Continuing conceptualising QOL through application to lives of young adults with Down syndrome

Quality of Life (QOL) has been used as a sensitising concept for decades, inviting all to consider the potential for individuals with intellectual and developmental disabilities to live a life full of meaning and purpose. This article presents the outcomes of our deliberations on domains of QOL undertaken for a study investigating lives of young adults with Down syndrome. Various groups have published domains and from these we distilled a list of six: Physical well-being, Emotional well-being; Self-determination; Material well-being; Personal beliefs and development; and Social inclusion. Our synthesis of domains raised two issues for further deliberation in the community of QOL scholars in the field of intellectual and developmental disability: the place of Information and Communication Technology (ICT) and Rights. ICT has not been considered as a domain but we argue it could be. Rights have been included as a domain by some researchers in previous conceptualisations but we do not. Instead we suggest they may be better placed as an underpinning principle, with fundamental impact on all aspects of QOL. A conclusion we are left with is that domains, while helpful for research, can never be a fixed list. What matters to individuals and society in general in framing lives of meaning and purpose will change over time. Even so, there is still value and need for setting domains for specific research studies.