena such as the distribution of income. Later studies assessed subjective indicators such as satisfaction with income and satisfaction with life, using measures such as Cantril's self-anchoring scale, Bradburn's Scale of Affect Balance and Campbell and Converse's Human Meaning of Social Change Scale (Cantril, 1965; Bradburn, 1969; Campbell and Converse, 1972). Traditionally, medicine had focused on objective outcomes, such as mortality and morbidity assessed by clinical and laboratory indicators.