Wisconsin Quality of Life Index
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Wisconsin Quality of Life Index
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Louis de la Parte Florida Mental Health Institute
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Wiconsin Quality of Life Index Client Questionniare CONCEPTUAL FRAMEWORK The Wisconsin Quality of Life Index (W-QLI) Client Questionnaire is a comprehensive multi-dimensional measurement tool that reflects the personal priorities and goals of individual mental health clients. On the basis of previous research, our clinical experience, and recommendations from an advisory board convened to develop the index, we defined QoL as made up of the following nine domains: 1) general life satisfaction, 2) activities and occupations, 3) psychological well-being, 4) physical health, 5) social relations/support, 6) economics, 7) activities of daily living, 8) symptoms, and 9) goal attainment. Each domain can be individually weighted depending on its relative importance to the patient. While this instrument can be used by itself, it is meant to be used in conjunction with two other instruments that measure patient QoL from the provider and caregiver perspectives. The Wisconsin Quality of Life Index Client Questionnaire was designed to be self-administered though clients can be assisted if necessary. DOMAINS General Satisfaction Level This domain measures the client’s overall life satisfaction about a broad array of issues such as satisfaction with their living environment, housing, food, clothing, and mental health services. Each indicator is also rated for importance, and the score for each item is determined by multiplying each patient’s satisfaction response with the importance response. Activities and Occupations These questions focus on the client’s day-to-day activities related to work, school or day programming. Other items in this domain relate to client’s capacity to work in his/her usual manner and how satisfied they are with the way they spend their time. Psychological Well-Being Among other things, this domain uses the well-validated Bradburn Affect Balance Scale (ABS) to measure the client’s sense of emotional well-being (1). The ABS is a widely used and well validated scale that has been used by other researchers attempting to operationalize and study psychological well-being. The ABS includes separate assessments of negative and positive affect. This domain also includes a global question asking the client to rate their overall mental health during the past four weeks. (1) See The structure of psychological well-being,by N.M. Brandburn, 1969, Chicago: Aldine.Symptoms/Outlook Questions in this domain focus on client’s mental health and subjective assessments of how his/her mental health symptoms affect their QoL and functional abilities. This domain also contains two questions that assess client’s propensity toward harming themselves or others. Physical Health This domain measures the client’s perceptions about his/her physical health. For example, the client is asked to rate his/her physical health during the past four weeks on a 5 point scale from poor to excellent. Another question asks respondents about how satisfied they are with their physical health. Social Relations/Support These questions measure the client’s social relations and social skills -- an area considered essential to the determination of clients’ QoL. The domain includes the International Pilot Study of Schizophrenia (IPSS) outcomes scale related to frequency and type of social contact. In addition, clients are asked to rate the amount of support they experience from their relationships and also their satisfaction with social relations. Money This section focuses on the economic aspects of the client’s QoL. Domain questions ask about the adequacy of client’s financial support and about his/her satisfaction with the amount of control he/she has over those financial resources. These indicators are also rated for importance by the client. This domain also includes a question asking the client how often lack of money prevents him/her from doing what he/she wants to do. Activities of Daily Living (ADL) This domain measures the client’s functional status in accomplishing independent living tasks such as preparing meals, doing laundry, running errands or practicing adequate personal hygiene. Goal Attainment This section focuses on the client’s personal mental health treatment goals. Clients are asked to specify three of the most important goals he/she hopes to accomplish as part of their treatment. Goals are ranked both in terms of their relative importance to the client as well as the extent to which the responder feels each goal has been achieved. Other Analyses of Interest in the W-QLI Client Questionnaire The W-QLI Client Questionnaire contains a number of items that do not load in any specific domains in the total QoL score but which are valuable in both an applied or theoretical context. Examples include: Alcohol & Other Drugs These questions can be used in clinical and program evaluations to stratify populations based on whether or not they use alcohol or drugs and the extent to which clients perceive their drug or alcohol use to be a problem in their lives. These questions allow clinicians and program evaluators to examine differences in QoL and program effectiveness for clients with and without AODA problems. These questions can also be used to compare the degree to which there is congruence between client and provider about whether AODA issues are a problem in the client’s life. Hope This question (Q5) provides the opportunity to examine the role of hope in overall QoL and how treatment outcomes vary depending on differing levels of hope. Locus of Control This question (Q6) provides the opportunity to examine how differences in clients’ sense of control impacts treatment outcomes and overall life quality.
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