Re: Instruments to measure QoL

[Guest guest]

Dear All,

"Quality of life" is an interesting topic to discuss.

The QLI was developed by Carol Estwing Ferrans and Marjorie Powers in 1984 to measure quality of life in terms of satisfaction with life. The QLI measures both satisfaction and importance regarding various aspects of life.

Importance ratings are used to weight satisfaction responses, so that scores reflect satisfaction with the aspects of life that are valued by the individual. The QLI produces five scores: quality of life overall and in four domains (health and functioning, psychological/spiritual domain, social and economic domain, and family).

The following parameters are taken in account while calculating Quality of Life index:

Cost of Living (15% of the final ranking). This is a guide to how much it will cost you to live in a style comparable to—or better than—the standard of living you’re likely enjoying in the U.S. The primary source in this category is the U.S. State Department’s Index of Overseas Living Costs, used to compute cost-of-living allowances for a Western-style of living in various countries. Each country’s income tax rates are also considered.

Culture and Leisure (10%). To calculate this score, literacy rate, newspaper circulation per 1,000 people, primary and secondary school enrollment ratios, number of people per museum, and a subjective rating of the variety of cultural and recreational offerings is considered.

Economy (15%). Interest rates, GDP, GDP growth rate, GDP per capita, the inflation rate, and GNP per capita to determine each country’s Economy score are considered.

Environment (10%). To figure a country’s score in this category, population density per square kilometer, population growth rate, greenhouse emissions per capita, and the percentage of total land that is protected is taken in account.

Freedom (10%). Freedom House’s 2009 survey is the main source for these scores, with an emphasis on a citizen’s political rights and civil liberties.

Health (10%). In this category, calorie consumption as a percentage of daily requirements, the number of people per doctor, the number of hospital beds per 1,000 people, the percentage of the population with access to safe water, the infant mortality rate, life expectancy, and public health expenditure as a percentage of a country’s GDP is considered.

Infrastructure (10%). To calculate a country’s Infrastructure score, the length of railways, paved highways, and navigable waterways in each country, and equated these things to each country’s population and size is taken in account. They also consider the number of airports, motor vehicles , telephones, Internet service providers, and cell phones per capita.

Safety and Risk (10%). For this category, they use the U.S. Department of State’s hardship Differentials and danger allowances, which are based on extraordinarily difficult, notably unhealthy, or dangerous living conditions.

Climate (10%). When deciding on a score for each country’s climate, they look at its average annual rainfall and average temperature…and consider its risk for natural disasters

Kind Regards and thanks

O.P.Singh

Consultant Health Research and Managment

194-B, 4 C Jamunapuri Colony,

Murlipura Scheme,

Jaipur 302013

Rajasthan India.

Ph: 91 9414752001 (m)

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody, Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita

[Guest guest]

Dear O.P. Singh

That was an interesting post as far as QoL in general is concerned. Can you come up with similar data on QoL in healthcare?

Dr. Smita

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody, Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita

[Guest guest]

Dear All,

Why is quality of life of interest for public health? First, a good or a poor quality of life is, in some ways, the ultimate marker of the success of preventive health practices and of health care. Second, many health care regimens often seem to detract from quality of life, at least in the short run. As individuals, with the help of their physicians, make decisions about treatment choices, they may take quality of life into account, and may seek information about the likely effects on the quality of their life. Third, and related to the previous point, recent rhetoric pits quantity of life against quality of life, especially in terms of end-of-life treatments; the argument is sometimes made that some treatments are inadvisable because the quality of life likely to result for the extra time gained is too poor. Thus, quality of life has

come to be seen as a gold standard for weighing the benefits and costs of life-extending treatments.

In health care, the term "health-related quality of life" (HRQL) is often used. This approach narrows consideration to those aspects of quality of life that are deemed to be affected positively or negatively by medical or health care intervention. Another important distinction is between a general HRQL measure (e.g., one that asks about quality of life affected by health) in contrast to a disease-specific HRQL measure. A disease-specific approach may pose questions in relation to the effects of a particular disease (e.g., cancer, arthritis, heart disease) and its treatment with items such as "have you experienced reduction in social activities because of your condition." Other

tools are comprised of objective items (for example, agree-disagree items) that are thought to be particularly relevant to the particular disease. A generic HRQL measure may simply be a general measure that attempts to tap health status using the full range of the World Health Organization's definition of health: "physical, psychological, and social well-being."

MEASURES OF QUALITY OF LIFE

Examples of some general HRQL measures in widespread use include the Sickness Impact Profile (SIP), which was developed by Bergner and colleagues in the 1970s, and the Medical Outcomes Studies (MOS) Short Form, known as the SF-36, developed by Ware and colleagues. The SIP, which was developed in the 1970s, contains 136 items that tap twelve categories of wellbeing: sleep and rest, eating, work, home management, recreation and pastimes, ambulation, mobility, body care and movement, social interaction, alertness behavior, emotional behavior, and communication. As its name suggests the SF-36 contains thirty-six questions and generates scores in eight categories: physical

functioning, role limitations due to physical problems, social functioning, bodily pain, general mental health, role limitations due to emotional problems, vitality, and general health perceptions; an SF-12 is also available that provides summary scores for physical and mental functioning.

The best known approach specifically for elderly people is the Multi-level Assessment Instrument (MIA), developed by Lawton and colleagues; this is a 152-item battery that generates scores in seven areas: physical health, cognition, activities of daily living, time use, social relations and interactions, personal adjustment, and perceived environment. More recently, Kane and colleagues have been conducting research to develop a self-report measure of the psychosocial aspects of quality of life for nursing home residents: Their eleven domains include comfort, functional competence, autonomy, dignity, individuality, privacy, relationships, meaningful activity, sense of security and

safety, enjoyment, and spiritual well-being.

The Quality of Well-being (QWB) Scale, developed by Kaplan and colleagues, differs from the approaches so far described because it defines quality on twenty-four functional states on a scale ranging from 0 for death to 1 for perfect health. The scoring weights were developed based on preferences that individuals assign to the various states.

Even if subjective appraisal is treated as a gold standard, some people will simply be unable to communicate about the quality of their lives, and alternative sources of information must be sought. This will be particularly true of people with severe cognitive impairments such as Alzheimer's disease, or people who suffer the communication and motor problems associated with stroke (which could prevent both written or oral administration of a questionnaire). It is, of course, also true of very young children, including newborn children with disabilities that are believed to severely compromise the quality of their current and expected future lives. The hospice movement has stimulated

interest in appraising quality of life at the time of death, yet many people cannot be effectively queried on the subject in the last few days of life.

The growing attention to quality of life and the desire to minimize the negative effects of disease and health care on this quality reflects the highest of public health aspirations. The science of measuring quality-of-life outcomes is still under development.

Kind Regards,

O.P.Singh

Consultant Health Research and Managment

194-B, 4 C Jamunapuri Colony,

Murlipura Scheme,

Jaipur 302013

Rajasthan India.

Ph: 91 9414752001 (m)

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody, Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita

[Guest guest]

Hi,

Thank you for providing comprehensive details.

I have mentioned in an earlier post about types of instruments for assessing QOL. Let us know more about these.

Disease specific HRQOL instruments can be used to measure the longitudinal changes in QOL of patients following the intervention.

Merits of disease-specific instruments:

1. High responsiveness

2. Clinical relevance to patients: assess the particular concerns and conditions related to that particular disease or health state

3. Sensitiveness to detect small changes between pre and post intervention period

Generic instrument assesses general aspect of HRQoL that are applicable to any disease or health conditions but lacks sensitivity to detect the changes after the intervention. Generic measures are good for comparing across populations.

Dr.Smita

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody, Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita

[Guest guest]

Very nice summary. Another point worth remembering is the use of quality of life in calculating disease burden of countries and regions within the countries. In these calculations, not just the number of years lost, but the amount of life lost in terms of quality adjustment is an issue as well. Which is where a disease specific or generic quality of life calculation becomes an important issue. ArinSent from my iPadOn 10/02/2011, at 5:07 AM, smita sontakke <smitaavanti@...> wrote:

Hi,

Thank you for providing comprehensive details.

I have mentioned in an earlier post about types of instruments for assessing QOL. Let us know more about these.

Disease specific HRQOL instruments can be used to measure the longitudinal changes in QOL of patients following the intervention.

Merits of disease-specific instruments:

1. High responsiveness

2. Clinical relevance to patients: assess the particular concerns and conditions related to that particular disease or health state

3. Sensitiveness to detect small changes between pre and post intervention period

Generic instrument assesses general aspect of HRQoL that are applicable to any disease or health conditions but lacks sensitivity to detect the changes after the intervention. Generic measures are good for comparing across populations.

Dr.Smita

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody, Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita

[Guest guest]

Thank u Arin for supplementing my answer. Am going to discuss in further detail the applications of QOL measures.

Dr. Smita

From: smita sontakke <smitaavanti@...>Subject: Instruments to measure QoL"netrum group" <netrum >Date: Wednesday, 9 February, 2011, 9:27 AM

Hello Everybody,

Number of instruments have been designed to measure QoL in a variety of settings. These instruments reflect the two philosophical approaches to measuring QoL: assessing it as a single, complete entity, or selecting individual components for measurement.

Consequently, some authors describe instruments which measure only one of these dimensions, such as functional disability, as QoL measures.

Most QoL measures are generic rather than disease specific and can be divided into two categories: those which provide a single, global score of well-being (health indices) and those designed to measure a number of dimensions of health status (health profiles). As such, hundreds of validated QoL questionnaires have been developed to suit the needs of various illnesses. QoL questionnaires should meet certain quality criteria, most importantly with regard to their reliability and validity. The questionnaires can be generalized into two categories:

(i) Generic instruments, which include general health profiles (e.g. SF-36, Short-Form with 36 questions) and

(ii) Disease or Disorder specific instruments, which focus on problems associated with individual diseases, patient groups or areas of function. (e.g. the LC -13 Lung Cancer module from the EORTC Quality of Life questionnaire library, or the HADS Hospital Anxiety and Depression Scale). Both types are multifactorial constructs and assess the individual's perception of physical, mental and social functioning. Two of the most widely used generic QoL questionnaires are the EuroQoL-5 Dimension (EQ-5D) and the ShortForm-12 (SF-12) questionnaire from QualiMetrics. Dr. Smita