How do you measure quality of life? The idea of quality of life (QOL) has been discussed in the psychological realm since the 1950s.
The Quality of Life Scale (QOLS) originated from John Flanagan, who was an American psychologist. (Burckhardt & Anderson, 2003)
The Quality of life scale measures things like satisfaction, perceptions of control, involvement, commitment, and work-life balance, in terms of one’s personal perception.
Quality of life also measures well-being in terms of your job or organization. (Psychology, n.d.)
The concept of quality of life is very subjective to the extent to which one believes they are living a good life. Many things, including how someone perceives things or how they see the world, color this belief.
This article will offer a brief review of quality of life and what it means in the psychological context as well as offer links to helpful questionnaires and assessments.
This article contains:
- What Does Quality of Life Mean in the Context of Psychology?
- In What Ways Can We Measure Quality of Life?
- A Look at the Reliability and Validity
- The Quality of Life Questionnaire
- McGill Quality of Life Questionnaire (MQOL)
- Measuring Health-Related Quality of Life (HRQOL)
- 3 More QOL Assessments
- A Take-Home Message
What Does Quality of Life Mean in the Context of Psychology?
Quality of life is a very abstract subject. It can be defined in many ways making both the definition and the measurement challenging.
To understand one’s quality of life, you must understand the conditions that influence one’s life. You must also understand someone’s values, and have some knowledge about how objective indicators might affect one’s experience of well-being.
In recent years, there has been a lot of focus on the impact of both physical and mental illness in terms of their impact on quality of life.
According to Skevington, (1999), the switch from measuring biomedical measures to measuring psychosocial issues has shown to play an integral role in ensuring a positive patient outcome from both the patient and the clinician’s perspective.
As part of this, there has also been an ongoing evaluation, in terms of quality of life, to move beyond the normal healthy individual to populations such as the elderly.
The idea of quality of life is undoubtedly a multidimensional concept, which emphasizes the self-perception of an individual’s current state of mind (Bonomi, Patrick, Bushnell, & Martin, 2000).
When measuring and examining quality of life, it’s essential to explore all domains, including social, environmental, psychological, and physical values.
In What Ways Can We Measure Quality of Life?
Your well-being depends on many things, including the circumstances of your life and how you view your life.
Positive psychology is concerned with the satisfaction you express when looking at the different realms of your life.
Your well-being is based on many things, including:
- Mental and physical well-being.
- Relationships with other people.
- Social, community, and civic activities.
- Personal development and fulfillment.
- Recreation and fun.
The quality of life scale can measure any domain of life. It is a reliable and valid instrument for doing so. While there may be many different definitions as to what domains of life are important for any one individual, the QOL assessment can be done within any of these domains.
Quality of Life Definition
Quality of life is very subjective. Everyone measures it a bit differently. Some people may view their life as good if they have a sense of inner peace while others may not feel their life is good until they achieve some level of success.
A Look at the Reliability and Validity
According to Burckhardt & Anderson (2003) estimates from a study of 240 American patients with chronic illnesses indicated that the original quality of life satisfaction scale was consistent internally.
These same indicators also reported that the test had high reliability when it came to testing and re-testing when used with groups that had chronic illnesses.
Other researchers also concurred, reporting similar levels of reliability (Burckhardt & Anderson, 2003).
Burckhardt & Anderson (2003) also indicate that both convergent and discriminant construct validity of quality of life for those with chronic illness was also evidenced with high correlations between the QOL score and the Life Satisfaction Index.
The Quality of Life Questionnaire
There are over 1,000 instruments that are currently designed to measure the quality of life according to Ubel, Loewenstein, & Jepson, (2003.)
The goal of the quality of life questionnaire is to assess one’s perceived satisfaction or dissatisfaction in the major domains of life.
Economists typically indicate that well-being can be inferred by simple observation. By observing the conditions in different domains of life, one can get a much better view of how satisfied or unsatisfied they may be within that realm.
The goal of this tool is to assess the client’s perceived satisfaction within different domains of life.
The tool is useful because it gives someone a place to start, especially if they are feeling a bit overwhelmed because the questionnaire can be done within any domain of life that needs focus.
McGill Quality of Life Questionnaire (MQOL)
The McGill quality of life questionnaire has been used extensively in palliative care research for those living with serious illnesses.
The McGill QOL questionnaire was first developed more than twenty years ago. It is a questionnaire that is relevant to all phases of disease, including diseases that may threaten someone’s life. (Cohen, Strobel & Bui., n.d.)
This questionnaire is different in that:
- It measures the existential domain.
- The physical domain, although relevant, is not predominant.
- It measures positive contributions that pertain to quality of life.
A principal components analysis examines four subscales:
- Physical symptoms
- Psychological symptoms
- Outlook on life
- Meaningful existence
The McGill quality of life questionnaire is a good option for examining quality of life for those suffering from chronic disease.
Measuring Health-Related Quality of Life (HRQOL)
Health-related quality of life (HRQOL) gauges how someone perceives their health, both physical and mental, over time. (Measuring Health-related quality of life, HRQoL, 2017).
Health-Related Quality of Life (HRQOL) is really about perception. It’s about how someone views his or her position in life in the context of many things, including the culture in which they live. It might also have to do with someone’s goals, standards, or expectations. (Vahedi, 2010).
It is a wide-ranging concept that pertains to one’s physical health, psychological state, their level of independence, social relationships, and their relationships to different features of their environment. (Vahedi, 2010).
There are many reasons to measure health-related quality of life:
- Provides added value. Patients, as well as those in the healthcare industry, recognize the value that this type of tool adds.
- Provides useful information. This type of data can be used to screen and monitor patients for various healthcare practices.
This type of tool can also be used as part of a population survey or to measure healthcare services in addition to being a helpful tool for regulators in terms of assessing new technologies.
There are many domains related to health-related quality of life. Patients see things and perceive things quite differently. Measuring health-related quality of life typically requires the capturing of various dimensions on what is important to patients.
For example, someone may have the same response to a simple question day after day, but not take into consideration their level of independence, which may be improving, or their level of psychological health, which could be deteriorating.
A simple question may not reveal the depth of someone’s response as well, or allow the caregiver to distinguish between a severely depressed individual who may be very mobile, to a non-mobile patient who is emotionally much healthier.
3 More QOL Assessments
As mentioned, there are over 1,000 instruments that are currently designed to measure the quality of life; some of these instruments are more generic than others or are designed to measure specific diseases or pathologies.
The Positive Psychology toolkit has its own quality of life scale.
The QOL scale is typically self-administered; however, it can also be done via an interview format. The assessment can be done in as little as 5 minutes and is generally administered via a 7-point response scale.
The QOL scale is scored by simply adding the score on each item. The range of scores is between 15 to 105, with a higher score or number being indicative of a higher quality of life. An average total rating for a healthy person is usually around 90, whereas a low quality of life measures around 15.
Our particular QOL scale measures five life domains:
- Material and physical well-being.
- Relationships with others.
- Social, community, and civic activities.
- Personal development and fulfillment.
These domains include things like financial security, health and personal safety, relationships with parents, siblings and friends and activities related to helping or encouraging others.
It also includes intellectual development, personal understanding, and even creativity and personal expression in addition to socializing and other recreational activities.
The World Health Organization also has a quality of life instrument called the WHOQOL-BREF, which is an abbreviated generic Quality of Life Scale developed through the World Health Organization. (Vahedi, 2010).
The World Health Organization scale is a well-known instrument when it comes to developing cross-cultural comparisons that have to do with quality of life. Moreover, it is available in more than 40 languages.
The WHOQOL-BREF is an instrument that consists of four domains:
- Physical health
- Psychological health
- Social relationships
- Environmental health
The instrument also contains quality of life and general health items.
The physical health domain includes things such as how mobile someone is or what kinds of activities they do every day.
The psychological domain measures things like negative thinking, self-image, self-esteem, and attitudes. (Vahedi, 2010).
The social relationship area looks at things like social support and personal relationships. The environmental health domain covers issues related to safety and health. (Vahedi, 2010).
There is also a quality of life scale for pain, which can help those with chronic pain communicate with their health care provider on how that pain is affecting their life or mental health. Knowing this information can help the doctor monitor improvements, deterioration, and treatment-related complications. (Khatri, n.d.).
A Take-Home Message
The quality of life scale was developed as a self-perceived measurement or scale. As we can see, it has been used not only to help someone measure how they perceive life, but also to help measure pain and help those with chronic illnesses get a much better idea of how those things affect their day-to-day life.
The quality of life scale is a valid instrument for providing a comprehensive measurement across multiple domains in life.
- Bonomi, A. E., Patrick, D. L., Bushnell, D. M., & Martin, M. (2000). Validation of the United States’ version of the World Health Organization Quality of Life (WHOQOL) instrument. Journal of Clinical Epidemiology, 53, 1-12. doi:10.1016/S0895-4356(99)00123-7
- Burckhardt, C. S., & Anderson, K. L. (2003). The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health and quality of life outcomes, 1, 60. doi:10.1186/1477-7525-1-60
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- Cohen SR, Mount BM, Bruera E, Provost M, Rowe J, Tong K. Validity of the McGill Quality of Life Questionnaire in the palliative care setting: A multi-centre Canadian study demonstrating the importance of the existential domain. Palliat Med. 1997;11 (1):3-20.
- Cohen, R., Strobel, M. G., & Bui. (n.d.). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of validity and acceptability – S Robin Cohen, Balfour M Mount, Michael G Strobel, France
- Bui, 1995. Retrieved from https://journals.sagepub.com/doi/abs/10.1177/026921639500900306?ssource=mfc&rss=1&
- Khatri, M., M.D. (n.d.). Quality of Life Scale for Pain. Retrieved from https://www.webmd.com/pain-management/guide/quality-of-life-scale-for-pain
- Measuring Health-related quality of life (HRQoL). (2017, April 19). Retrieved from https://www.eupati.eu/health-technology-assessment/measuring-health-related-quality-life-hrqol/
- Psychology. (n.d.). Retrieved from https://psychology.iresearchnet.com/industrial-organizational-psychology/job-satisfaction/quality-of-work-life/
- Skevington, S. M. (1999). Measuring quality of life in Britain: Introducing the WHOQOL-100. Journal of Psychosomatic Research, 47(5), 449-459. doi:10.1016/S0022-3999(99)00051-3
- Ubel, P. A., Loewenstein, G., & Jepson, C. (2003). Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Quality of Life Research, 12(6),599–607.
- Vahedi, S. (2010). World Health Organization Quality-of-Life Scale (WHOQOL-BREF): Analyses of Their Item Response Theory Properties Based on the Graded Responses Model. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395923/