by Fred B. Bryant, Ph.D., Emeritus Professor of Psychology, Loyola University Chicago
& Linda S. Perloff, Ph.D., President, Behavioral Measurement Database Services
One of the most frequently studied concepts in the health and psychosocial sciences concerns a person’s self-perception of how well their life is going. Over the years, theorists and researchers have used a wide variety of different conceptual terms—including quality of life, subjective well-being, psychological well-being, subjective mental health, and morale—to denote people’s self-evaluations of how well they are functioning and feeling in their daily lives. These self-assessments of how one’s life is going are distinct from symptoms of psychiatric disorder that epidemiologists and psychiatrists study using diagnostic tools.
Why might one want to measure subjective quality of life? The importance of studying self-assessed life quality has been documented by studies that link self-perceived well-being to enhanced physiological functioning (Ryff & Singer, 1998), greater ability to cope with stress (Salovey, Rothman, Detweiler, & Steward, 2000), and even reduced mortality (Chida & Steptoe, 2008). In clinical practice, counselors and psychotherapists can use measures of quality of life to identify and prioritize clients’ personal problems, screen for hidden issues, facilitate shared clinical decision-making, and monitor changes in response to treatment (Higginson & Carr, 2001). More generally, measures of well-being can facilitate efforts to enhance people’s quality of life by providing concrete criteria to use in evaluating the effectiveness of structured interventions and in pinpointing determinants of subjective life quality. The two terms most often used to designate people’s own subjective views of how well their lives are going are “quality of life” and “well-being” (Wish, 1986).
Where did measures of quality of life and well-being originate? Self-report measures of subjective quality of life originally evolved from the use of quantitative indices to monitor objective social conditions. Sociologists and public administrators first studied “social indicators” or aggregate statistics reflecting unemployment rates and social status, to assess how economic, social, and political changes influence the objective quality of life (Bauer, 1966). As this work progressed, however, researchers began to recognize the importance of also considering individuals’ own perceptions of the subjective quality of life. Likewise, healthcare evaluators initially focused on objective health indicators, such as mortality rates and functional status, to assess the impact of medical treatments on quality of life (Berg, 1975). But later this objective focus was expanded to include patients’ own thoughts and feelings about their inner experience (Freed, 1984).
In general, the concept of quality of life is somewhat more central to theory and research in the health sciences, whereas the concept of well-being is somewhat more central to theory and research in the psychosocial sciences. However, both concepts are prevalent in the health and psychosocial science literatures.
What is the difference between quality of life and well-being? What exactly do the terms “quality of life” and “well-being” mean, and how do these two concepts relate to one another? Although quality of life and subjective well-being are often used synonymously in research, policy, and practice, they are not equivalent and are in fact connected to different theoretical concepts (Skevington & Böhnke, 2018). While there are numerous definitions of both terms, these alternative definitions generally share a common emphasis on people’s self-perceptions of their inner experience along multiple dimensions, including thoughts, feelings, and behaviors (Diener, 1984). However, quality of life can be assessed using not only subjective measures, but also objective measures—for example, social scientists would consider individual self-perceptions of wealth as reflecting life quality (Cummins, 2000), whereas economists would regard physical, tangible measures of wealth (e.g., annual income, real estate holdings) as reflecting an individual’s life quality.
Concerning the conceptual content of quality of life, the World Health Organization has defined quality of life as “an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns” (The WHOQOL Group, 1995, p. 1403).
Concerning the conceptual content of well-being, theory and research reflect two general emphases—namely: (a) hedonic experience, exemplified by subjective well-being, which focuses on happiness, life satisfaction, and perceived level of stress; and (b) eudaimonic experience, exemplified by psychological well-being, which focuses on meaning, personal growth, and self-acceptance (Ring, Höfer, McGee, Hickey, & O’Boyle, 2006; VanderWeele et al., 2020).
General versus Context-Specific Measures of Quality of Life and Well-being. Within both the quality of life and well-being literatures, there is a distinction between instruments that are designed to assess (a) how people are functioning or feeling in general versus (b) how they are functioning or feeling in relation to specific circumstances or concerns that they may be facing. With respect to quality of life, researchers have developed both general measures, as well as disease-specific measures of quality of life in relation to a variety of health concerns, including arthritis, cancer, diabetes, chronic pain, heart disease, kidney disease, and pulmonary disease. With respect to well-being, researchers have developed both general measures as well as domain-specific measures of well-being in relation to a variety of life concerns, including marriage, parenting, finances, spirituality, and work. What’s more, there are also conceptually narrower instruments designed to measure separate facets of quality of life (e.g., functional status, physical activity, social participation) or well-being (e.g., happiness, life satisfaction, future morale). In addition, researchers have developed population-specific self-report measures to assess quality of life or well-being among children, adolescents, and older adults.
Finding an Appropriate Measurement Instrument
Given the tremendous breadth and diversity of measures available for assessing quality of life or well-being, how should one go about finding the most appropriate instrument to use? Clearly, the first steps in identifying an appropriate instrument are to decide: (a) whether you want to measure people’s perceptions of how they are functioning versus how they are feeling; (b) whether you want to focus on general versus specific ways of functioning or feeling; and (c) whether you want to focus on functioning or feeling in relation to life in general versus in relation to one or more specific contexts. Without first making these decisions, you may end up with an instrument that measures a different construct than the one you intended to measure.
Having decided exactly what it is that you wish to assess, then you can use the Health and Psychosocial Instrument (HaPI) database to pinpoint the specific measurement instruments that are most suitable for your particular purposes.
Self-Report Instruments for Assessing Quality of Life and Well-Being Covered in the HaPI Database
If someone uses the HaPI database to search for bibliographic information on instruments that measure quality of life or well-being, what would they find? More specifically, how many different measures of quality of life or well-being does the HaPI database include?
To give you a sense of the breadth and depth of information in the HaPI database about instruments that measure quality of life or well-being, we conducted a search of the database in November 2024. Here’s what we found.
Quality of life. HaPI contains records for 524 unique instruments that have “quality of life” in their title. Just to name a few of these instruments (and this is just the tip of the iceberg), HaPI contains records describing:
- Overall Quality of Life Measure (Sousa & Chen, 2002), which examines four domains of life quality (cognition, vitality, mental health, and health worry);
- Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q; Endicott, Nee, Yang, & Wohlberg, 2006), designed to assess quality of life in children and adolescents over the past week, including their evaluations of various aspects of their lives (e.g., health, mood, school, ability to get along with friends and family, free time, and the place where they live);
- Quality of Life in Adult Cancer Survivors (QLACS; Avis et al., 2005), which measures quality of life in long-term cancer survivors, including generic domains (e.g., positive and negative affect, cognitive difficulties, physical pain, fatigue) and cancer-specific domains (e.g., concerns about appearance, financial problems, worry over recurrence, family-related distress);
- Work-Related Quality of Life Scale for Healthcare Workers (WRQoL; Van Laar, Edwards, & Easton, 2007), which addresses the quality of work life among health personnel, including work-based factors (e.g., job satisfaction, work stress), as well as broader non-work factors such as home-work interface;
- Schizophrenia Caregiver Quality of Life Questionnaire (S-CGQoL; Richieri et al., 2011), designed to evaluate quality of life among caregivers of individuals with schizophrenia; and
- Body Image Quality of Life Inventory (BIQLI; Cash & Fleming, 2002), which measures the positive and negative impact of body image on perceived quality of life, including effects on emotional states, interpersonal relationships, sexual experiences, and functioning at work and school.
In addition, HaPI contains records covering quality of life instruments in 40 different languages, including Albanian, Arabic, Bengali, Bosnian, Chinese, Croatian, Czech, Danish, Dutch, English, Filipino, Finnish, French, German, Greek, Hebrew, Hindi, Hmong, Hungarian, Indonesian, Italian, Japanese, Korean, Lithuanian, Malay, Norwegian, Persian, Polish, Portuguese, Punjabi, Romanian, Russian, Slovenian, Spanish, Swahili, Thai, Turkish, Vietnamese, and Zulu.
Well-Being. Our November 2024 search revealed that the HaPI database contains records for 138 unique instruments that have “well-being” in their title. Just to name a few of these instruments (and, again, this is just the tip of the iceberg), HaPI contains records describing:
- General Well-Being Schedule (GWB; Dupuy, 1987), a measure of subjective feelings of psychological well-being and distress for use in community surveys;
- Index of Well-Being (IWB; Kaplan, Bush, & Berry, 1976), a measure of health status that includes two distinct components (level of well-being and prognosis);
- Body-Mind-Spirit Well-Being Inventory (BMSWBI; Ng et al., 2005), a multidimensional inventory designed to assess holistic health along four dimensions (physical distress, daily functioning, affect, and spirituality);
- Spiritual Well-Being Scale (SWBS; Paloutzian & Ellison, 1982), a measure of religious and existential aspects of well-being;
- Scales of Psychological Well-Being (Ryff, 1989), which evaluates six dimensions of psychological well-being (self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth); and
- Warwick-Edinburgh Mental Well-Being Scale (WEMWBS; Tennant et al., 2007), which assesses positive aspects of mental health using items tapping both hedonic and eudaimonic well-being (including positive affect, social relationships, self-acceptance, personal development, competence, and autonomy).
In addition, HaPI contains records covering well-being instruments in 30 different languages, including Catalan, Chinese, Croatian, Danish, Dutch, English, Estonian, Finnish, Flemish, French, German, Hebrew, Hindi, Hungarian, Icelandic, Italian, Japanese, Konkani, Korean, Malaya, Norwegian, Persian, Polish, Portuguese, Spanish, Swedish, Turkish, and Urdu.
Conclusion
To summarize, the HaPI database enables students, researchers, and practitioners to identify a wide range of health and psychosocial instruments designed to measure either quality of life or subjective well-being. With respect to quality of life, the database includes bibliographic information for both broad-band instruments that assess general, overall quality of life, as well as narrow-band instruments that assess quality of life in relation to a variety of specific diseases and health concerns. With respect to well-being, the database includes bibliographic information for both broad-band instruments that assess general, overall well-being, as well as narrow-band instruments that assess well-being with respect to specific life domains or individual facets of well-being. There are also records for measures of quality of life and well-being specifically designed for children, adolescents, adults, or the elderly, as well as for measures in a host of different languages. Clearly, the HaPI database is an invaluable resource for finding measures of quality of life or well-being.
References
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