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Health related quality of life (HRQOL) is presented as a largely subjective construct of increasing importance in health discourse and practice. Key difficulties with the assessment and measurement of quality of life (QOL) are discussed. A Q methodological investigation of subjective constructions of health-related QOL is then reported using importance items derived from studies of the WHOQOL. Eight factors emerged from a factor analysis of the Q sorts of 90 healthy participants, each corresponding to a distinct construction of the meaning and relevance of QOL. The factors are interpreted and discussed under the following headings: 'Happy families, 'Stand on my own two feet', 'Emotional independence', 'Just do it!', 'Life as a positive challenge', 'In God we trust', 'Staying healthy enough to bring home the bacon' and 'You can't choose your family'. This diversity of views has implications for QOL testing. (C) 2003 Elsevier Science Ltd. All rights reserved.
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