CHAPTER ONE
INTRODUCTION
1.1. Background of the Study                           
The benefits of good health can never be over-emphasized as its importance is evident not only in the life of the individual but to the family unit and the larger society. This accounts therefore, for the reason behind the numerous research on health and the various factors affecting it such as; lifestyle, environment, genetics, nutrition and even diseases. The World Health Organization (2013) defined human health in a broader sense as a state of physical, social and mental well-being and not merely the absence of disease or infirmity. More recently, Alan (2017), defined health as the experience of physical and psychological well being
             Quality of life (QOL) on the other hand is a broad multi-dimensional concept that usually includes subjective of both positive and negative aspects of life. Although health is one of the important aspects of Quality of Life, there are other notable aspects such as jobs, housing, neighborhood, etc. The concept of Quality of Life refers to the degree to which one enjoys in the area of being (who one is physical, psychological and spiritual being) belonging (connections with one’s environment; physical belonging, social belonging, community belonging) and becoming (achieving personal goals, hopes and aspirations; practical becoming, leisure becoming, growth becoming) the important possibilities of his or her life (Centre for Health Promotion, 2004). One of the central components in the area of being, belonging and becoming is one’s perception of his or her own health. Thus, the importance of shedding more light on the concept of Health Related Quality of Life (HRQOL).
The concept of health-related quality of life (HRQOL) and its determinants have evolved since the 1980s to encompass those aspects of overall quality of life that can be clearly shown to affect health—either physical or mental (Centre for Disease Control, 2000; McHourney,1999; Gandek, Sinclair, Kosinski& Ware, 2004). Health-related quality of life (HRQOL) has been identified as a goal for all people across all life stages by leading health organizations (Center for Disease Control and Prevention, 2000; World Health Organization, 2007). HRQOL, that is, quality of life relative to one’s health or disease status, is a concern of policymakers, researchers, and health care practitioners (Till, Osoba, Pater & Young, 2000). Especially important is the need to align HRQOL research priorities with the needs and values of patients and their families.