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Quality of Life Questionnaire

Using the WHO quality of life document, we can develop a questionnaire to assess a patient’s suffering. Someone who is dealing with a health condition may be suffering, which will impact their life.

It’s important to state that I have quite a few patients with severe medical conditions who don’t suffer. We’ll discuss that in future articles. For now, let’s go through the questions to assess the quality of life of a patient who might be dealing with a medical problem.

Quality of Life Questionnaire Items

The following QOL questionnaire can be interpreted as a Health Suffering Questionnaire to assess how someone feels or copes with their health status.

  1. Physical Health
    • How would you rate your quality of life?
    • How satisfied are you with your health?
    • Do you have enough energy for everyday life?
    • How satisfied are you with your ability to perform your daily activities?
    • How satisfied are you with your capacity to perform work?
  2. Psychological Health
    • How much do you enjoy life?
    • To what extent do you feel your life to be meaningful?
    • How well are you able to concentrate?
    • How satisfied are you with yourself?
    • How often do you have negative feelings such as blue mood, despair, anxiety, and depression?
  3. Social Relationships
    • How satisfied are you with your personal relationships?
    • How satisfied are you with your sex life?
    • How satisfied are you with the support you get from your friends?
  4. Environment
    • How safe do you feel in your daily life?
    • How healthy is your physical environment (e.g. pollution, noise, traffic, climate)?
    • Do you have enough money to meet your needs?
    • How available is the information you need in your day-to-day life?
    • To what extent do you have the opportunity for leisure activities?
    • How satisfied are you with your living conditions?
    • How satisfied are you with your access to health services?
    • How satisfied are you with your transport?

QOL Questionnaire Scoring System

Absolute scores are insightful but shouldn’t be used in isolation. In my practice, I assess patients regularly to see how their scores change over time.

Each item is rated on a 5-point Likert scale. Don’t think too much about these; just go with your gut instinct.

  • 1 = Not at all
  • 2 = A little
  • 3 = Moderate
  • 4 = Very much
  • 5 = Extreme

Calculating Domain Scores

Domain scores are important because each chapter contributes to a human being’s overall suffering. The goal of breaking the questionnaire and score into domains is to know which aspects to focus on.

  1. Physical Health Domain Score: Sum of items 3, 4, 10, 15, 16, 17, 18
  2. Psychological Health Domain Score: Sum of items 5, 6, 7, 11, 19, 20, 21
  3. Social Relationships Domain Score: Sum of items 22, 23, 24
  4. Environment Domain Score: Sum of items 8, 9, 12, 13, 14, 25, 26

Each domain score is scaled in a positive direction so that higher scores indicate higher quality of life. The raw domain scores are converted to a 0-100 scale for easier interpretation and comparison across studies and populations.

Example Calculations

If a patient rates the following:

  • Physical Health: 4, 3, 2, 4, 4, 3, 4
  • Psychological Health: 3, 4, 2, 5, 3, 4, 3
  • Social Relationships: 4, 3, 5
  • Environment: 4, 3, 2, 5, 4, 3, 2
  1. Physical Health Domain Score: 4+3+2+4+4+3+4=24
  2. Psychological Health Domain Score: 3+4+2+5+3+4+3=24
  3. Social Relationships Domain Score: 4+3+5=12
  4. Environment Domain Score: 4+3+2+5+4+3+2=23

To convert these scores to a 0-100 scale:

Converted score for each domain=((Raw Score−Min Score)/(Max Score−Min Score))×100

For example, if the minimum possible score for Physical Health is 7 and the maximum is 35, the converted score would be:

((24−7)/(35−7))×100=60.71

To obtain the overall score calculation, we’d use the following equation. For example:

  • Domain Scores:
    • Physical Health: 60
    • Psychological Health: 70
    • Social Relationships: 75
    • Environment: 65

Overall Score:

(60+70+75+65)/4=67.5

This overall score represents the average quality of life across all domains, with higher scores indicating better overall quality of life, 100 being the maximum.

This methodology ensures that scores are comparable across different domains and populations, providing a comprehensive measure of an individual’s quality of life.

However, these aren’t weighted. Each domain contributes the same value to the overall score. Physical health may be a much more important contributor (weight) to overall wellbeing than your environment.

The WHO believes these are all fairly equally weighted. To discover which has a more important weight, a therapist who can help uncover which domain contributes more to overall wellbeing would need to assess it.

Optimal Scores

Again, we aren’t necessarily trying to compare one person to the rest of the world. But it’s still a good rule for health and suffering; there is no reason one of my patients should suffer so much from indigestion compared to another patient. That would be a major red flag to me.

  1. Physical Health: Higher scores indicate better physical functioning and fewer physical limitations.
  2. Psychological Health: Higher scores suggest better mental health, emotional stability, and cognitive functioning.
  3. Social Relationships: Higher scores reflect more satisfying personal relationships and better social support.
  4. Environment: Higher scores indicate a better living environment, safety, and access to information and resources.

In general, scores closer to 100 are considered optimal, representing a better quality of life in each domain. Even more importantly, my treatments should help my patients improve their scores.

Therefore, improving scores is more important than overall scores.

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