Tools
Quality of Well-being Scale
Summary / Explanation
Introduction
Health professionals, researchers, and policymakers find it crucial to measure how well treatments and interventions work on improving health. It is essential to measure, monitor, and document changes in health status over time. There are a variety of existing ways to assess health changes over time by looking at factors such as blood pressure or body weight. However, many tools are highly specific or too narrow in scope to fully capture the person’s overall functioning and well-being.[1] After several iterations of development and refinement, the Quality of Well-Being Scale (QWB) was developed as a comprehensive assessment tool to measure health-related quality of life factors. Since its development in the 1970s, the Quality of Well-Being Scale has been validated, and its associated psychometric properties have been well established.[2]
Health-related quality of life is a term used to encapsulate a full picture of how one’s health impacts their overall well-being. With regard to health-related quality of life, the standard measurement in medical cost-effectiveness research is the quality-adjusted life year.[2] The quality-adjusted life year incorporates health-related quality of life in addition to one’s entire life to create a single all-inclusive expression of health outcomes. The quality of well-being scale was the first assessment tool specifically created to measure the quality of life to estimate quality-adjusted life years.[1] By using the quality of well-being scale before and after treatments in well-controlled studies, researchers can see how well treatments work and whether one’s quality of life improves as a result. Tools such as this can assist healthcare professionals in making informed treatment decisions.[2]
Patient Populations
Many studies have been conducted using the Quality of Well-Being Scale on a variety of patient populations. Notable examples include patients with:
- Emphysema [3]
- Osteoarthritis [4][5][6]
- Musculoskeletal disease [7]
- Chronic obstructive pulmonary disease [8]
- Alzheimer disease [9]
- Panic disorder [10]
- Epilepsy [11]
- AIDS [6]
- Cystic fibrosis [12]
- Atrial fibrillation [13]
- Depression [14][5]
- Limb amputations [15]
- High-risk pregnancy [16]
- Fibromyalgia [5]
- Diabetes [17]
- Headaches [18]
Modes of Administration
The caliber of the Quality of Well-Being Scale has been somewhat limited due to its length, complexity, branching questions, and the need for a trained interviewer for administration. In response to these limiting factors and in an effort to increase utility, the scale expanded its modes of administration to include four options for administration: self-administered, interviewer-administered, proxy-administered, and online.
Self-Administered Version
The Quality of Well-Being Scale Self-Administered version takes approximately ten minutes to complete and does not require a trainer interviewer.[19] This version asks patients about symptoms and functioning over the past three days. The purpose behind this timeframe is to reduce recall bias without reducing the scale’s ability to measure over a period of time. The Quality of Well-Being Scale Interviewer-Administered version asks patients about the past six days. While the self-administered version assesses over half the amount of time (prior 3 days), there was no significant difference in scores, suggesting strong concordance validity.[19] The Quality of Well-Being Scale Self-Administered version covers many symptoms and asks patients about various aspects of health, including signs and predictors of numerous disease conditions and their associated severity. When creating the self-administered version, several focus groups of physicians assisted in the creation of this tool, and as such, this assessment closely resembles how a healthcare professional would conduct an examination (interview and assessment) of a patient’s symptoms, adding to its clinical utility. To further increase its clinical utility, the Quality of Well-Being Scale Self-Administered version has been translated into Swedish, Dutch, Spanish, French-Canadian, German, Chinese, and Italian.
Scoring algorithms are covered in the Quality of Well-Being Scale Self-Administered Scale User’s Manual 2008, available to all individuals and entities signing a QWB-SA copyright agreement with the William J. Sieber, Erik J. Groessl, Kristin M. David, Theodore G. Ganiats, and Robert M. Kaplan.[2]
Register For Free And Read The Full Article
Search engine and full access to all medical articles- 10 free questions in your specialty
- Free CME/CE Activities
- Free daily question in your email
- Save favorite articles to your dashboard
- Emails offering discounts
Learn more about a Subscription to StatPearls Point-of-Care
References
Kaplan RM, Hays RD. Health-Related Quality of Life Measurement in Public Health. Annual review of public health. 2022 Apr 5:43():355-373. doi: 10.1146/annurev-publhealth-052120-012811. Epub 2021 Dec 9 [PubMed PMID: 34882431]
Level 2 (mid-level) evidencede la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, Gemio Del Rey IA. Quality-adjusted life years and surgical waiting list: Systematic review of the literature. World journal of gastrointestinal surgery. 2024 Apr 27:16(4):1155-1164. doi: 10.4240/wjgs.v16.i4.1155. Epub [PubMed PMID: 38690041]
Level 1 (high-level) evidenceKaplan RM, Sun Q, Ries AL. Quality of well-being outcomes in the National Emphysema Treatment Trial. Chest. 2015 Feb:147(2):377-387. doi: 10.1378/chest.14-0528. Epub [PubMed PMID: 25340383]
Level 2 (mid-level) evidenceGroessl EJ, Kaplan RM, Cronan TA. Quality of well-being in older people with osteoarthritis. Arthritis and rheumatism. 2003 Feb 15:49(1):23-8 [PubMed PMID: 12579590]
Level 2 (mid-level) evidenceVan Dyne A, Moy J, Wash K, Thompson L, Skow T, Roesch SC, Cronan T. Health, Psychological and Demographic Predictors of Depression in People with Fibromyalgia and Osteoarthritis. International journal of environmental research and public health. 2022 Mar 14:19(6):. doi: 10.3390/ijerph19063413. Epub 2022 Mar 14 [PubMed PMID: 35329109]
Kaplan RM, Anderson JP, Wu AW, Mathews WC, Kozin F, Orenstein D. The Quality of Well-being Scale. Applications in AIDS, cystic fibrosis, and arthritis. Medical care. 1989 Mar:27(3 Suppl):S27-43 [PubMed PMID: 2921885]
Level 2 (mid-level) evidenceFrosch DL, Kaplan RM, Ganiats TG, Groessl EJ, Sieber WJ, Weisman MH. Validity of self-administered quality of well-being scale in musculoskeletal disease. Arthritis and rheumatism. 2004 Feb 15:51(1):28-33 [PubMed PMID: 14872452]
Level 2 (mid-level) evidenceKaplan RM, Atkins CJ, Timms R. Validity of a quality of well-being scale as an outcome measure in chronic obstructive pulmonary disease. Journal of chronic diseases. 1984:37(2):85-95 [PubMed PMID: 6420431]
Level 2 (mid-level) evidenceKerner DN, Patterson TL, Grant I, Kaplan RM. Validity of the Quality of Well-Being Scale for patients with Alzheimer's disease. Journal of aging and health. 1998 Feb:10(1):44-61 [PubMed PMID: 10182417]
Level 2 (mid-level) evidenceRubin HC, Rapaport MH, Levine B, Gladsjo JK, Rabin A, Auerbach M, Judd LL, Kaplan R. Quality of well being in panic disorder: the assessment of psychiatric and general disability. Journal of affective disorders. 2000 Jan-Mar:57(1-3):217-21 [PubMed PMID: 10708834]
Level 2 (mid-level) evidenceGao L, Xia L, Pan SQ, Xiong T, Li SC. Validation of a Chinese version of the Quality of Well-Being Scale-Self-Administered (QWB-SA) in patients with epilepsy. Epilepsia. 2013 Sep:54(9):1647-57. doi: 10.1111/epi.12324. Epub 2013 Jul 22 [PubMed PMID: 23875999]
Level 1 (high-level) evidenceOrenstein DM, Nixon PA, Ross EA, Kaplan RM. The quality of well-being in cystic fibrosis. Chest. 1989 Feb:95(2):344-7 [PubMed PMID: 2914486]
Level 2 (mid-level) evidenceGaniats TG, Browner DK, Dittrich HC. Comparison of Quality of Well-Being scale and NYHA functional status classification in patients with atrial fibrillation. New York Heart Association. American heart journal. 1998 May:135(5 Pt 1):819-24 [PubMed PMID: 9588411]
Level 2 (mid-level) evidencePyne JM, Sieber WJ, David K, Kaplan RM, Hyman Rapaport M, Keith Williams D. Use of the quality of well-being self-administered version (QWB-SA) in assessing health-related quality of life in depressed patients. Journal of affective disorders. 2003 Sep:76(1-3):237-47 [PubMed PMID: 12943954]
Level 2 (mid-level) evidenceEskridge SL, Dougherty AL, Watrous JR, McCabe CT, Cancio JM, Mazzone BN, Galarneau MR. Prosthesis satisfaction and quality of life in US service members with combat-related major lower-limb amputation. Prosthetics and orthotics international. 2022 Feb 1:46(1):68-74. doi: 10.1097/PXR.0000000000000054. Epub [PubMed PMID: 34789707]
Level 2 (mid-level) evidenceMirzakhani K, Khadivzadeh T, Faridhosseini F, Ebadi A. Development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index in Mashhad: a methodological study. Reproductive health. 2022 Dec 1:19(1):218. doi: 10.1186/s12978-022-01529-0. Epub 2022 Dec 1 [PubMed PMID: 36457135]
Cherrington AL, Tripputi MT, Younes N, Herman WH, Katona A, Groessl EJ, Craig J, Gonzalez JS, Garg R, Casula S, Kuo S, Florez HJ, GRADE Research Group. Impact of Glucose-Lowering Medications on Health-Related Quality of Life in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes care. 2024 Apr 1:47(4):603-609. doi: 10.2337/dc23-1648. Epub [PubMed PMID: 38190625]
Level 2 (mid-level) evidenceHazewinkel MHJ, Gfrerer L, Ashina S, Austen WG, Klassen AF, Pusic A, Kaur MN. Readability analysis and concept mapping of PROMs used for headache disorders. Headache. 2024 Apr:64(4):410-423. doi: 10.1111/head.14706. Epub 2024 Mar 25 [PubMed PMID: 38525832]
Andresen EM, Rothenberg BM, Kaplan RM. Performance of a self-administered mailed version of the Quality of Well-Being (QWB-SA) questionnaire among older adults. Medical care. 1998 Sep:36(9):1349-60 [PubMed PMID: 9749658]
Level 2 (mid-level) evidence