The WHO (Ten) Well-Being Index: validation in diabetes. Reliability and validity of the Thai version of the WHO-Five Well-Being Index in primary care patients. Changes in quality of life in chronic psychiatric patients: A comparison between EuroQol (EQ-5D) and WHOQoL EQ-5D in a general population survey – A description of the most commonly reported EQ-5D health states using the SF-36 Determinants of objective and subjective quality of life in first-time-admission schizophrenic patients in Poland: a longitudinal study Effects of a health examination programme on quality of life and subjective well-being The well-being questionnaire: evidence for a three-factor structure with 12 items (W-BQ12). Validation of the WHO Quality of Life assessment instrument (WHOQOL-100) in a population of Dutch adult psychiatric outpatients. A single European currency for EQ-5D health states Valuing health‐related quality of life: An EQ‐5D‐5L value set for England The EQ-5D: A useful quality of life measure in borderline personality disorder? Development of a brief measure to assess quality of life in obesity. Proxy Reporting of Quality of Life Using the EQ-5D Workplace Telecommunications Technology to Identify Mental Health Disorders and Facilitate Self-Help or Professional Referrals Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Psychometric assessment of the Quality of Life Index. A comparison of the standard and the computerized versions of the Well-being Questionnaire (WBQ) and the Diabetes Treatment Satisfaction Questionnaire (DTSQ)
BACKGROUND In a European trial in 8 countries , the subjective well-being of patients on alternative forms of treatment for insulin-dependent diabetes was compared using the 28-item WHO Well-Being Question naire , covering four dimensions of depression , anxiety , energy and positive well-being . The objective of the analysis reported here has been to identify the items of the WHO question naire which belong to an overall index of negative and positive well-being . METHODS Adult patients at 10 study centres in 8 countries who had been on insulin for at least 2 years were invited to participate in a r and omised , cross-over trial to compare insulin pump treatment with injection therapy . At each phase , patients completed questions on well-being and general health . Internal validity of the well-being index was evaluated by Cronbach 's alpha and Loevinger 's and Mokken 's homogeneity coefficients , as well as factor analysis . External validity was evaluated by comparisons with results of the general assessment questions and by the ability to discriminate between the alternative forms of treatment . RESULTS 358 patients had sufficient data for analysis . Ten items were found to constitute a valid index of well-being with respect to internal and external validity . Coefficients of homogeneity were acceptable and there was evidence for both concurrent and discriminant validity . CONCLUSIONS The WHO ( Ten ) well-being index includes negative and positive aspects of well-being in a single uni-dimensional scale . Its advantage lies in its ability to show overall change along the continuum of well-being , thus facilitating comparisons between patient groups and treatments . It is not specific to diabetes , and therefore may be useful as a disease-independent index of well-being in a broad range of health care studies AIMS Because of the high patient load in Thail and , we need a practical measurement to help primary physicians detect depression . This study aim ed to examine the reliability and validity of the Thai version of the World Health Organization-Five Well-Being Index  ( WHO-5-T ) , which is short and easy to use as a screening tool for major depression in primary care patients . METHODS The English version of the WHO-Five Well-Being Index was translated into Thai . Back-translations , cross-cultural adaptation and field testing of the pre-final version with final adjustments were performed accordingly . The WHO-5-T was administered r and omly to 300 patients in our primary care clinic . Then the patients were further assessed using the  Mini International Neuropsychiatric Interview  and the  Hamilton Rating Scale for Depression  as the gold st and ard of diagnosis and symptom severity , respectively . RESULTS Completed data were obtained from 274 respondents . Their mean age was 44.6 years [ st and ard deviation ( SD ) = 14.7 ] and 73.7 % of them were female . The mean WHO-5-T score was 14.32 ( SD = 5.26 ) . The WHO-5-T had a satisfactory internal consistency ( Cronbach 's alpha = 0.87 ) and showed moderate convergent validity with the Hamilton Rating Scale for Depression ( r = -0.54 ; P < 0.001 ) . The optimal cut-off score of the WHO-5-T < 12 revealed a sensitivity of 0.89 and a specificity of 0.71 in detecting depression . The area under the curve in this study was 0.86 ( SD = 0.03 , 95 % confidence interval 0.81 to 0.89 ) . CONCLUSIONS The Thai version of the WHO-Five Well-Being Index was found to be a reliable and valid self- assessment to screen for major depression in primary care setting at a cut-off point of < 12 It has often been postulated that simple , short question naires are unable to reflect complex changes in well-being of individuals with chronic psychiatric disorders . To investigate these assumptions we included two recently developed instruments to measure quality of life  ( the WHOQoL-Bref and the EuroQoL EQ-5D ) in a r and omised control trial ( RCT ) in which two treatment conditions were compared . Aims of the study were to assess the sensitivity and validity of these  quality of life (QoL)-instruments  , to establish their relationship and to examine the predictors of changes in QoL. Subjective changes in QoL were measured on three assessment s waves in a period of 18 months and compared to objective changes in psychopathology and social functioning in a sample of 76 chronic schizophrenic patients who participated in the RCT . Results indicated that both WHOQoL-Bref and EuroQoL EQ-5D are capable of detecting changes in QoL over time in physical and psychological well-being . The instruments partly measure the same aspects of QoL , indicated by 50 % common variance on total scores . Reduction of positive psychotic symptoms appeared to be the most important factor in improving QoL. The weighted TTO-score of EuroQoL-5D , which is often used as an index in economic evaluations of health care , did however not correspond with these changes , which indicates that it is less sensitive to changes in social and psychological well-being . It ’s use as the core measure in ( economic ) health evaluation in the field of psychiatry therefore seems less appropriate The importance of study ing health-related quality of life in the general population has increasingly been emphasized . From a public health perspective , this benefits the identification of population inequalities in health status . One of the currently most popular instruments is the EQ-5D . Evaluations of the EQ-5D generally focus on the overall preference-based index . As this index has a built-in value , exploration of the information from the underlying health states is also important . In this study , the ten most commonly reported EQ-5D health states are described using the SF-36 . Data collected in 1999 by question naires mailed to a r and om sample aged 20–74 in south-eastern Sweden were used ( n = 9489 ) . Almost 43 % reported the best possible EQ-5D health state and 78 % were accounted for by three EQ-5D health states . The EQ-5D health state classification was largely reflected by the SF-36 , with the EQ-5D items mobility , usual activities , pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning , role limitations due to physical health problems , bodily pain , and mental health , respectively . However , within the same level of EQ-5D ( i.e. , moderate problems ) there was a rather large variation of SF-36 scale scores , particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP Objectives This study involved a naturalistic , prospect i ve project assessing objective and subjective dimensions of quality of life ( QoL ) and the range of its putative determinants in first-episode schizophrenia . Methods Seventy-four patients , mean age 24.7 years , participated in the study . The patients were assessed 1 month following the first hospitalisation ( Time 1 ) , 12 months later ( Time 2 ) , and 4–6 years after Time 1 ( Time 3 ) . The Social Functioning Scale and World Health Organisation Quality of Life-BREF ( WHOQOL-BREF ) were applied to evaluate objective and subjective QoL , respectively . The Positive and Negative Syndrome Scale was used to examine psychopathological status , and the Global Assessment Scale was applied to evaluate social adjustment prior to hospitalisation . Results The objective and subjective QoL was relatively low at Time 1 . Over time , the objective QoL improved in three domains , decreased in one domain , and remained stable in three domains . The subjective QoL did not change . The most important predictors of both dimensions of QoL were psychopathology and duration of untreated psychosis . Conclusions Because psychopathology seems to have the greatest impact on the QoL , there is a need to develop community psychosocial treatment to reduce these symptoms and to support patients in the early phase of the disease The effects on quality of life and psychological well-being of a health examination programme in a branch of Swedish industry were studied by means of question naires in 124 white-collar workers . They were asked to answer two question naires , one before and the other one month after the examination ( the Nottingham Health Profile ( NHP ) and the Psychological General Well-being Schedule ( PGWB ) ) . Both are well-known and well-documented st and ard question naires used for estimating quality of life and degree of subjective well-being . The answers were compared with those of a control group comprising other white-collar workers in the same industry , of the same sex and age but who did not participate in the health examination  and who were asked to complete the same question naires twice . The group that had participated in the health examination did not differ generally from the control group with respect to intra-individual differences as studied in the question naires on the two occasions . This indicates that no deterioration of quality of life or of psychological well-being was experienced by the participants in the health examination BACKGROUND The Well-being Question naire ( W-BQ ) has been design ed to measure psychological well-being in people with a chronic somatic illness and is recommended by the World Health Organization for widespread use . However , studies into the factor structure of this instrument are still limited and their findings are inconsistent . This study aim ed to investigate the factor structure of the Dutch version of the W-BQ . METHODS A cross-validation design was used . A total of 1472 people with diabetes completed the W-BQ  and were r and omly assigned to group A or B. In group A ( N = 736 ) , exploratory factor analyses were conducted . Group B ( N = 736 ) was split up into four subgroups of male or female patients with type 1 or type 2 diabetes . In these subgroups , confirmatory factor analyses were employed to test the model(s ) developed in group A and the two models described in the literature ( four-factor model with 22 items and a three-factor model with 12 items ) . RESULTS Exploratory factor analyses yielded a three-factor model with 21 items ( negative well-being , energy and positive well-being ) . In the subgroups of group B confirmatory factor analyses only accepted the three-factor model with 12 items . This factor solution was stable across gender , type of diabetes and level of education . CONCLUSIONS The best description of the factor structure of the Dutch translation of the W-BQ was given by a three-factor solution with 12 items ( W-BQ12 ) , measuring positive well-being ( four items ) , negative well-being ( four items ) and energy ( four items ) BACKGROUND Research concerning the psychometric properties of the  WHO Quality of Life Assessment Instrument ( WHOQOL-100 ) in general population s of psychiatric out patients has not been performed systematic ally . AIMS To examine the content validity , construct validity , and reliability of the WHOQOL-100 in a general population of Dutch adult psychiatric out patients . METHOD A total of 533 psychiatric out patients entered the study ( 438 r and omly selected , 85 internally referred ) . Participants completed self-administered question naires for measuring quality of life ( WHOQOL-100 ) , psychopathological symptoms ( SCL-90 ) , and perceived social support ( PSSS ) .  In addition , they underwent two semi-structured interviews in order to obtain Axis-I and Axis-II diagnoses , according to DSM-IV . RESULTS The drop-out percentage was low ( 7.1 % ) . Of the 24 facets of the WHOQOL-100 , 22 had a good distribution of scores , leaving out the facets physical environment and transport . Exploratory factor analysis revealed a four-factor structure , which was similar to earlier findings in patients with specific somatic diseases and depressive disorders . Various-a priori expected-positive and negative correlations were found between facets and domains of the WHOQOL-100 , and dimensions of the SCL-90 and the PSSS-score , indicating good construct validity of the WHOQOL-100 . The internal consistency of all facets and the four domains of the WHOQOL-100 was good ( Cronbach 's alpha 's ranging from 0.62 to 0.93 and 0.64 to 0.84 , respectively ) . Sparse and relatively low correlations were found between demographic characteristics ( age and sex ) and WHOQOL-100 scores . CONCLUSIONS Content validity , construct validity , and reliability of the WHOQOL-100 in a population of adult Dutch psychiatric out patients are good . The WHOQOL-100 appears to be a suitable instrument for measuring quality of life in adult psychiatric out patients Abstract The EQ-5D question naire is a widely used generic instrument for describing and valuing health that was developed by the EuroQol Group . A primary objective of the EuroQol Group is the investigation of values for health states in the general population in different countries . As part of the EuroQol enterprise 11 population surveys were carried out in six Western European countries ( Finl and , Germany , The Netherl and s , Spain , Sweden and the UK ) to value health states as defined by the EQ-5D using a st and ardised visual analogue scale ( EQ-5D VAS ) . This contribution reports how a European set of general population preference weights was derived from the data collected in the 11 valuation studies . The scores from this set of preference weights can be applied to generate a VAS-based weighted health status index for all the potential 243 EQ-5D health states for use in multi-national studies . To estimate the preference weights a multi-level regression analysis was performed on 82,910 valuations of 44 EQ-5D health states elicited from 6,870 respondents . Stable and plausible solutions were found for the model parameters . The R2 value was 75 % . The analysis showed that the major source of variance , apart from ' r and om error ' , was variance between individuals ( 28.3 % of the total residual variance ) . These results suggest that VAS values for EQ-5D health states in six Western European countries can be described by a common model Abstract A new version of the EQ‐5D , the EQ‐5D‐5L , is available . The aim of this study is to produce a value set to support use of EQ‐5D‐5L data in decision‐making . The study design followed an international research protocol . R and omly selected members of the English general public completed 10 time trade‐off and 7 discrete choice experiment tasks in face‐to‐face interviews . A 20‐parameter hybrid model was used to combine time trade‐off and discrete choice experiment data to generate values for the 3,125 EQ‐5D‐5L  health states . Valuation data are available for 996 respondents .  Face validity of the data has been demonstrated , with more severe health states generally given lower values . Problems with pain/discomfort and anxiety/depression received the greatest weight . Compared to the existing EQ‐5D‐3L value set , there are considerably fewer “ worse than dead ” states ( 5.1 % , compared with over one third ) , and the minimum value is higher . Values range from −0.285 ( extreme problems on all dimensions ) to 0.950 ( for health states 11211 and 21111 ) . Results have important implication s for users of the EQ‐5D‐5L both in Engl and and internationally . Quality ‐adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated INTRODUCTION Borderline Personality Disorder ( BPD ) is a severe psychiatric disorder and is associated with significant impairment in quality of life . The aim of the present study is to assess the internal and external responsiveness of the  EuroQoL-5D ( EQ-5D ) in BPD patients . PATIENTS AND METHODS Data from 49 patients included in a multi-center Dutch r and omized trial were used . We used both the EQ-5D utility score and the Visual Analogue Scale of the EuroQoL , and the  Borderline Personality Disorder Severity Index-IV ( BPDSI-IV ) . To determine internal responsiveness , we calculated the st and ardized response mean ( SRM ) . To determine external responsiveness , we calculated Spearman correlations for the change scores , and compared EQ-5D scores for clinical ly improved vs. non- clinical ly improved patients as measured with the BPDSI-IV . RESULTS Patient scores improved on all instruments during the three years . SRMs for BPDSI-IV were significantly higher than EQ-5D utility . Three-year Spearman correlation between change scores of BPDSI-IV and EQ-5D utility was 0.487 , between BPDSI-IV and EQ-VAS it was 0.404 , both statistically significant . EQ-5D utility scores for patients who clinical ly improved were significantly higher than for patients who did not . DISCUSSION We conclude that the EQ-5D is fairly responsive in BPD , and , therefore , especially because of its brevity and user-friendliness , can serve as a useful tool in economic evaluations in patients with BPD OBJECTIVE Obesity research ers have a growing interest in measuring the impact of weight and weight reduction on quality of life . The Impact of Weight on  Quality of Life question naire ( IWQOL ) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life . Although the IWQOL has demonstrated excellent psychometric properties , its length ( 74 items ) makes it somewhat cumbersome as an outcome measure in clinical research . This report describes the development of a 31-item version of the IWQOL ( IWQOL-Lite ) . RESEARCH METHODS AND PROCEDURES IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite . Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls . RESULTS Confirmatory factor analysis provided strong support for the adequacy of the scale structure . The five identified scales of the IWQOL-Lite  ( Physical Function , Self-Esteem , Sexual Life , Public Distress , and Work ) and the total IWQOL-Lite score demonstrated excellent psychometric properties . The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score . Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite . Changes in  IWQOL-Lite scales over time correlated significantly with changes in weight , supporting its sensitivity to change . Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index , supporting the utility of the IWQOL-Lite across the body mass index spectrum . DISCUSSION The IWQOL-Lite appears to be a psychometrically sound and clinical ly sensitive brief measure of quality of life in obese persons Background . The economic evaluation of health interventions for older people is complicated by the difficulty in obtaining self-reports of quality of life from persons with cognitive impairments , physical impairments , or both . Objectives . Using the EQ-5D ( EuroQoL ) measures , to assess : ( 1 ) agreement between subjects and proxies on subject ’s quality of life ratings at different points in time ; ( 2 ) agreement between subjects and proxies on change of subject ’s quality of life ratings over time ; and ( 3 ) subject and proxy characteristics related to agreement . Research Design . Prospect i ve study of subjects visiting hospital emergency departments ( ED ) . Data were collected at enrollment in the ED and at follow-up , 1 and 4 months after the ED visit . Subjects . The study comprised 231 pairs of cognitively intact patients aged 65 years or older and their primary caregivers . Measures . Quality of life was measured using both components of the EQ-5D scale , the index score and the Visual Analogue Scale ( VAS ) . Demographic characteristics and health status ( physical and mental ) were measured for both subjects and proxies . Subjects and proxies were interviewed either in English or French . Results . There was low to moderate agreement between subjects and proxies at different points in time ( intraclass correlation coefficient [ ICC ] = 0.22 to 0.59 ) , and between subject and proxy change scores over time ( ICC = 0–0.50 ) , on both the index score and the VAS . Better agreement between subjects and proxies was found at the 4 months follow-up , when the subject was less depressed , and when the proxy ’s native language was English . Conclusions . Proxy EQ-5D responses , either for a specific point in time or for assessing change over time , may not be valid measures of self-reported quality of life among older medically-ill patients Purpose . Test the feasibility and impact of an automated workplace mental health assessment and intervention . Design . Efficacy was evaluated in a r and omized control trial comparing employees who received screening and intervention with those who received only screening .  Setting . Workplace . Subjects . 463 volunteers from Boston Medical Center , Boston University , and EMC and other employed adults , among whom 164 were r and omized to the intervention ( N = 87 ) and control ( N = 77 ) groups . Intervention . The system administers a panel of telephonic assessment instruments followed by tailored information , education , and referrals . Measures . The Work Limitation Question naire , the Medical Outcomes Question naire Short Form-12 , the Patient Health Question naire-9 , question 10 from the Patient Health Question naire to measure functional impairment , and the Perceived Stress Scale-4 and questions written by study psychiatrists to measure emotional distress and social support respectively . The WHO-Five Well-being Index was administered to measure overall well-being . Analysis . Independent sample t-tests and χ2 tests as well as mean change were used to compare the data . Results . No significant differences on 16 of the 20 comparisons at 3- and 6-month time points . The intervention group showed a significant improvement in depression ( p ≤ .05 ) at 3 months and on two Work Limitation Question naire subscales , the Mental-Interpersonal Scale ( p ≤ .05 ) and the Time and Scheduling Scale ( p ≤ .05 ) , at 3 and 6 months respectively with a suggestive improvement in mental health at 6 months ( p ≤ .10 ) . Conclusions . This is a potentially fruitful area for research with important implication s for workplace behavioral interventions . ( Am J Health Promot 2011;25[3]:207–216 . OBJECTIVES The purpose s of this analysis were to evaluate the construct validity of the EQ-5D and compare responses on the EQ-5D with the Physical Component Summary ( PCS-12 ) and Mental Component Summary ( MCS-12 ) scores of the SF-12 Health Survey . METHODS Data were collected via a survey instrument mailed to 4,200 r and omly selected subjects in the province of Alberta , Canada . The instrument contained the EQ-5D and SF-12 health surveys , with additional questions eliciting clinical and demographic information from the respondents . RESULTS 1,555 respondents returned mailed question naires ; 606 question naires were returned undeliverable . The SF-12 summary scores were calculated for 1,380 respondents . Analysis of the EQ-5D responses by demographic variables found significant differences among categories of age , gender , and self-reported chronic medical conditions . Corresponding dimensions and summary scores were more strongly related ( eg , mobility and PCS-12 ; F ratio = 598.3 , P < 0.001 ) than dissimilar dimensions ( eg , mobility and MCS-12 ; F ratio = 18.8 , P < 0.001 ) . The EQ-5D index scores were moderately correlated with SF-12 summary scores ( r = 0.41 for MCS-12 and r = 0.68 for PCS-12 ) . For subjects reporting no problems on the EQ-5D , PCS-12 and MCS-12 scores were significantly lower for people reporting medical problems or feelings of depression . CONCLUSIONS The results of this investigation generally supported the validity of the EQ-5D . However , an important ceiling effect was observed for the EQ-5D in this sample . The combination of the EQ-5D and SF-12 provides relatively broad coverage of important health domains and scores for various purpose The purpose of this study was to examine the psychometric properties of the  Quality of Life Index  ( QLI ) ( Ferrans & Powers , 1985a ) . The sample consisted of 349 patients selected r and omly from the adult , in-unit hemodialysis patient population of Illinois . Factor analysis was used to examine the underlying factor structure . A four-factors solution best fit the data , indicating that there were four dimensions underlying the QLI : health and functioning , socioeconomic , psychological/spiritual , and family . Factor analysis of the four primary factors revealed one higher order factor , representing quality of life . Construct validity also was supported by the contrasted groups approach . As predicted , it was found that those who had higher incomes had significantly higher quality of life scores on the social and economic subscale . Support for convergent validity was provided by a strong correlation ( r = .77 ) between scores from the QLI and an assessment of life satisfaction . Findings supported the internal consistency reliability of the entire QLI ( alpha = .93 ) and the four subscales ( alphas = .87 , .82 , .90 , .77 ) In the present study , the equivalence of paper and pencil assessment versus computer assessment of two self-administered question naires was investigated by means of a r and omized cross-over design . Therefore , 105 out- patients with diabetes were invited to participate ; 76 patients completed both the computer and the paper and pencil version of the Well-being Question naire ( WBQ ) and the Diabetes Treatment Satisfaction Question naire ( DTSQ ) in a r and omized order , with a mean interval of 7 days . The scales showed high test-retest correlations and the means , dispersions , kurtosis and skewness were found to be approximately the same in both versions . In both modes of assessment , the depression and the energy scale proved to be sensitive for carry-over effects , result ing in better well-being scores at the second measurement . Almost all subjects reported that using the personal computer in the realization of a question naire was easy . It is concluded that the paper and pencil and the computerized versions of the WBQ and DTSQ can be considered equivalent . Therefore , the norms and cut-off scores obtained from paper and pencil assessment s can be used in computerized versions of the WBQ and DTSQ and vice versa
The review demonstrated that the WHO-5 has high clinimetric validity , can be used as an outcome measure balancing the wanted and unwanted effects of treatments , is a sensitive and specific screening tool for depression and its applicability across study fields is very high .
Conclusions : The WHO-5 is a short question naire consisting of 5 simple and non-invasive questions , which tap into the subjective well-being of the respondents .
The scale has adequate validity both as a screening tool for depression and as an outcome measure in clinical trials and has been applied successfully across a wide range of study fields
Background : The 5-item World Health Organization Well-Being Index ( WHO-5 ) is among the most widely used question naires assessing subjective psychological well-being .
Since its first publication in 1998 , the WHO-5 has been translated into more than 30 language s and has been used in research studies all over the world .
We now provide a systematic review of the literature on the WHO-5 .