Psychology RootsQuality of Life Index
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About Quality of Life Index
Scale Name
Quality of Life Index
Author Details
W.O. Spitzer
Translation Availability
English
Background/Description
The Quality of Life Index (QL Index), developed by W.O. Spitzer in 1980, is a brief tool designed to measure general well-being in terminally ill patients with cancer or other chronic diseases, evaluating treatment and palliative care effects, though its use has broadened. Published in Journal of Chronic Diseases (1980), it was derived from an opinion survey of patients, relatives, health professionals, and healthy individuals, identifying 14 themes, narrowed to five after pilot testing: activity level (including occupation), activities of daily living, feelings of healthiness, quality of social support, and psychological outlook. Administered by a healthcare professional or self-completed, it takes ~2 minutes, scoring each category 0–2 (increasing well-being), with a total range of 0–10. No differential weights are applied.
Spitzer also developed a complementary QL Uniscale (visual analogue scale from “lowest quality” to “highest quality”), correlating 0.70 with the QL Index in breast cancer patients. Validated with terminally ill samples (mean age ≈ 50–75 years, mixed gender, multi-country), it correlates with well-being measures. Used in palliative care, oncology, and chronic disease management, access requires permission from Journal of Chronic Diseases or the author.
Administration, Scoring and Interpretation
- Obtain the QL Index from Spitzer (1980) or Journal of Chronic Diseases, ensuring ethical permissions.
- Explain to participants (terminally ill patients 18+ with cancer/chronic diseases) or administrators (healthcare professionals) that the tool assesses well-being, emphasizing confidentiality and voluntary participation.
- Administer the 5-item scale via interview or self-report, scoring each category 0–2 based on the past period (typically recent), with an optional QL Uniscale.
- Estimated completion time is ~2 minutes.
- Ensure a supportive environment; provide palliative care resources (e.g., counseling) and adapt for accessibility (e.g., large print, assistance) if needed.
Reliability and Validity
The QL Index demonstrates solid psychometric properties (Spitzer, 1980). Internal consistency is moderate to high (Cronbach’s alpha ≈ 0.70–0.85, N not specified). Test-retest reliability is strong (r ≈ 0.75–0.80) over short intervals. Inter-rater reliability is supported by healthcare professional consistency (specific r not provided).
Convergent validity is supported by a 0.70 correlation with the QL Uniscale and moderate correlations with QoL scales (e.g., Karnofsky Scale, r ≈ 0.60–0.70). Discriminant validity is evidenced by its ability to differentiate well-being levels (e.g., 0 vs 10), with category scores reflecting distinct domains. Factor analysis supports the five-theme structure, reinforcing construct validity. The QL Index reliably assesses well-being. Pairing with the McGill Pain Questionnaire or FACT enhances comprehensive assessment.
Available Versions
05-Items
Reference
Spitzer, W. O., Dobson, A. J., Hall, J., Chesterman, E., Levi, J., Shepherd, R., … & Catchlove, B. R. (1981). Measuring the quality of life of cancer patients: a concise QL-index for use by physicians. Journal of chronic diseases, 34(12), 585-597.
Important Link
Scale File:
Frequently Asked Questions
What does the QL Index measure?
It measures general well-being in terminally ill patients with cancer or chronic diseases.
Who is the target population?
Terminally ill adults (18+) with cancer or chronic conditions in palliative care.
How long does it take to administer?
Approximately 2 minutes.
Can it inform interventions?
Yes, it assesses well-being to guide treatment and palliative care plans.
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